Objective To investigate the correlation of short-term systolic blood pressure variability (SBPV) with esti?mated glomeruar filtration rate (eGFR) in the elderly. Methods In physical examination for the third time of kailuan group, the method of cluster sampling was used to collect randomly retired employees, age≥60 in kailuan group. The 24-hour am?bulatory blood pressure monitoring was given to these objects. Finally, 1 405 participants with integral data were recruited in?to the survey. SBPV indices were standard deviation of systolic blood pressure (SD), variability independent of the mean (VIM), maximum-minimum difference (MMD), and average real variability (ARV). Multivariate stepwise linear regression models were used to analyze the influence of short-term SBPV on eGFR. Results (1) Among 1 405 participants (67.16 ± 5.82) years, 933 individuals (66.4%) were male and 472 (33.6%) were female. (2) Study population were divided into four groups based on the 24-hour mean SBP, daytime mean SBP, night time mean SBP (group 1:mean SBP<120 mmHg, group 2:120≤mean SBP<140 mmHg, group 3:140≤mean SBP<160 mmHg, group 4:mean SBP≥160 mmHg), respectively. Values of SD, MMD and ARV, but not VIM were increased with increased mean SBP. (3) The participants were grouped according to the median SBPV with between-group comparison of the eGFR. The average eGFR levels were lower in the high 24-hour SB?PV group (SD, VIM, MMD and ARV), day-time SBPV group (SD, VIM, MMD and ARV) and night-time SBPV group (SD, MMD and ARV) than those in the low SBPV groups (P<0.05). (4) Multivariate stepwise linear regression showed that eGFR increased with 3 indices of 24-hour SBPV (SD, MMD and ARV) and 2 indices of day-time SBPV (MMD and ARV) but not for night-time SBPV (β=-0.07,-0.11,-0.07,-0.12 and-0.07, respectively). Conclusion There is a certain degree of asso?ciation between short-term SBPV indices and eGFR.

Objective:To explore whether hyperuricemia was an independent risk factor for all-cause mortality in patients with atrial fibrillation.Methods:Patients with atrial fibrillation who were confirmed by 12-lead electrocardiogram in 11 hospitals of Kailuan Group from 2006 to 2007 were selected as the research objects.All patients were followed up by prospective cohort study, and all-cause deaths were observed.The last follow-up time was December 31, 2013.Kaplan-Meier curve and Cox proportional hazards model were used to analyze and compare the risk of all-cause mortality in patients with atrial fibrillation in the hyperuricemia group compared with the normal uric acid group.Results:A total of 388 community-based patients with atrial fibrillation were included in the final statistical analysis, with 136 all-cause deaths occurred during an average follow-up period of 6.93 years.The incidence of all-cause mortality was 9.24% per year(36/390)in the hyperuricemia group, whereas 5.16% per year(100/1 937) in the normal uric acid group.In the univariate Cox proportional risk model analysis, the risk ratio (95% CI) of all-cause death in patients with atrial fibrillation in the hyperuricemia group (95% CI) was 1.84(1.26-2.69) times that in the normal uric acid group ( P<0.01). After adjusting for potential confounding variables, the adjusted risk ratio (95% CI) of all-cause death in patients with atrial fibrillation in hyperuricemia group was still 1.94(1.32-2.85) times of that in normal uric acid group ( P<0.01). After adjustment for potential confounding variables, for each 0.01 g/L increase in uric acid (1 g/L=5 950 μmol/L), the risk of all-cause death in patients with atrial fibrillation increased by 1.15 (1.05-1.26) times ( P<0.01). Conclusion:Hyperuricemia was an independent risk factor for all-cause death in patients with atrial fibrillation in community.

Objective: To investigate the relationship between long-, short-term systolic blood pressure variability (SBPV) and renal damage in elder population. Methods: Our research was conducted in the 3rd physical examination of healthy population from Kailuan group by cohort study. Cluster sampling was used by 25% ratio in subjects≥60 years of age to monitor their 24-hour ambulatory blood pressure and finally, 2464/3064 participants with inclusion criteria were recruited. SBPV indexes as standard deviation of systolic blood pressure (SSD), variability independent of the mean (VIM), maximum-minimum difference (MMD) and average real variability (ARV) were examined; renal damage indexes as estimated glomerular filtration rate (eGFR) and microalbuminuria (ALBU) were detected. Relationships between different long-term, short-term SBPV indexes and eGFR, ALBU were studied by multi-liner regression analysis. Results:①The mean age of 2464 participants was (67.41 ± 6.05) years including 1667 (67.7%) male and 797 (32.3%) female.②Multi-liner regression analysis indicated that different long-term SBPV indexes were not related to eGFR and ALBU; 24h SBPV in all 4 indexes and day-time SSD, MMD, ARV were negatively related to eGFR; 24h ARV and day-time MMD, ARV were positively related to ALBU; night-time SBPV indexes were not related to eGFR and ALBU.Conclusion: Different short-term SBPV indexes were, at certain point related to eGFR and ALBU

Objective To investigate the relationship between waist circumference and new-onset non-alcoholic fatty liver disease in non-obese patients with diabetes mellitus. Methods A total of 1 950 patients with diabetes mellitus, who determined fasting plasma glucose(FPG)≥7.0 mmol/L or who were using hypoglycemic drugs and FPG<7.0 mmol/L,and body mass index (BMI)< 25 kg/m2, was selected in this study using prospective cohort method. Patients were divided into five groups according to the baseline data of waist circumference, including waist circumference<78 cm (A group, n=387), 78 cm90 cm (E group, n=421). Multiple Logistic regression model was used to analyze influential factors of new-onset non-alcoholic fatty liver disease in non-obese patients with diabetes mellitus. Re?sults The average duration of follow-up was(47.24±5.13) months. The incidence rate was 11.85%(231/1 950) in patients with non-alcoholic fatty liver disease. The incidence rates were 6.98%, 9.28%, 12.38%, 14.19%and 15.68%in A, B, C, D and E groups, and which were increased with the increased waist circumference (P<0.05). Results of multiple Logistic re?gression model analysis showed that compared with A group,OR values were 1.97 and 2.19 in D and E groups respectively (P<0.05). Conclusion Waist circumference≥85 cm was the risk factors of new-onset non-alcoholic fatty liver disease in non-obese patients with diabetes mellitus.

Objective To investigate the incidence of miocardial infarction and risk factors in patients with different levels TG.Methods From June 2006 to October 2007,Kailuan coal mine group conducted an on-the-job and retired workers were took physical examination in Kailuan area,and their results were used in our study(n=100 271).According to different levels of TG,all cases were divided into five groups(TG1-5):TG1 group(0.0125 kg/m2,FBG≥6.1 mmol/L,HDL-C<1.5 mmol/L were all the risk factors for myocardial infarction (P<0.05).Cox proportional hazards regression model showed that after adjustment for sex,age and other factors,with the increase in TG levels.Conclusion In study of Kailuan crowd,the increased fasting triglycerides increase the risk of myocardial infarction,and the risk factors for myocardial infarction are age,BMI,FBG and HDL-C.

Objective To investigate the relationship between high-sensitivity C-reactive protein (hsCRP) and retinal vascular diameter.Methods This study was a cross-sectional study,the population was from the Kailuan study (clinical trial research registration NO.:ChiCTR-TNC-1100 1489) in 2012-2013 (age ≥ 40 years).All the people was checked by cardiovascular and epidemiological examination,of which 3 447 people had an analytical results of fundus color photography.The retinal vascular diameter was analyzed by software.Take the value of hsCRP 1％ to 99％ points and 3 363 people were finally included in the statistical analysis.The mean age of 3 363 people (male 1 880,female 1 483) was 56.69± 10.10 years old.The correlation between hsCRP and central retinal artery equivalent (CRAE),central retinal vein equivalent (CRVE),arteriovenous ratio (AVR) were evaluated by Spearman correlation coefficient.Multivariate linear regression analysis was used to futher analyze the association between hsCRP and retinal fundus diameter parameters.Results The median value of hsCRP was 1.10 (0.50,2.21) mmo/L,CRAE was (174.16±24.36) μm,CRVE was (282.70±26.32) μm,AVR was 0.62-±0.09.Spearman correlation analysis showed that hsCRP was positively correlated with CRVE (r =0.052,P =0.003) and negatively correlated with AVR (r =-0.052,P =0.002).The non-normal variables hsCRP were transformed into continuous variables lghsCRP,and CRAE,CRVE and AVR were used for multivariate linear regression analysis.After a number of factors were gradually corrected,the results showed that association between lghsCRP and CRVE (β =3.428) or AVR (β =-0.006) was statistically significant (P＜0.05).LghsCRP was a risk factor for CRVE both in men and women after the calculation of gender stratification.Conclusions CRVE increased and AVR decreased with the increase of hsCRP.The changes of retinal vascular diameter may be associated with hsCRP as a marker to predict cardiovascular and cerebrovascular disease.

OBJECTIVETo observe the effect of resting heart rate (RHR) on the progression to hypertension in patients with prehypertension.

METHODSPeople who participated the physical examination between 2006 and 2007 at Kailuan medical group and diagnosed as prehypentension were selected as the observation cohort. The second and the third physical examination were conducted between 2008 and 2009 and between 2010 and 2011. The observation population was divided into five groups according to the different levels of RHR at baseline: the first group ( ≤69 beats/min), the second group (70-74 beats/min), the third group (75-79 beats/min), the fourth group (80-84 beats/min) and the fifth group ( ≥85 beats/min). The rate of the progression to hypertension was compared among five groups, and the relationship between RHR and the progression to hypertension was estimated using Cox proportional hazard analysis.

RESULTSA total of 34 512 patients with prehypentension were recruited and 25 392 patients were involved in the final statistics after excluding patients who died or were lost to follow-up. A total of 13 228 (52.1%) patients with prehypentension developed hypertension during follow-up. The rate of the progression to hypertension increased with the RHR (first group: 51.2%, second group: 50.1%, third group: 52.9%, fourth group: 53.5%, fifth group: 57.5%). Multiple Cox regression models showed that the risk of the progression to hypertension increased with the RHR levels. Patients in the fifth group carried 1.25 times higher risk for developing hypertension than patients in the second group after adjustment for age, gender, systolic blood pressure, diastolic blood pressure, waist circumference, body mass index, triglyceride, total cholesterol, low density lipoprotein cholesterol, high density lipoprotein cholesterol, fasting blood glucose, serum uric acid, C-reactive protein, smoking, drinking, physical exercise and family history of hypertension at baseline.

CONCLUSIONElevated RHR is an independent risk factor for the progression to hypertension in patients with prehypertension.

Adult ; Blood Pressure ; Body Mass Index ; C-Reactive Protein ; Cholesterol ; Cholesterol, HDL ; Cholesterol, LDL ; Cohort Studies ; Disease Progression ; Female ; Heart Rate ; Humans ; Hypertension ; Male ; Middle Aged ; Prehypertension ; Proportional Hazards Models ; Risk Factors ; Triglycerides

OBJECTIVETo investigate the distribution and major influencing factors of annual systolic blood pressure variability from a large population cohort.

METHODSIn this prospective cohort study, data from Kailuan Group employees who attended all 4 physical examinations ( taken in June 2006 to October 2007, June 2008 to October 2009, June 2010 to October 2011, June 2012 to October 2013, respectively) were analyzed (32 959 males and 10 401 females, mean age: (48.2 ± 11.5) years old). Systolic blood pressure variability was defined as the standard deviation (SSD) and the coefficient of variation (SCV) of systolic blood pressure of 4 physical examinations. Multivariate linear regression analysis was used to determine the related influencing factors of SSD and SCV.

RESULTS(1) The mean of SSD and SCV for this cohort was 10.91 mmHg (1 mmHg = 0.133 kPa) and 8.34%, respectively. SSD and SCV increased in male and female with increasing age (both P < 0.001). (2) Multiple linear regression analysis showed that systolic blood pressure (β = 0.225, P < 0.001), age (β = 0.163, P < 0.001), fasting blood glucose (β = 0.038, P < 0.001), the use of anti-hypertensive drugs (β = 0.038, P < 0.001), sex (β = 0.038, P < 0.001), smoking (β = 0.025, P < 0.001), alcohol drinking (P = -0.022, P < 0.001), physical exercise (β = -0.018, P = 0.001), high-sensitivity c-reactive protein (β = 0.016, P = 0.001) body mass index (β = -0.011, P = 0.018) were related to SSD. Age (β = 0.139, P < 0.001), sex (β = 0.055, P < 0.001), systolic blood pressure (β = 0.047, P < 0.001), fasting blood glucose (P = 0.033, P < 0.001), drinking (β = -0.030, P < 0.001), body mass index (β = -0.026, P < 0.001), the use of anti- hypertensive drugs (β = 0.026, P < 0.001), smoking (β = 0.024, P < 0.001), physical exercise (β = -0.015, P = 0. 001), high-sensitivity c-reactive protein (β = 0. 014, P = 0. 001) were related to SCV.

CONCLUSIONSSSD and SCV increase with increasing age. Systolic blood pressure, age, fasting blood glucose, the use of anti-hypertensive drugs, sex, smoking, drinking, physical exercise, high-sensitivity c-reactive protein, body mass index are major influencing factors for SSD. Age, sex, systolic blood pressure, fasting blood glucose, alcohol drinking, body mass index, the use of anti-hypertensive drugs, smoking, physical exercise, high-sensitivity c-reactive protein are major influencing factors for SCV.

Alcohol Drinking ; Antihypertensive Agents ; Blood Pressure ; Body Mass Index ; C-Reactive Protein ; Cohort Studies ; Exercise ; Female ; Humans ; Male ; Middle Aged ; Prospective Studies ; Smoking

Objective: To investigate the impact of improved AHA cardiovascular health behavior score (CHS) on short-time systemic blood pressure variability (SBPV) in elder population.
Methods: A total of 2464 participants ≥ 60 years from 3 hospitals of Kailuan area were taken for cohort study. The participants had no cardiovascular disease, not taking anti-psychotic drug, Parkinson treatment drug, anti-depression drug and analgesic drug within 2 weeks. All participants received 24-hour ambulatory blood pressure monitoring (ABPM) and the 24-hour, day-time, night-time SBPV were deifned by the standard deviation of 24-hour, day-time, night-time systolic blood pressure. The influence of CHS on SBPV was studied by multi-linear regression analysis. Improved cardiovascular health behavior and factors implied as changing the vegetable intake amount to salt amount by American Humane Association, 2010; boundary of BMI based on《Guidelines for prevention of overweight and obesity in Chinese adults》; status of exercise was deifed as the ideal status: ≥80 min/week, general status: < 80 min/week and bad status: no exercise.
Results: Finally, 1812 participants were recruited for survey and they were divided into 3 groups according to improved CHS: Group①, CHS (0-4) points,n=56, Group②, CHS (5-9) pointsn=1600 and Group③, CHS (10-14) points,n=156. The 24-hour SBPV in Groups①,②and③were 16.02 mmHg, 14.91 mmHg and 13.18 mmHg; day-time SBPV were 15.42 mmHg, 14.50 mmHg and 13.22 mmHg; night-time SBPV were 12.68 mmHg, 11.44 mmHg and 10.16 mmHg, allP<0.05. Multi-linear regression analysis indicated that with adjusted confounding factors, with 1 point of CHS elevation, the 24 hour-, day-time, night-time SBPV would reduce for 0.20 mmHg, 0.19 mmHg and 0.37 mmHg respectively, allP<0.05.
Conclusion: CHS was negatively related to short-time SBPV in elder population.

Objective To explore the relationship between‘ideal’cardiovascular behaviors and factors and the incidence of hypertension. Methods A prospective cohort study including 52 133 workers who had participated in the 2006-2007 Kailuan health examination without history of cerebral infraction,myocardial infarction or hypertension but with complete data,was carried out. All workers were followed on their occurrence of hypertension. According to the AHA definition of‘ideal’ cardiovascular health behaviors and factors,the cumulative incidence rates of hypertension in different groups were calculated under the life table method,and compared by Log-rank test,Cox proportional hazards regression was used to calculate the hazard rations and 95% confidence intervals for baseline behaviors and factors. Results The cumulative incidence rates of hypertension according 0-1,2,3,4, 5-7 ideal cardiovascular health behaviors and factors were 65.72%,59.14%,54.59%,50.24% and 34.22%,respectively in the 0-1,2,3,4,5-7 groups. Data from the Cox proportional hazards model showed that after adjusting for age,education level and family history of hypertension,the ones who had 2,3,4,5-7 ideal cardiovascular behaviors/factors were 0.75,0.69,0.63,0.36 times more than those who had 0-1 ideal behaviors. Conclusion The incidence of hypertension and risk reduced along with the increase of ideal cardiovascular health behaviors and factors.