Objective: To investigate the distribution of blood pressure and analyze the associated factors of blood pressure of the elderly with type 2 diabetes in Jiangsu Province. Methods: The elderly over 60 years old participants with type 2 diabetes in the communities of Huai'an City and Changshu City, Jiangsu Province were selected in this study. They were divided into two groups: taking antihypertensive drugs and not taking antihypertensive drugs. The demographic characteristics, such as age and sex, and relevant factors were collected by questionnaire. The systolic blood pressure (SBP) and diastolic blood pressure (DBP) were measured by physical examination. The percentile of SBP and DBP in each age group of men and women were described. The kernel density estimation curve was used to show the blood pressure distribution. The trend of blood pressure with age was fitted by locally weighted regression. The logistic regression model was used to analyze relevant factors of blood pressure. Results: A total of 12 949 participants were included in this study, including 7 775 patients in the antihypertensive drug group and 5 174 patients in the group without antihypertensive drugs. The SBP of participants was concentrated at 140-160 mmHg, and their DBP was concentrated at 75-85 mmHg. There were significant differences in the distribution of blood pressure among the subgroups of body mass index (BMI) and rural areas whether taking antihypertensive drugs and not. For participants aged under 80 years old, the SBP showed an increasing trend with age and the DBP showed a decreasing trend with age. Age, BMI ≥24 kg/m², fasting blood glucose ≥7.0 mmol/L, living in rural areas and no smoking were influencing factors of the elevated SBP; BMI ≥24 kg/m², male, living in rural areas, no smoking, drinking alcohol and not receiving drug hypoglycemic treatment were influencing factors of the elevated DBP. Conclusion: The SBP of older diabetic adults in Jiangsu Province is at a high level, and the distribution of blood pressure is significantly different between men and women in taking antihypertensive drugs group. The SBP presents a rising trend and the DBP is decreasing at the age of 60-80 years. The blood pressure level of this population are mainly affected by age, BMI, urban and rural areas, smoking.
Adult ; Aged ; Humans ; Male ; Female ; Middle Aged ; Aged, 80 and over ; Blood Pressure/physiology* ; Diabetes Mellitus, Type 2/epidemiology* ; Antihypertensive Agents/therapeutic use* ; Smoking ; Body Mass Index ; Hypertension/epidemiology*

BACKGROUND: The Hokkaido Study on Environment and Children's Health is an ongoing study consisting of two birth cohorts of different population sizes: the Sapporo cohort and the Hokkaido cohort. Our primary objectives are to (1) examine the effects that low-level environmental chemical exposures have on birth outcomes, including birth defects and growth retardation; (2) follow the development of allergies, infectious diseases, and neurobehavioral developmental disorders, as well as perform a longitudinal observation of child development; (3) identify high-risk groups based on genetic susceptibility to environmental chemicals; and (4) identify the additive effects of various chemicals, including tobacco. METHODS: The purpose of this report is to provide an update on the progress of the Hokkaido Study, summarize recent results, and suggest future directions. In particular, this report provides the latest details from questionnaire surveys, face-to-face examinations, and a collection of biological specimens from children and measurements of their chemical exposures. RESULTS: The latest findings indicate different risk factors of parental characteristics on birth outcomes and the mediating effect between socioeconomic status and children that are small for the gestational age. Maternal serum folate was not associated with birth defects. Prenatal chemical exposure and smoking were associated with birth size and growth, as well as cord blood biomarkers, such as adiponectin, leptin, thyroid, and reproductive hormones. We also found significant associations between the chemical levels and neuro development, asthma, and allergies. CONCLUSIONS Chemical exposure to children can occur both before and after birth. Longer follow-up for children is crucial in birth cohort studies to reinforce the Developmental Origins of Health and Disease hypothesis. In contrast, considering shifts in the exposure levels due to regulation is also essential, which may also change the association to health outcomes. This study found that individual susceptibility to adverse health effects depends on the genotype. Epigenome modification of DNA methylation was also discovered, indicating the necessity of examining molecular biology perspectives. International collaborations can add a new dimension to the current knowledge and provide novel discoveries in the future.
Biomarkers/blood* ; Child ; Child Health ; Child, Preschool ; Cohort Studies ; Environmental Exposure/adverse effects* ; Environmental Health ; Environmental Pollutants/adverse effects* ; Female ; Fetal Blood/chemistry* ; Follow-Up Studies ; Growth/drug effects* ; Humans ; Hypersensitivity/etiology* ; Infant ; Japan/epidemiology* ; Male ; Neurodevelopmental Disorders/etiology* ; Pregnancy ; Prenatal Exposure Delayed Effects/etiology* ; Prevalence ; Smoking/adverse effects*

To investigate the risk factors associated with acute renal failure (ARF) after thoracoabdominal aortic aneurysm (TAAA) surgery. A total of 156 patients underwent TAAA repair between January 2009 and December 2017. Renal failure was defined based on the Kidney Disease Improving Global Outcomes criteria. The patients were divided into ARF group and non-ARF group based on the presence/absence of postoperative ARF. The risk factors of ARF were analyzed by univariate analysis and multivariate logistic analysis. The subjects included 111 males and 45 females aged (40.4±10.9) years (range:19-65 years). The surgical reasons included aortic dissection (=130,83.3%),aneurysm (=22,14.1%),and pseudoaneurysm (=4,2.6%). The degrees of repair included Crawford extent I in 6 patients (3.8%),extent Ⅱ in 128 patients (82.1%),extent Ⅲ in 20 patients (12.8%),and extent Ⅳ in 2 patients(1.3%). There were 3 patients presented with aortic rupture and 6 patients received emergent operations. Nine patients (5.8%) died within 30 days after surgery,and 8 patients (5.1%) suffered from permanent paraplegia. Thirty-six patients (23.1%) had ARF after surgery,and 18 of them needed dialysis. Multivariate logistic analysis showed that smoking ( =2.637,95%=1.113-6.250,=0.028),packed red blood cell usage in operation (≥6 U) ( =5.508,95%=2.144-11.930,=0.000),reoperation for bleeding (=3.529,95%=1.298-9.590,=0.013) were independent risk factors for ARF after TAAA repair. Smoking,packed red blood cell usage in operation (≥6 U),reoperation for bleeding are the independent risk factors of ARF after TAAA surgery.
Acute Kidney Injury ; etiology ; Adult ; Aged ; Aortic Aneurysm, Thoracic ; surgery ; Blood Transfusion ; Blood Vessel Prosthesis Implantation ; adverse effects ; Female ; Humans ; Male ; Middle Aged ; Postoperative Complications ; Reoperation ; Retrospective Studies ; Risk Factors ; Smoking ; Treatment Outcome ; Young Adult

Epidemiologic studies have revealed diabetes mellitus is an important determining factor not only for the presence of peripheral arterial disease (PAD) but also for the severity of PAD. As PAD is closely related to mortality and morbidity in individuals with diabetes as well as the general population, the primary prevention for PAD is very important. Age, disease duration, the level of hyperglycemia, blood pressure, and smoking status are independent risk factors for development of PAD in diabetic patients, and management of those risk factors might be an effective tool for reducing PAD burden.
Blood Pressure ; Diabetes Mellitus ; Epidemiologic Studies ; Epidemiology ; Humans ; Hyperglycemia ; Mortality ; Peripheral Arterial Disease ; Primary Prevention ; Risk Factors ; Smoke ; Smoking

Peripheral artery disease (PAD) and diabetes increase the risk of significant morbidity and mortality and can affect quality of life. PAD is a progressive disease, and the presence of diabetes mellitus increases the risk of adverse outcomes among patients with PAD. Diabetes patients should undergo an initial screening for PAD that evaluates walking speed, leg fatigue, claudication, and pedal pulses. Healthcare providers should discuss with their patients controllable risk factors for PAD that can be modified. A comprehensive care plan for patients with PAD and diabetes mellitus is important and may include smoking cessation, structured exercise therapy, foot care, glycemic control and management of other cardiovascular risk factors (weight management, diet, and control of blood pressure and cholesterol). PAD with diabetes mellitus is a lifelong chronic medical condition, and prompt identification and treatment of PAD are crucial. Patient education is needed to prevent complications and to encourage a healthy and active lifestyle.
Blood Pressure ; Diabetes Mellitus ; Diet ; Education ; Exercise Therapy ; Fatigue ; Foot ; Health Education ; Health Personnel ; Humans ; Leg ; Life Style ; Mass Screening ; Mortality ; Patient Education as Topic ; Peripheral Arterial Disease ; Quality of Life ; Risk Factors ; Smoking Cessation ; Walking

Early intervention in patients with diabetes may slow the progression of kidney disease, and early recognition of renal impairment is critical to achieving optimal patient outcomes. Annual screening for the presence of albuminuria in diabetic patients is necessary to prevent diabetic neuropathy. Selection of the appropriate medication to control blood glucose and blood pressure is also important. In addition, however, patients should be willing to manage themselves to overcome diabetic kidney disease through lifestyle changes such as diet, smoking, and weight management, and restrictions on private therapies.
Albuminuria ; Blood Glucose ; Blood Pressure ; Diabetic Nephropathies ; Diabetic Neuropathies ; Diet ; Early Intervention (Education) ; Humans ; Kidney Diseases ; Life Style ; Mass Screening ; Self Care ; Smoke ; Smoking

BACKGROUND: Night shift work induces physiological and psychological stress by altering sleep and biological rhythms and is associated with hypertension, diabetes, obesity, and cardiovascular diseases. Few studies have been conducted on the control of hypertension and diabetes. This study aimed to examine the effect of night shift work on the control rate of hypertension and diabetes. METHODS: Subjects comprised workers aged 20–65 years who underwent specific health examination at a single facility in seven different affiliated examination centers from 1 January to 31 December 2016. Workers were categorised into day workers and night shift workers. Demographic and medical history were taken, and physical examination was done. Blood pressure (BP) and fasting glucose were measured. The control rate of each disease was evaluated based on treatment goals presented in the treatment guidelines of the Korean Society of Hypertension and the Korean Diabetes Association (systolic BP < 140 mmHg and diastolic BP < 90 mmHg; fasting glucose ≤ 130 mg/dL). RESULTS: Among 631,418 subjects, 11.2% (70,450) were night shift workers. Of whom 6.1% (4,319) were taking antihypertensive medication and 2.5% (1,775) were taking diabetes medication. Among patients taking antihypertensive medications, the proportion of those whose BP was controlled to suit treatment goals was 81.7% (26,635) of day workers and 77.4% (3,343) of night shift workers, which was significantly different (p < 0.001). Among patients taking diabetes medications, the proportion of those whose blood glucose was controlled to suit treatment goals was 37.4% (4,489) of day workers and 36.5% (647) of night shift workers, but the difference was not significant. The control rates for patients taking antihypertensive medications (odds ratio [OR]: 0.74, 95% confidence interval [CI]: 0.68–0.80) were lower among night shift workers than day workers with adjustment for age, sex, smoking history, alcohol consumption, exercise, and obesity. However, there were no differences in control rates for patients taking diabetes medications (OR: 0.99, 95% CI: 0.87–1.10) between day workers and night shift workers. CONCLUSIONS: Night shift work can have an effect on the uncontrolled BP in workers taking antihypertensive medications. Therefore, additional efforts for disease control are necessary for night shift workers with hypertension.
Alcohol Drinking ; Blood Glucose ; Blood Pressure ; Cardiovascular Diseases ; Diabetes Mellitus ; Fasting ; Glucose ; Humans ; Hypertension ; Obesity ; Periodicity ; Physical Examination ; Smoke ; Smoking ; Stress, Psychological ; Treatment Outcome

BACKGROUND: Recently, several studies have assessed the association between diabetes and hearing impairment. However, the effect of diabetes on hearing impairment is not well known in diabetic patients exposed to noise, a typical cause of hearing impairment. The aim of this study is to longitudinally analyze the effect of diabetes on hearing impairment in workers exposed to similar noise levels from 2013 to 2017 who had experienced little change in their working conditions. METHODS: The study subjects included 2,087 male workers exposed to noise in a single company and who underwent health examinations at the same hospital in Ulsan city in 2013 and 2017. Hearing impairment was defined that a pure-tone average of pure-tone audiometry (PTA) thresholds at 1,000, 2,000, 3,000, and 4,000 Hz was 25 dB and over in both ears. Statistical analyses were conducted using χ2 tests, ANOVA, and Cox proportional hazard models. We analyzed covariates that might affect hearing impairment, including age; working period; levels of total cholesterol, triglyceride, and serum creatinine; smoking and alcohol history; and noise level. RESULTS: The average PTA thresholds and their average changes between 2013 and 2017 were significant in the diabetes mellitus (DM) group than those in the normal and impaired fasting glucose group. Among the subjects with the same status of fasting glucose group in 2013 and 2017, the adjusted hazard ratios for incident hearing impairment among those in the DM group compared to normal group were 3.35 (95% confidence interval [CI], 1.54–7.29) in the left ear and 5.66 (95% CI, 2.01–15.98) in the right ear. CONCLUSIONS: This study suggested that the risk of hearing impairment in the DM group was significantly higher than that in the normal group in both ears, even when exposed to similar noise levels.
Audiometry, Pure-Tone ; Blood Glucose ; Cholesterol ; Creatinine ; Diabetes Mellitus ; Ear ; Fasting ; Glucose ; Hearing Loss ; Hearing ; Humans ; Longitudinal Studies ; Male ; Noise ; Proportional Hazards Models ; Smoke ; Smoking ; Triglycerides ; Ulsan

BACKGROUND: Depression is considered as a risk factor for cardiovascular disease (CVD) and associated with changes in individuals' health status that might influence CVD risk. However, most studies have scrutinized this relationship on a rather narrower and specific study population. By focusing on general population of Korea, we sought to inspect the association of depression with CVD risk and cardiovascular risk factors. METHODS: The data from the first year (2016) of the 7th Korea National Health and Nutrition Examination Survey was used. Participants were classified by the Patient Health Questionnaire-9 (PHQ-9) score as such: normal group (PHQ-9 score 0–4), mild depression (MD) group (PHQ-9 score 5–9) and moderate and severe depression (MSD) group (PHQ-9 score 10–27). General linear model was used to analyze differences and the trend of mean CVD risk according to depression level. Adjusted odds ratios (AORs) were calculated by logistic regression to identify the association between depression and cardiovascular risk factors after adjusting for age. RESULTS: Mean CVD risk of MSD group was higher than that of normal group (p < 0.05). There was a tendency of CVD risk to increase as depression worsened (p < 0.01). Among men, MSD group was associated with current smoking (AOR, 2.97; 95% confidence interval [CI], 1.78–4.97), taking antihypertensive medications (AOR, 2.42; 95% CI, 1.26–4.66), increased fasting blood sugar (> 125 mg/dL; AOR, 2.37; 95% CI, 1.25–4.50) and taking diabetes medications (AOR, 3.08; 95% CI, 1.65–5.72). MD group was associated with current smoking (AOR, 1.60; 95% CI, 1.18–2.17). Among women, MSD group was associated with high body mass index (≥ 25 kg/m2; AOR, 1.61; 95% CI, 1.11–2.32), large waist circumference (≥ 85 cm; AOR, 1.63; 95% CI, 1.12–2.37), current smoking (AOR, 5.11; 95% CI, 3.07–8.52) and taking diabetes medications (AOR, 2.62; 95% CI, 1.68–4.08). MD group was associated with current smoking (AOR, 1.86; 95% CI, 1.18–2.93). CONCLUSIONS: We suggest that depression is associated with increased risk for CVD occurrence in general population of Korea.
Blood Glucose ; Body Mass Index ; Cardiovascular Diseases ; Depression ; Fasting ; Female ; Humans ; Korea ; Linear Models ; Logistic Models ; Male ; Nutrition Surveys ; Odds Ratio ; Risk Factors ; Smoke ; Smoking ; Waist Circumference

BACKGROUND: In Korea, around the abandoned metal mines, heavy metals are being accumulating in the cultivated areas. Among exposed heavy metals, mercury is known to harm for cardiovascular system known to affect blood pressure. So, we studied the relationship between blood mercury level and hypertension in residents around abandoned metal mines. METHODS: From 2008 to 2011, we surveyed 7,055 residents in provinces affected by abandoned metal mines and collected data from 6 Hospitals. We conducted a personal questionnaire interview survey with residents on the basis of household questionnaires, sex, age, household income, smoking, and drinking items. Multiple logistic regression analysis was performed to investigate the association between blood mercury level and hypertension. RESULTS: We compared residents with low and high groups based on blood mercury level 5.8 μg/L, and higher group was significantly higher risk of hypertension than lower group (odds ratio [OR]: 1.277; 95% confidence interval [CI]: 1.135–1.436), also in adjusted model, higher group was significantly higher risk of hypertension than lower group (OR: 1.276; 95% CI: 1.117–1.457). CONCLUSIONS: This study showed a significant correlation between mercury and hypertension in residents around abandoned metal mines. Therefore, we should continuously monitor people who are higher than the standard value and the hypertensive patients.
Blood Pressure ; Cardiovascular System ; Drinking ; Family Characteristics ; Humans ; Hypertension ; Korea ; Logistic Models ; Metals, Heavy ; Smoke ; Smoking