Epidemiologic patterns of pulmonary arterial hypertension differ by era and region and may shed light on the pathophysiology and treatment of the disease. New efforts to target one or more of the recently studied therapies could establish personalized medicine as standard care in pulmonary arterial hypertension.
Humans ; Hypertension, Pulmonary ; epidemiology ; physiopathology ; therapy ; Risk Factors

OBJECTIVETo study and analysis prevalence and incidence of target organ injury and the relative factors for isolated systolic hypertension (ISH) in Beijing.

METHODS1002 cases aged 80 to 99 years were investigated in 28 cadre retirement centers in Beijing. Blood pressure was taken for three times with mercurial sphygmomanometer in every person, the mean values were recorded and the relative material was gathered according to questionnaire after the health education. Physical examination form of outpatient department and inpatient case history in fixed hospital were analyzed.

RESULTSIn 1002 very old persons, there were 673 hypertensive patients (67.2%) and 455 ISH (45.4%). Among all hypertensive patients, the rate of ISH was 67.6% and double hypertension was 32.4%. Awareness rate was 87.90% and 97.71%, taking antihypertensive drug rate was 77.58% and 80.73%, control rate was 58.68% and 62.84% in ISH and in double hypertension group, respectively, which were no significant differences between the two groups. There was no significant difference in morbidities of cardiac heart disease, myocardial infarction and chronic renal insufficiency between the two groups. The incidences of heart failure, cerebrovascular disease, disability and dementia were 4.62% and 8.72%, 41.54% and 55.50%, 10.55% and 16.06%, 8.57% and 12.84% in ISH and double hypertension group, respectively, which were significant differences between the two groups (P < 0.01). The susceptible age period for ISH was 70 to 79 years in this study.

CONCLUSIONISH is more common in hypertensive patients in very old persons at 28 cadre retirement centers in Beijing. Morbidity of heart failure, cerebrovascular disease, disability and dementia were higher in double hypertension group compared with those in ISH group. The results showed that increase of both systolic and diastolic blood pressure was more dangerous than that of systolic pressure only for very old persons. The improvement of small arterial plastic and the control of blood pressure to target level (< 140/90 mm Hg) in very old hypertensive patients are very important for decreasing the incidence of target organ injury and increasing their life quality and late survival rate.

Aged, 80 and over ; Cardiovascular Diseases ; epidemiology ; Cerebrovascular Disorders ; epidemiology ; China ; epidemiology ; Diabetes Mellitus ; epidemiology ; Female ; Humans ; Hyperlipidemias ; epidemiology ; Hypertension ; epidemiology ; physiopathology ; Kidney Failure, Chronic ; epidemiology ; Male ; Prevalence ; Systole

Female sexual dysfunction (FSD) is an age-related progressive disease and may affect up to half of adult women, but it has failed to receive due attention for a long time. Hypertension is a common and frequently encountered disease, and female sexual dysfunction is closely related to hypertension and antihypertensive drugs. Hypertension-related atherosclerosis, endothelial disorder and antihypertensive drugs are important risk factors for female sexual function. This article reviews the mechanisms of hypertension-induced FSD and advances in their studies.
Female ; Humans ; Hypertension ; epidemiology ; physiopathology ; Prevalence ; Risk Factors ; Sexual Dysfunctions, Psychological ; epidemiology ; etiology

OBJECTIVETo analyze the associations of blood pressure (BP) level with carotid intima-media thickness (CIMT) and plaque in a middle-aged and elderly hypertensive population.

METHODSBy block randomized sampling, an epidemiological investigation was conducted among hypertensives aged 45 - 75 years in the northern rural area of Jiangsu Province. Blood pressure was measured, and carotid CIMT and plaque were determined using a coloured ultrasonograph. The relationship between blood pressure level and CIMT or plaque was analyzed using a multivariable linear regression or logistic regression model.

RESULTSA total of 524 subjects (male 242) were enrolled. CIMT and plaque prevalence were (0.7 ± 0.1) mm and 46.3% in males and (0.7 ± 0.1) mm and 34.0% in females. After adjustment for relevant variables, CIMT increased 0.001 12 mm with 1 mmHg systolic BP increase in males (P < 0.001) but this trend was not significant in females. The risk of plaque number > 1 was significantly higher in those with grade III hypertension compared to grade I hypertensives (OR: 2.136, 95%CI: 1.138 - 4.012, P = 0.018).

CONCLUSIONIn this middle-aged and elderly hypertensive population, carotid CIMT is positively in relation to systolic BP, especially for male patients. Higher BP is associated with higher risk of plaque occurrence. Hypertension is thus an independent risk factor for the formation of atherosclerosis.

Aged ; Blood Pressure ; physiology ; Carotid Intima-Media Thickness ; Female ; Humans ; Hypertension ; epidemiology ; physiopathology ; Male ; Middle Aged ; Plaque, Atherosclerotic ; epidemiology ; physiopathology

OBJECTIVETo assess the clinical significance of ankle-brachial index(ABI) in aged Chinese hypertensive men and to determine the association of ABI with clinical coronary heart disease, stroke.

METHODSAnkle-brachial index (ABI) was measured by means of peripheral vascular lab in aged hypertensive men from 301 Hospital and Anzhen Hospital while the clinical characteristics of the study population were investigated and collected. ABI < or = 0.9 was defined as peripheral arterial disease (PAD), 1.01 - 1.30 as borderline PAD.

RESULTSThere were 244 aged Chinese hypertensive men with antihypertensive treatment and with mean age 76.47 +/- 9.75 enrolled in this study, in whom 15 men with missing data except general information and ABI measurement. The mean ABI was 0.941 +/- 0.258 with the highest frequency 1.01 - 1.30. Eighty five men were diagnosed as PAD, 22 as borderline PAD, 135 normal ABI and 2 with ABI > 1.3. ABI and rate of hypertension control in PAD and borderline PAD men were significantly lower than those with normal ABI. In both PAD and borderline PAD patients, the hypertension duration (except in borderline PAD), creatinine level, neutrophil count (except in borderline PAD), percentage of alcohol drinking, prevalence of diabetes mellitus (except in borderline PAD), coronary artery disease, stroke and dyslipidemia (except in borderline PAD) were significantly higher than those with normal ABI patients. The prevalences of PAD, borderline PAD, coronary artery disease and stroke in this study population were 35.1%, 9.1%, 64.0%, 40.5%, respectively. The prevalences of PAD, borderline PAD, coronary artery disease and stroke increased significantly with increasing age. Logistic regression analysis showed that lower ABI was inversely associated with clinical coronary artery disease and stroke after adjustment for age, body mass index, hypertension duration, rate of hypertension control, systolic blood pressure, diastolic blood pressure, status of smoking, alcohol drinking, diabetes mellitus, dyslipidemia. The fully-adjusted odds ratios (ORs) for PAD and borderline PAD group compared with normal ABI group for the prevalence of coronary artery disease, and stroke demonstrated that these conditions were conversely related to ABI.

CONCLUSIONAged hypertensive men have high prevalence of PAD. Low ABI level was independently associated with coronary artery disease and stroke.

Aged ; Aged, 80 and over ; Ankle Brachial Index ; China ; epidemiology ; Coronary Disease ; epidemiology ; etiology ; physiopathology ; Humans ; Hypertension ; complications ; physiopathology ; Male ; Middle Aged ; Prevalence ; Stroke ; epidemiology ; etiology ; physiopathology

BACKGROUNDThe incidence of diabetic nephropathy (DN) increases year by year. However, clinical characteristics of DN patients on maintenance hemodialysis (MHD) were rarely reported in China. The purpose of this study was to examine the clinical characteristics of the DN patients on MHD in Anhui Province, Eastern China.

METHODSThe clinical data of MHD patients in the hemodialysis centers of 26 hospitals in Anhui Province from January 1, 2014, to March 31, 2014, were examined. The differences between DN patients and non-DN patients were compared regarding vascular access, nutritional status, mineral and bone disorder, and other indexes.

RESULTSAmong the selected 2768 adult MHD patients, 427 had DN. The incidence of hypertension, coronary heart disease, and cerebral thrombus in DN patients was 94.1%, 21.5%, and 15.0%, respectively, which were higher than those in non-DN patients (P < 0.001). Category of vascular access for hemodialysis in DN patients was arteriovenous fistula (AVF) (87.4% [373/427]) and tunneled cuffed catheter (TCC) (11.2% [48/427]). The percentage of AVF was significantly lower than that of non-DN patients (P < 0.001), and percentage of TCC was significantly higher than that of non-DN patients (P < 0.001). Hemoglobin achievement rate in DN patients was 32.0%. The incidence of hypoalbuminemia was 24.7%, significantly higher than that in non-DN patients (P < 0.001). The achievement rate of the target range in mineral values was 55.9% in corrected serum calcium level, 30.1% in serum phosphorus level, and 49.3% in intact parathyroid hormone (iPTH) level in DN patients. Compared with non-DN patients, the achievement rate of serum phosphorus was significantly higher in DN patients.

CONCLUSIONSDN patients on MHD in Anhui province exhibited different clinical characteristics compared to non-DN hemodialysis patients. They presented higher percentage in TCC use and cardiovascular complication, lower serum albumin and iPTH levels than those in non-DN patients.

Aged ; Calcium ; blood ; China ; Coronary Disease ; blood ; epidemiology ; physiopathology ; Cross-Sectional Studies ; Diabetic Nephropathies ; blood ; epidemiology ; physiopathology ; Female ; Humans ; Hypertension ; blood ; epidemiology ; physiopathology ; Intracranial Thrombosis ; blood ; epidemiology ; physiopathology ; Male ; Middle Aged ; Parathyroid Hormone ; blood ; Phosphorus ; blood ; Renal Dialysis

OBJECTIVETo assess and compare the predictive effects of hypertension before puberty and during puberty on adult hypertension.

METHODSA total of 412 adults from the "Beijing children and adolescents blood pressure (BP) study" cohort were followed up in a clinical examination in 2005. Systolic and diastolic BP, height, and weight in childhood were measured at a baseline survey in 1987. The participants were divided into pre-puberty and puberty sub-cohorts according to their pubertal development stage at baseline. Information on adult BP, anthropometric indices and life style were collected through questionnaire and physical examination. BP changes and the predictive effect on adult hypertension were compared between the two sub-cohorts. Correlation of BP levels between 1987 and 2005 was examined through linear regression models.

RESULTSFrom childhood to adulthood, the regression coefficients of systolic BP were similar in the two sub-cohorts (both β=0.34, P<0.001), while the coefficient of diastolic BP was larger in the pubertal cohort (β=0.31, P<0.001) compared with the pre-pubertal cohort (β=0.12, P=0.017). Fifty percent of children with pubertal hypertension became hypertensive adults, while pre-pubertal hypertension resulted in 34.3%. After adjustment for sex, age, family history of hypertension, obesity in childhood, and adulthood, pubertal hypertension predicted a higher risk of adult hypertension than pre-pubertal hypertension, with odds ratios (95% confidence intervals) of 10.00 (3.03-33.07) and 2.71 (0.83-8.85), respectively.

CONCLUSIONOur results suggest that hypertension during puberty is likely to result in adult hypertension.

Adolescent ; Adult ; Age Factors ; Blood Pressure ; Body Mass Index ; Child ; China ; epidemiology ; Cohort Studies ; Female ; Humans ; Hypertension ; epidemiology ; physiopathology ; Male ; Overweight ; epidemiology ; physiopathology ; Puberty ; physiology ; Risk Factors

This article is to overview the literature of syndrome differentiation of traditional Chinese medicine on hypertension. According to the theory of disease in combination with syndrome, we concluded syndrome types of hypertension in four aspects, including national standards, industry standards, teaching standards and personal experience. Meanwhile, in order to provide new methods and approaches for normalized research, we integrated modern testing methods and statistical methods to analyze syndrome differentiation for the treatment of hypertension.
Humans ; Hypertension ; classification ; diagnosis ; epidemiology ; physiopathology ; therapy ; Medicine, Chinese Traditional ; methods ; standards ; Reference Standards

OBJECTIVETo explore the perpetual impact of pregnancy-induced hypertension on blood pressure.

METHODSThis retrospective cohort study included 782 cases of pregnant women who hospitalized at Kailuan Linxi hospital between October 1976 and August 2001. Patients were divided to with pregnancy induced hypertension (PIH, n = 77) group and non pregnancy induced hypertension (NPIH, n = 705) group. Patients were followed for 5 to 34 years (mean 18.8 +/- 5.3 years), the incidence of essential hypertension was obtained in July 2006-September 2007.

RESULTS(1) The cumulative incidence of essential hypertension during follow up was significantly high in PIH group (29.87%) than that in NPIH group 18.87% (P = 0.022). (2) At the final follow up, waist circumference; [(86.06 +/- 10.15) cm vs. (83.07 +/- 8.19) cm, P = 0.015], BMI [(24.83 +/- 4.01) kg/m(2) vs. (23.50 +/- 3.39) kg/m(2), P = 0.006], TC [(5.11 +/- 0.88) mmol/L vs. (4.89 +/- 0.94) mmol/L, P = 0.045] and GLU [(5.57 +/- 1.78) mmol/L vs. (5.20 +/- 1.38) mmol/L, P = 0.010] were all significantly higher in PIH group than those in NPIH group. (3) After adjustment of age and BMI, PIH was still significantly correlated with long-term systolic blood pressure levels (P = 0.048), fasting glucose level was also significantly associated with long-term systolic blood pressure. Age, BMI, white blood cell count and uric acid were also predictors for perpetual systolic and diastolic blood pressure levels.

CONCLUSIONSIncidence of essential hypertension in women with PIH was higher than that in women without PIH. After adjustment of covariates including age, BMI, and glucose, PIH was significantly associated with the level of systolic blood pressure. BMI, fasting glucose and cholesterol levels might contribute to the increase of systolic blood pressure in patients with PIH.

Adult ; Blood Pressure ; China ; epidemiology ; Cohort Studies ; Female ; Humans ; Hypertension, Pregnancy-Induced ; epidemiology ; physiopathology ; Incidence ; Pregnancy ; Retrospective Studies ; Young Adult

BACKGROUNDLeft ventricular hypertrophy (LVH) and geometric abnormality are associated with morbidity and mortality of cardiovascular disease and stroke. Hypertension is the major cause of LVH. Yet the prevalence and other risk factors of LVH and geometric abnormality in Chinese hypertensive population are unknown. The objective of this study was to investigate the prevalence and risk factors of LVH and geometric abnormality in community-based Chinese hypertensive population.

METHODSThe study was a community-based cross-sectional study, and comprised 4270 hypertension patients with integrated clinical and echocardiographic data. Left ventricular mass was measured by transthoracic echocardiography. LVH was diagnosed by using the criteria of over 49.2 g/m(2.7) for men and 46.7 g/m(2.7) for women. LV geometric patterns (normal, concentric remodeling, concentric or eccentric hypertrophy) were calculated according to LVH and relative wall thickness. Logistic regression model was used to determine the odds ratio (OR) and 95% confidence intervals (CI) of the risk factors of LVH.

RESULTSThe prevalence of LVH was 42.7% in 4270 hypertensive patients, with 37.4% in males and 45.4% in females, respectively. The prevalence of concentric remodeling, concentric or eccentric hypertrophy was 24.7%, 20.2%, and 22.6%, respectively. In Logistic regression model, female (OR 1.3, 95%CI 1.1 - 1.5, P < 0.01), age (OR 1.02, 95%CI 1.01 - 1.03, P < 0.01), body mass index (OR 1.2, 95%CI 1.15 - 1.20, P < 0.01), systolic blood pressure (OR 1.02, 95%CI 1.01 - 1.03, P < 0.01), and serum triglyceride (OR 1.10, 95% CI 1.00 - 1.20, P < 0.01) were risk factors of LVH. Female, age, body mass index, systolic blood pressure and serum triglyceride were also risk factors of left ventricular geometric abnormality.

CONCLUSIONSThe echocardiographic LVH is the major complication of patients with hypertension in rural area of China, especially for women. To effectively treat hypertension, weight loss and control of serum triglyceride may help to prevent LVH in hypertensive population.

Adult ; Aged ; Cross-Sectional Studies ; Echocardiography ; Female ; Heart Ventricles ; anatomy & histology ; pathology ; physiopathology ; Humans ; Hypertension ; epidemiology ; physiopathology ; Hypertrophy, Left Ventricular ; epidemiology ; Male ; Middle Aged ; Prevalence ; Risk Factors