Hypotension is a leading cause of age-related cognitive impairment. The available literature evidences that vascular factors are associated with dementia and that hypotension alters cerebral perfusion flow and can aggravate the neurodegeneration of Alzheimer's disease (AD). Despite the discovery of biomarkers and the recent progress made in neurovascular biology, epidemiology, and brain imaging, some key issues remain largely unresolved: the potential mechanisms underlying the neural deterioration observed in AD, the effect of cerebrovascular alterations on cognitive deficits, and the positive effects of hypotension treatment on cognition. Therefore, further well-designed studies are needed to unravel the potential association between hypotension and cognitive dysfunction and reveal the potential benefits of hypotension treatment for AD patients. Here, we review the current epidemiological, pathobiological, and treatment-related literature on neurovascular changes and hypotension-related cognitive dysfunction and highlight the unsettled but imminent issues that warrant future research endeavors.
Humans ; Hypotension/complications* ; Cognitive Dysfunction/etiology* ; Alzheimer Disease/epidemiology* ; Cerebrovascular Circulation/physiology* ; Cognition Disorders/etiology*

BACKGROUND: Spicy food consumption has been reported to be inversely associated with mortality from multiple diseases. However, the effect of spicy food intake on the incidence of vascular diseases in the Chinese population remains unclear. This study was conducted to explore this association. METHODS: This study was performed using the large-scale China Kadoorie Biobank (CKB) prospective cohort of 486,335 participants. The primary outcomes were vascular disease, ischemic heart disease (IHD), major coronary events (MCEs), cerebrovascular disease, stroke, and non-stroke cerebrovascular disease. A Cox proportional hazards regression model was used to assess the association between spicy food consumption and incident vascular diseases. Subgroup analysis was also performed to evaluate the heterogeneity of the association between spicy food consumption and the risk of vascular disease stratified by several basic characteristics. In addition, the joint effects of spicy food consumption and the healthy lifestyle score on the risk of vascular disease were also evaluated, and sensitivity analyses were performed to assess the reliability of the association results. RESULTS: During a median follow-up time of 12.1 years, a total of 136,125 patients with vascular disease, 46,689 patients with IHD, 10,097 patients with MCEs, 80,114 patients with cerebrovascular disease, 56,726 patients with stroke, and 40,098 patients with non-stroke cerebrovascular disease were identified. Participants who consumed spicy food 1-2 days/week (hazard ratio [HR] = 0.95, 95% confidence interval [95% CI] = [0.93, 0.97], P <0.001), 3-5 days/week (HR = 0.96, 95% CI = [0.94, 0.99], P = 0.003), and 6-7 days/week (HR = 0.97, 95% CI = [0.95, 0.99], P = 0.002) had a significantly lower risk of vascular disease than those who consumed spicy food less than once a week ( Ptrend <0.001), especially in those who were younger and living in rural areas. Notably, the disease-based subgroup analysis indicated that the inverse associations remained in IHD ( Ptrend = 0.011) and MCEs ( Ptrend = 0.002) risk. Intriguingly, there was an interaction effect between spicy food consumption and the healthy lifestyle score on the risk of IHD ( Pinteraction = 0.037). CONCLUSIONS Our findings support an inverse association between spicy food consumption and vascular disease in the Chinese population, which may provide additional dietary guidance for the prevention of vascular diseases.
Humans ; Male ; Female ; Prospective Studies ; Middle Aged ; Aged ; Vascular Diseases/etiology* ; Risk Factors ; China/epidemiology* ; Adult ; Proportional Hazards Models ; Cerebrovascular Disorders/epidemiology* ; East Asian People

The incidence of cardiovascular diseases (CVD) together with their associated risk factors increasingly impact public health. According to the data provided in the 2024 Annual Report on Cardiovascular Health and Diseases in China, the crude incidence of cardiovascular and cerebrovascular diseases among Chinese residents aged ≥18 years, including acute myocardial infarction (AMI), angina pectoris treated by percutaneous transluminal coronary angioplasty/stent implantation and/or coronary artery bypass grafting, stroke, and sudden cardiac death was 620.33 per 100,000 population, with 87.6 for AMI. Stroke had an incidence of 491.0 per 100,000 population. The prevalence of adult coronary heart disease (CHD, aged ≥18 years) was 758 per 100,000 population. The CVD mortality in 2021 remained the highest, exceeding that of cancer and other causes. The crude mortality rate of CVD in 2021 was 364.16 per 100,000 population in rural areas and 305.39 per 100,000 population in urban areas. The crude mortality rates of cerebrovascular diseases and CHD among urban and rural residents in 2021 were 140.02 and 175.58, 135.08 and 148.19 per 100,000 population, respectively. In addition to interpreting the key findings of CVD incidence and mortality in China, we also update the data of associated risk factors, including tobacco use, physical activity, diet and nutrition, overweight and obesity, hypertension, dyslipidemia, diabetes, chronic kidney disease, sleep and psychological factors, environmental factors, and the diagnostic conditions of CVD diseases, aiming to provide a scientific foundation for advancing CVD prevention and control, and to inform relevant public health policy development.
Humans ; China/epidemiology* ; Cardiovascular Diseases/mortality* ; Risk Factors ; Adult ; Male ; Female ; Middle Aged ; Incidence ; Cerebrovascular Disorders/epidemiology* ; Aged

Being the leading cause of death among both urban and rural residents in Hunan Province, China, cardiovascular and cerebrovascular diseases hold a significant position in the region's public health landscape. Their prevalence and impact not only underscore the urgency of effective disease prevention and control but also provide crucial guidance for future initiatives. Consequently, the Hunan Province Cardiovascular and Cerebrovascular Health and Disease Report Summary (2020) hereinafter referred to as the "Annual Report", serves as an extensive and informative document. It meticulously examines the current status of these diseases, highlighting both the existing challenges and opportunities for prevention and control efforts in Hunan Province. The primary objective of this report is to furnish valuable insights and evidence that will empower and enrich future endeavors aimed at combatting cardiovascular and cerebrovascular diseases within the region. In 2017, the year of life expectancy lost due to cardiovascular and cerebrovascular diseases in Hunan Province remained higher than the national average. Additionally, the per capita life expectancy in 2019 (77.1 years) was slightly lower by 0.2 years compared with the national average (77.3 years). Alarmingly, the mortality rates associated with cardiovascular and cerebrovascular diseases were consistently ranking highest, indicating an upward trajectory. Moreover, the prevalence and mortality rates of conditions such as hypertension, coronary heart disease, and stroke, all encompassed within the domain of cardiovascular and cerebrovascular diseases, surpassed the national averages. Consequently, the economic burden attributable to cardiovascular and cerebrovascular diseases is on the rise. And under vertical comparison, in 2019, the life expectancy per capita in Hunan Province increased by 1.26 years compared with 2015. The incidence rate of cardiovascular and cerebrovascular events decreased by 8.34% compared with 2017. A new model of hypertension medical and preventive integration has been established with the efforts of many experts in Hunan Province, and full coverage of standardised outpatient clinics for hypertension at the grassroots level has been realised. The rate of standardised management of patients with hypertension under management in Changsha County, a demonstration area, rose to 65.27%, and the incidence rate of cardiovascular and cerebrovascular events, the incidence rate of stroke, and the mortality rate due to cardiovascular and cerebrovascular events were reduced by 28.08%, 28.62%, and 25.00%, respectively. Hunan Province has made significant strides in the prevention and control of cardiovascular and cerebrovascular diseases in recent years.
Humans ; Cerebrovascular Disorders/epidemiology* ; Life Expectancy ; Incidence ; Stroke/epidemiology* ; China/epidemiology* ; Hypertension

Objective To explore the effect of air temperature on the hospitalization of rural residents with cardiovascular diseases and its lag effect in Dingxi city. Methods The meteorological data and air pollution data of Dingxi city from 2018 to 2019,as well as the daily hospitalization data of rural residents due to cardiovascular diseases,were collected.The distributed lag non-linear models were employed to analyze the relationship between daily mean air temperature and the number of inpatients with cardiovascular diseases.Meanwhile,stratified analysis was carried out according to gender,age,and disease. Results There was a non-linear relationship between air temperature and the number of hospitalized rural residents with cardiovascular diseases in Dingxi city.The exposure-response curve approximated a bell shape.The curves for different cardiovascular diseases appeared similar shapes,with different temperature thresholds.Low temperature(-7 ℃) and moderately low temperature(0 ℃) exhibited a cumulative lag effect on the number of patients hospitalized with cardiovascular diseases.With a cumulative lag of 7 days at -7 ℃ and 14 days at 0 ℃,the RR values peaked,which were 1.121(95% CI=1.002-1.255) and 1.198(95% CI=1.123-1.278),respectively.With a cumulative lag of 14 days at 0 ℃,the RR values were 1.034(95% CI=1.003-1.077) and 1.039(95% CI=1.004-1.066) for the number of hospitalized patients with ischemic heart disease and heart rhythm disorders,respectively.The cumulative lag effects of moderately high temperature(17 ℃) and high temperature(21 ℃) on ischemic heart disease,heart rhythm disorders,and cerebrovascular disease all peaked on that day.Specifically,the RR values at 17 ℃ and 21 ℃ were 1.148(95% CI=1.092-1.206) and 1.176(95% CI=1.096-1.261) for ischemic heart disease,1.071(95% CI=1.001-1.147) and 1.112(95% CI=1.011-1.223) for heart rhythm disorders,and 1.084(95% CI=1.025-1.145) and 1.094(95% CI=1.013-1.182) for cerebrovascular disease,respectively.There was no cumulative lag effect of air temperature on the number of hospitalized patients with heart failure.In addition,stratified analysis showed that low temperature(-7 ℃) and moderately low temperature(0 ℃) affected the number of hospitalized female patients with cardiovascular diseases,and only moderately low temperature(0 ℃) affected males.The cumulative lag effect of high temperature on females was higher than that on males.Air temperature exhibited a stronger impact on female patients than on male patients. Additionally,the population aged<65 years old was more sensitive to low temperature and high temperature than that aged ≥65 years old. Conclusions Air temperature changes increase the hospitalization risk of rural residents with cardiovascular diseases in Dingxi city,which presents a lag effect.The effects of air temperature on patients hospitalized due to cardiovascular diseases varied among different etiologies,genders,and ages.It is necessary to emphasize on the impact of temperature changes on health in residents,especially for key populations such as females,people aged<65 years old,and those with ischemic heart disease.
Aged ; Air Pollutants/analysis* ; Cardiovascular Diseases/epidemiology* ; Cerebrovascular Disorders ; China/epidemiology* ; Female ; Hospitalization ; Hospitals ; Humans ; Male ; Myocardial Ischemia/epidemiology* ; Temperature

Objective: Predictive models were used to evaluate the impact of common risk factors on the number of cardio-cerebrovascular deaths and the probability of premature death. Methods: Using the data for China estimated by the Global Burden of Disease study 2015 (GBD 2015), we calculated the population attribution fraction (PAF) of risk factors. The proportional change model was used to estimate the number of unattributable deaths by 2030, and to predict the number of deaths, mortality, standardized mortality and probability of premature death by 2030. Results: According to the natural change trend of risk factors from 1990 to 2015, the number of deaths and mortality would reach 6.12 million and 428.53/100 000 by 2030, with an increase of 59.92% and 52.87%. By 2030, the probability of premature death from cardio-cerebrovascular diseases among Chinese aged 30-70 years old would continue to decline, from 11.43% to 11.28% for men, and from 5.79% to 4.43% for women. If the goals of all included risk factors were reached by 2030, 2 289 200 cardio-cerebrovascular deaths would be avoided. If only the exposure to a single risk factor was achieved by 2030, blood pressure, total cholesterol, and fine particulate matter exposure were the three most important factors affecting cardio-cerebrovascular deaths, which would reduce 1 332 800, 609 100 and 306 800 deaths, respectively. Among the involved risk factors, the control of blood pressure would mostly decrease the number of deaths due to ischemic heart disease and hemorrhagic stroke, about 677 300 and 391 100 deaths, accordingly. Conclusion: The control of risk factors is of great significance in reducing deaths and probability of premature death due to cardio-cerebrovascular diseases. If the control targets of all risk factors could be achieved by 2030, the burden of cardio-cerebrovascular diseases would be reduced greatly.
Adult ; Aged ; Blood Pressure ; Cerebrovascular Disorders/epidemiology* ; China/epidemiology* ; Female ; Humans ; Male ; Middle Aged ; Mortality, Premature ; Risk Factors

Cardio-cerebrovascular disease (CCVD) is a major comorbidity of Coronavirus disease 2019 (COVID-19). However, the clinical characteristics and outcomes remain unclear. In this study, 102 cases of COVID-19 from January 22, 2020 to March 26, 2020 in Xixi Hospital of Hangzhou were included. Twenty cases had pre-existing CCVD. Results showed that compared with non-CCVD patients, those with CCVD are more likely to develop severe disease (15% versus 1%), and the proportion of pneumonia severity index grade IV was significantly higher (25% versus 3.6%). Computed tomography images demonstrated that the proportion of multiple lobe lesion involvement was significantly higher in the CCVD group than in the non-CCVD group (90% versus 63.4%). Compared with non-CCVD group, the levels of C-reactive protein, fibrinogen, D-dimer, and serum amyloid-A were higher, whereas the total protein and arterial partial PaO
COVID-19 ; Cerebrovascular Disorders/epidemiology* ; Comorbidity ; Humans ; SARS-CoV-2 ; Tomography, X-Ray Computed

The objective of this study was to evaluate the usefulness of the China-PAR equations in predicting the 10-year risk of cardiovascular disease (CVD) in the Inner Mongolians population. A population-based, prospective cohort of 2,589 Mongolians were followed up from 2003 to 2012. Participants were categorized into 4 subgroups according to their 10-year CVD risks calculated using the China-PAR equations: < 5%, 5%-9.9%, 10%-19.9%, and ⪖ 20%. The China-PAR equations discriminated well with good C statistics (range, 0.76-0.86). The adjusted hazard ratios for CVD showed an increasing trend among the 4 subgroups (P for trend < 0.01). However, the China-PAR equations underestimated the 10-year CVD risk in Mongolians, and the calibration was unsatisfactory (Hosmer-Lemeshow χ2 = 19.98, P < 0.01 for men, χ2 = 46.58, P < 0.001 for women). The performance of the China-PAR equations warrants further validation in other ethnic groups in China.
Asian Continental Ancestry Group ; Cardiovascular Diseases ; epidemiology ; Cerebrovascular Disorders ; epidemiology ; China ; epidemiology ; Cohort Studies ; Female ; Humans ; Incidence ; Male ; Middle Aged ; Mongolia ; ethnology ; Proportional Hazards Models ; Prospective Studies ; Risk Assessment ; Risk Factors

BACKGROUND: To date, there have been few reports on the nationwide population-based epidemiology of Dupuytren's disease (DD). We investigated the prevalence and incidence of DD in Korea using the large dataset provided by the Korean Health Insurance Review and Assessment Service. This study is the second nationwide epidemiological study of DD after the study in Taiwan. METHODS: Records of patients diagnosed with DD between 2007 and 2014 were extracted from the large dataset by diagnostic code searching (International Classification of Disease 10th revision code M72.0) and were included in the study. We calculated the prevalence and incidence of DD based on the total population of Korea provided by the Korean Statistical Information Service. Diseases associated with DD and the trends in surgery for DD were also analyzed. RESULTS: A total 16,630 patients were diagnosed with DD during the study period. The mean annual prevalence was 32.2 per 100,000 population (41.8 per 100,000 for men; 22.5 per 100,000 for women). The mean annual incidence was 1.09 per 100,000 population (1.80 per 100,000 for men; 0.38 per 100,000 for women). The common diseases associated with DD were hypertension (30.5%), diabetes mellitus (26.7%), hyperlipidemia (20.4%), ischemic heart disease (7.9%), and cerebrovascular disease (4.6%). The mean annual proportion of the patients who had surgery for DD was 5.24% of all DD patients. CONCLUSION: The prevalence and incidence of DD in Korea were 100–1,000 times lower than those in western countries; however, it was slightly larger than that in Taiwan.
Cerebrovascular Disorders ; Classification ; Comorbidity ; Dataset ; Diabetes Mellitus ; Dupuytren Contracture* ; Epidemiologic Studies ; Epidemiology* ; Humans ; Hyperlipidemias ; Hypertension ; Incidence ; Information Services ; Insurance, Health ; Korea* ; Male ; Myocardial Ischemia ; Prevalence ; Taiwan

Asia, which holds 60% of the world’s population, comprises some developing countries which are in economic transition. This paper reviews the epidemiology of stroke in South, East and South-East Asia. Data on the epidemiology of stroke in South, East, and South-East Asia were derived from the Global Burden of Disease study (mortality, disability-adjusted life-years [DALYs] lost because of stroke), World Health Organization (vascular risk factors in the community), and publications in PubMed (incidence, prevalence, subtypes, vascular risk factors among hospitalized stroke patients). Age- and sex-standardized mortality is the lowest in Japan, and highest in Mongolia. Community-based incidence data of only a few countries are available, with the lowest rates being observed in Malaysia, and the highest in Japan and Taiwan. The availability of prevalence data is higher than incidence data, but different study methods were used for case-finding, with different age bands. For DALYs, Japan has the lowest rates, and Mongolia the highest. For community, a high prevalence of hypertension is seen in Mongolia and Pakistan; diabetes mellitus in Papua New Guinea, Pakistan, and Mongolia; hypercholesterolemia in Japan, Singapore, and Brunei; inactivity in Malaysia; obesity in Brunei, Papua New Guinea, and Mongolia; tobacco smoking in Indonesia. Hypertension is the most frequent risk factor, followed by diabetes mellitus and smoking. Ischemic stroke occurs more frequently than hemorrhagic stroke, and subarachnoid hemorrhages are uncommon. There are variations in the stroke epidemiology between countries in South, East, and South-East Asia. Further research on stroke burden is required.
Asia* ; Brunei ; Cerebrovascular Disorders ; Developing Countries ; Diabetes Mellitus ; Epidemiology* ; Hypercholesterolemia ; Hypertension ; Incidence ; Indonesia ; Japan ; Malaysia ; Mongolia ; Mortality ; Obesity ; Pakistan ; Papua New Guinea ; Prevalence ; Risk Factors ; Singapore ; Smoke ; Smoking ; Stroke* ; Subarachnoid Hemorrhage ; Taiwan ; World Health Organization