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Imaging-Based Patient Selection and Endovascular Therapy of Ischemic Stroke

Fanfan Zheng, Wuxiang Xie
2015 Medicine  
The extent of variability across studies attributable to Zheng and Xie Medicine Volume 94, Number 38, September 2015 heterogeneity beyond chance was estimated using the I 2 statistic.  ...  Zheng and Xie Medicine Volume 94, Number 38, September 2015 FIGURE 1 . 1 Study selection flow diagram adapted from the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Statement  ... 
doi:10.1097/md.0000000000001539 pmid:26402810 pmcid:PMC4635750 fatcat:2wck27rfizfg3fzmqhfqt6l5z4

Recent Trends in Hospitalization for Acute Myocardial Infarction in Beijing

Qian Zhang, Dong Zhao, Wuxiang Xie, Xueqin Xie, Moning Guo, Miao Wang, Wei Wang, Wanru Liu, Jing Liu
2016 Medicine  
Comparable data on trends of hospitalization rates for STsegment elevation myocardial infarction (STEMI) and non-STEMI (NSTEMI) remain unavailable in representative Asian populations. To examine the temporal trends of hospitalization for acute myocardial infarction (AMI) and its subtypes in Beijing. Patients hospitalized for AMI in Beijing from January 1, 2007 to December 31, 2012 were identified from the validated Hospital Discharge Information System. Trends in hospitalization rates,
more » ... al mortality, length of stay (LOS), and hospitalization costs were analyzed by regression models for total AMI and for STEMI and NSTEMI separately. In total, 77,943 patients were admitted for AMI in Beijing during the 6 years, among whom 67.5% were males and 62.4% had STEMI. During the period, the rate of AMI hospitalization per 100,000 population increased by 31.2% (from 55.8 to 73.3 per 100,000 population) after age standardization, with a slight decrease in STEMI but a 3-fold increase in NSTEMI. The ratio of STEMI to NSTEMI decreased dramatically from 6.5:1.0 to 1.3:1.0. The age-standardized in-hospital mortality decreased from 11.2% to 8.6%, with a significant decreasing trend evident for STEMI in males and females (P < 0.001) and for NSTEMI in males (P ¼ 0.02). The rate of percutaneous coronary intervention increased from 28.7% to 55.6% among STEMI patients. The total cost for AMI hospitalization increased by 56.8% after adjusting for inflation, although the LOS decreased by 1 day. The hospitalization burden for AMI has been increasing in Beijing with a transition from STEMI to NSTEMI. Diverse temporal trends in AMI subtypes from the unselected "real-world" data in Beijing may help to guide the management of AMI in China and other developing countries. (Medicine 95(5):e2677) Abbreviations: AMI = acute myocardial infarction, CABG = coronary artery bypass graft, CHD = coronary heart disease, HDIS = Hospital Discharge Information System, ICD-10 = the International Classification of Diseases 10th Revision, ICD-9-CM-3 = International Classification of Diseases Clinical Modification of 9th Revision Operations and Procedures, LOS = length of stay, NSTEMI = non-ST-segment elevation myocardial infarction, PCI = percutaneous coronary intervention, STEMI = STsegment elevation myocardial infarction. Editor: Leonardo Roever. Data are displayed as a percentage except age, which is presented as mean and standard deviation. CABG ¼ coronary artery bypass grafting; NSTEMI ¼ non-ST-segment elevation myocardial infarction; PCI ¼ percutaneous coronary intervention; STEMI ¼ ST-segment elevation myocardial infarction. FIGURE 2. Proportion and the number of patients hospitalized for different subtypes of acute myocardial infarction in Beijing, 2007 to 2012. NSTEMI ¼ non-ST-segment elevation myocardial infarction; STEMI ¼ ST-segment elevation myocardial infarction.
doi:10.1097/md.0000000000002677 pmid:26844503 pmcid:PMC4748920 fatcat:4pa54ilnmrfijfaoc323wwmxpm

Medical Plants and Immunological Regulation

Cheng Xiao, Qingdong Guan, Yong Tan, Lifei Hou, Wuxiang Xie
2018 Journal of Immunology Research  
Cheng Xiao Qingdong Guan Yong Tan Lifei Hou Wuxiang Xie  ... 
doi:10.1155/2018/9172096 pmid:30009189 pmcid:PMC6020459 fatcat:qnfwydaivbetvegdds6xbdlsz4

Association Between Sleep Duration and Cognitive Decline

Yanjun Ma, Lirong Liang, Fanfan Zheng, Le Shi, Baoliang Zhong, Wuxiang Xie
2020 JAMA Network Open  
An association between sleep duration and the trajectory of cognitive decline has not been conclusively demonstrated. To investigate the association between sleep duration and cognitive decline by a pooled analysis of 2 nationally representative aging cohorts. A pooled cohort study using data from waves 4 to 8 (2008-2009 to 2016-2017) in the English Longitudinal Study of Ageing and waves 1 to 3 (2011 to 2015) in the China Health and Retirement Longitudinal Study in a population-based setting.
more » ... rticipants were 2 randomly enrolled cohorts comprising 28 756 individuals living in England who were 50 years or older and those living in China who were 45 years or older. Self-reported sleep duration per night according to face-to-face interviews. Global cognitive z scores were calculated according to immediate and delayed recall test, an animal fluency test, the serial sevens test, an intersecting pentagon copying test, and a date orientation test. Data were analyzed from 20 065 participants, including 9254 from the English Longitudinal Study of Ageing (mean [SD] age, 64.6 [9.8] years; 55.9% [5174 of 9254] women; median follow-up duration, 8 [interquartile range, 6-8] years) and 10 811 from the China Health and Retirement Longitudinal Study (mean [SD] age, 57.8 [9.0] years; 50.2% [5425 of 10 811] men; median follow-up duration, 4 [interquartile range, 4-4] years). During 100 000 person-years of follow-up, global cognitive z scores in individuals with 4 hours or less (pooled β = -0.022; 95% CI, -0.035 to -0.009 SD per year; P = .001) and 10 hours or more (pooled β = -0.033; 95% CI, -0.054 to -0.011 SD per year; P = .003) of sleep per night declined faster than in the reference group (7 hours per night) after adjusting for a number of covariates. An inverted U-shaped association between sleep duration and global cognitive decline was also observed. In this pooled cohort study, an inverted U-shaped association between sleep duration and global cognitive decline was found, indicating that cognitive function should be monitored in individuals with insufficient (≤4 hours per night) or excessive (≥10 hours per night) sleep duration. Future studies are needed to examine the mechanisms of the association between sleep duration and cognitive decline.
doi:10.1001/jamanetworkopen.2020.13573 pmid:32955572 pmcid:PMC7506513 fatcat:wwjvkjhh2zhtnlckm7ie6zjic4

Identification of an RNase that preferentially cleaves A/G nucleotides

Jumin Xie, Zhen Chen, Xueyan Zhang, Honghe Chen, Wuxiang Guan
2017 Scientific Reports  
This study was supported by One Hundred Talent Program from Chinese Academy of Sciences to Wuxiang Guan.  ... 
doi:10.1038/srep45207 pmid:28322335 pmcid:PMC5359670 fatcat:lh2gp2zvavfczjnl7zwlx2amty

HbA1c, diabetes and cognitive decline: the English Longitudinal Study of Ageing

Fanfan Zheng, Li Yan, Zhenchun Yang, Baoliang Zhong, Wuxiang Xie
2018 Diabetologia  
Aims/hypothesis The aim of the study was to evaluate longitudinal associations between HbA 1c levels, diabetes status and subsequent cognitive decline over a 10 year follow-up period. Methods Data from wave 2 (2004)(2005) to wave 7 (2014-2015) of the English Longitudinal Study of Ageing (ELSA) were analysed. Cognitive function was assessed at baseline (wave 2) and reassessed every 2 years at waves 3-7. Linear mixed models were used to evaluate longitudinal associations. Results The study
more » ... ed 5189 participants (55.1% women, mean age 65.6 ± 9.4 years) with baseline HbA 1c levels ranging from 15.9 to 126.3 mmol/mol (3.6-13.7%). The mean follow-up duration was 8.1 ± 2.8 years and the mean number of cognitive assessments was 4.9 ± 1.5. A 1 mmol/mol increment in HbA 1c was significantly associated with an increased rate of decline in global cognitive z scores (−0.0009 SD/year, 95% CI −0.0014, −0.0003), memory z scores (−0.0005 SD/year, 95% CI −0.0009, −0.0001) and executive function z scores (−0.0008 SD/year, 95% CI −0.0013, −0.0004) after adjustment for baseline age, sex, total cholesterol, HDL-cholesterol, triacylglycerol, high-sensitivity C-reactive protein, BMI, education, marital status, depressive symptoms, current smoking, alcohol consumption, hypertension, CHD, stroke, chronic lung disease and cancer. Compared with participants with normoglycaemia, the multivariable-adjusted rate of global cognitive decline associated with prediabetes and diabetes was increased by −0.012 SD/year (95% CI −0.022, −0.002) and −0.031 SD/year (95% CI −0.046, −0.015), respectively (p for trend <0.001). Similarly, memory, executive function and orientation z scores showed an increased rate of cognitive decline with diabetes. Conclusions/interpretation Significant longitudinal associations between HbA 1c levels, diabetes status and long-term cognitive decline were observed in this study. Future studies are required to determine the effects of maintaining optimal glucose control on the rate of cognitive decline in people with diabetes.
doi:10.1007/s00125-017-4541-7 pmid:29368156 fatcat:frhetz4jzba4llb6pcsoxgjewy

Persistent depressive symptoms and cognitive decline in older adults

Fanfan Zheng, Baoliang Zhong, Xiaoyu Song, Wuxiang Xie
2018 British Journal of Psychiatry  
BackgroundLittle is known about the effect of persistent depressive symptoms on the trajectory of cognitive decline.AimsWe aimed to investigate the longitudinal association between the duration of depressive symptoms and subsequent cognitive decline over a 10-year follow-up period.MethodThe English Longitudinal Study of Ageing cohort is a prospective and nationally representative cohort of men and women living in England aged ≥50 years. We examined 7610 participants with two assessments of
more » ... ssive symptoms at wave 1 (2002–2003) and wave 2 (2004–2005), cognitive data at wave 2 and at least one reassessment of cognitive function (wave 3 to wave 7, 2006–2007 to 2014–2015).ResultsThe mean age of the 7610 participants was 65.2 ± 10.1 years, and 57.0% were women. Of these, 1157 (15.2%) participants had episodic depressive symptoms and 525 participants (6.9%) had persistent depressive symptoms. Compared with participants without depressive symptoms at wave 1 and wave 2, the multivariable-adjusted rates of global cognitive decline associated with episodic depressive symptoms and persistent depressive symptoms were faster by –0.065 points/year (95% CI –0.129 to –0.000) and –0.141 points/year (95% CI –0.236 to –0.046), respectively (P for trend &lt; 0.001). Similarly, memory, executive and orientation function also declined faster with increasing duration of depressive symptoms (all P for trend &lt; 0.05).ConclusionsOur results demonstrated that depressive symptoms were significantly associated with subsequent cognitive decline over a 10-year follow-up period. Cumulative exposure of long-term depressive symptoms in elderly individuals could predict accelerated subsequent cognitive decline in a dose-response pattern.Declaration of interestNone.
doi:10.1192/bjp.2018.155 pmid:30132434 fatcat:eeoy7javybf5vj67cs5oky5744

Obstructive Sleep Apnea and Serious Adverse Outcomes in Patients with Cardiovascular or Cerebrovascular Disease

Wuxiang Xie, Fanfan Zheng, Xiaoyu Song
2014 Medicine  
30 vs 5< AHI <30 HR: 1.72 (1.01-2.91) Xie et al Medicine Volume 93, Number 29, December 2014 FIGURE 2.Meta-analysis of OSA and associated risk of stroke in patients with stroke or IHD.  ... 
doi:10.1097/md.0000000000000336 pmid:25546682 pmcid:PMC4602614 fatcat:ud5fyrl6offtfbbazlapyhhy3y

Study protocol: The INTERMAP China Prospective (ICP) study

Li Yan, Ellison Carter, Yu Fu, Dongshuang Guo, Pinchun Huang, Gaoqiang Xie, Wuxiang Xie, Yidan Zhu, Frank Kelly, Paul Elliott, Liancheng Zhao, Xudong Yang (+4 others)
2019 Wellcome Open Research  
Unfavourable blood pressure (BP) level is an established risk factor for cardiovascular diseases (CVD), while the exact underlying reasons for unfavourable BP are poorly understood. The INTERMAP China Prospective (ICP) Study is a prospective cohort to investigate the relationship of environmental and nutritional risk factors with key indicators of vascular function including BP, arterial stiffness, and carotid-intima media thickness. Methods: A total of 839 Chinese participants aged 40-59 years
more » ... from three diverse regions of China were enrolled in INTERMAP in 1997/98; data collection included repeated BP measurements, 24-hour urine specimens, and 24-hour dietary recalls. In 2015/16, 574 of these 839 persons were re-enrolled along with 208 new participants aged 40-59 years that were randomly selected from the same study villages. Participant's environmental and dietary exposures and health outcomes were assessed in this open cohort study, including BP, 24-hour dietary recalls, personal exposures to air pollution, grip strength, arterial stiffness, carotid-media thickness and plaques, cognitive function, and sleep patterns. Serum and plasma specimens were collected with 24-hour urine specimens. Discussion: Winter and summer assessments of a comprehensive set of vascular indicators and their environmental and nutritional risk factors were conducted with high precision. We will leverage advances in exposome research to identify biomarkers of exposure to environmental and nutritional risk factors and improve our understanding of the mechanisms and pathways of their hazardous cardiovascular effects. The ICP Study is observational by design, thus subject to several biases including selection bias (e.g., loss to follow-up), information bias (e.g., measurement error), and confounding that we sought to mitigate through our study design and measurements. However, extensive efforts will apply to minimize those limitations (continuous observer training, repeated measurements of BP, standardized methods in data collection and measurements, and on-going quality control).
doi:10.12688/wellcomeopenres.15470.1 fatcat:g5iomub55ve3laflgmwjjf47mu

Study protocol: The INTERMAP China Prospective (ICP) study

Li Yan, Ellison Carter, Yu Fu, Dongshuang Guo, Pinchun Huang, Gaoqiang Xie, Wuxiang Xie, Yidan Zhu, Frank Kelly, Paul Elliott, Liancheng Zhao, Xudong Yang (+4 others)
2020 Wellcome Open Research  
Unfavourable blood pressure (BP) level is an established risk factor for cardiovascular diseases (CVD), while the exact underlying reasons for unfavourable BP are poorly understood. The INTERMAP China Prospective (ICP) Study is a prospective cohort to investigate the relationship of environmental and nutritional risk factors with key indicators of vascular function (BP, arterial stiffness, carotid-intima media thickness) among middle-aged/older men and women. Methods: A total of 839 Chinese
more » ... icipants aged 40-59 years from three diverse regions of China were enrolled in INTERMAP in 1997/98; data collection included repeated BP measurements, 24-hour urine specimens, and 24-hour dietary recalls. In 2015/16, 574 of these 839 persons were re-enrolled along with 208 new participants aged 40-59 years that were randomly selected from the same study villages. Participant's environmental and dietary exposures and health outcomes were assessed in this open cohort study, including BP, 24-hour dietary recalls, personal exposures to air pollution, grip strength, arterial stiffness, carotid-media thickness and plaques, cognitive function, and sleep patterns. Serum and plasma specimens were collected with 24-hour urine specimens. A follow-up visit has been scheduled for 2020-2021. Discussion: Winter and summer assessments of a comprehensive set of vascular indicators and their environmental and nutritional risk factors were conducted with high precision. We will leverage advances in exposome research to identify biomarkers of exposure to environmental and nutritional risk factors and improve our understanding of the mechanisms and pathways of their hazardous cardiovascular effects. The ICP Study is observational by design, thus subject to several biases including selection bias (e.g., loss to follow-up), information bias (e.g., measurement error), and confounding that we sought to mitigate through our study design and measurements. However, extensive efforts will apply to minimize those limitations (continuous observer training, repeated measurements of BP, standardized methods in data collection and measurements, and on-going quality control).
doi:10.12688/wellcomeopenres.15470.2 fatcat:zdyun6ug6vcr3i2yrj4ekuxp6y

Different hypertension thresholds and cognitive decline: a pooled analysis of three ageing cohorts

Yanjun Ma, Rong Hua, Zhenchun Yang, Baoliang Zhong, Li Yan, Wuxiang Xie
2021 BMC Medicine  
Background The 2017 American College of Cardiology (ACC)/American Heart Association (AHA) guidelines for high blood pressure (BP) in adults came up with a new definition of hypertension with a threshold BP level of 130/80 mmHg. But the 2018 European Society of Cardiology (ESC)/European Society of Hypertension (ESH) guidelines adhered to a conventional hypertension definition as BP ≥ 140/90 mmHg. We aimed to compare the trajectories of cognitive decline between participants with BP < 130/80 mmHg
more » ... in all BP measurement waves and others with all BP < 140/90 mmHg. Methods This pooled analysis involved middle-aged and older participants from three nationally representative ageing cohorts, including the Health and Retirement Study (HRS), the English Longitudinal Study of Ageing (ELSA), and the China Health Retirement Longitudinal Study (CHARLS). Participants were divided into the Normal (BP < 130/80 mmHg on all occasions throughout the study), the Borderline (BP < 140/90 mmHg on all occasions throughout the study but not in the Normal group), and the High (the rest of participants) BP groups. Global cognitive Z score was calculated from tests on memory, executive function, and orientation. Results A total of 17,590 participants (HRS 6964, median follow-ups 12 years; ELSA 5334, median follow-ups 16 years; CHARLS 5292, median follow-ups 7 years) were included. No significant difference in global cognitive decline rate was detected between the Normal and the borderline groups (men, pooled β = − 0.006 standard deviation [SD]/year; 95% confidence interval [CI], − 0.020 to 0.008; P = 0.377; women, pooled β = 0.006 SD/year; 95% CI − 0.005 to 0.018; P = 0.269). Participants in the High group had a significantly faster cognitive decline (men, pooled β = − 0.011 SD/year; 95% CI − 0.020 to − 0.002; P = 0.013; women, pooled β = − 0.017 SD/year; 95% CI − 0.026 to − 0.008; P < 0.001) than that in the Borderline group. Conclusions Individuals in the Borderline group did not experience significantly faster cognitive decline compared with those in the Normal group. It might not be necessary for individuals with borderline BP (between 130/80 and 140/90 mmHg) to initiate antihypertension therapy in consideration of cognitive decline.
doi:10.1186/s12916-021-02165-4 pmid:34724953 pmcid:PMC8561998 fatcat:xqjnkncfy5cizowsm5flclm6li

Trends in Hospitalization Expenditures for Acute Exacerbations of COPD in Beijing from 2009 to 2017

Lirong Liang, Yunxiao Shang, Wuxiang Xie, Julie Shi, Zhaohui Tong, Mohammad S Jalali
2020 International Journal of COPD  
Chronic obstructive pulmonary disease (COPD) is the cause of substantial economic and social burden. We investigated trends in hospitalizations for acute exacerbation of COPD in Beijing, China, from 2009 to 2017. Investigations were conducted using data from the discharge records of inpatients that were given a primary diagnosis of acute exacerbation of COPD. The dataset was a retrospective review of information collected from electronic medical records and included 315,116 admissions (159,368
more » ... atients). Descriptive analyses and multivariate regressions were used to investigate trends in per admission and per capita expenditures, as well as other potential contributing factors. The mean per admission expenditures increased from 19,760 CNY ($2893, based on USD/CNY=6.8310) in 2009 to 20,118 CNY ($2980) in 2017 (a growth rate of 0.11%). However, the per capita expenditures increased from 23,716 CNY ($3472) in 2009 to 31,000 CNY ($4538) in 2017 (a growth rate of 1.7%). In terms of per admission expenditures, drug costs accounted for 52.9% of the total expenditures in 2009 and dropped to 39.4% in 2017 (P trend < 0.001). The mean length of stay (LOS) decreased from 16.0 days to 13.5 days (P trend < 0·001). Age, gender, COPD type, LOS, and hospital level were all associated with per admission and per capita expenditures. Relatively stable per admission expenditures along with the decline in drug costs and LOS reflect the effectiveness of cost containment on some indicators in China's health care reform. However, the increase in hospitalization expenditures per capita calls for better policies for controlling hospitalizations, especially multiple admissions.
doi:10.2147/copd.s243595 pmid:32547004 pmcid:PMC7247615 fatcat:uyjl2r52vjdzjlfp65neqolydq

A Meta-Analysis of Effect of Dietary Salt Restriction on Blood Pressure in Chinese Adults

Miao Wang, Andrew E. Moran, Jing Liu, Yue Qi, Wuxiang Xie, Keane Tzong, Dong Zhao
2015 Global Heart  
OBJECTIVE-To estimate the effects of dietary salt reduction on blood pressure (BP) in Chinese adults and the effects of China-specific cooking salt reduction strategies (salt substitute and saltrestriction spoon). METHODS-PubMed and China National Knowledge Infrastructure databases were searched for studies satisfying search criteria. Outcomes extracted from each included study were 24-hour urinary sodium (Na) excretion, salt (sodium chloride) intake, and BP level before and after dietary salt
more » ... owering. A random-effects meta-analysis was performed and results were evaluated for evidence of publication bias and heterogeneity. Because most studies aggregated results for hypertensive and normotensive participants, estimates were made for hypertensives only and for hypertensives and normotensives combined. RESULTS-Six salt-restriction experiment studies (3,153 participants), four cooking saltrestriction spoon studies (3,715 participants), and four cooking salt substitute studies (1,730 participants) were analyzed. In salt-restriction experiment studies, the pooled estimate of mean change in 24-hour urinary Na excretion in hypertensive participants was −163.0 mmol/day (95% confident interval (CI): −233.5 to −92.5 mmol/day), which was associated with a mean reduction of −8.9 mmHg (95%CI: −14.1 to −3.7 mmHg) in systolic BP. Each 1.00g dietary salt reduction in hypertensives was associated with a reduction of 0.94 mmHg in systolic BP (95%CI: 0.69 to 1.03 mmHg). These systolic BP reductions in hypertensives were 1.71 times greater compared with the mixed hypertensive and normotensive group. Salt-restriction spoon studies demonstrated a 1.46 g decrease on daily salt intake level. The effect of salt substitute use on systolic BP control was substantial among the hypertensives (−4.2, 95%CI: −7.0 to −1.3 mmHg), but the change did not reach statistical significance in hypertensives and normotensives combined (−2.31, 95%CI: −5.57 to 0.94 mmHg) CONCLUSIONS-Salt restriction lowers mean BP in Chinese adults, with the strongest effect among hypertensives. Future studies of salt restriction strategies should report results stratified by hypertension status and adjust for medication use.
doi:10.1016/j.gheart.2014.10.009 pmid:26014655 pmcid:PMC4529389 fatcat:pwd4vafoyvhyxit6lhz6jf6ed4

Effect of salt reduction interventions in lowering blood pressure in Chinese populations: a systematic review and meta-analysis of randomised controlled trials

Aoming Jin, Wuxiang Xie, Yangfeng Wu
2020 BMJ Open  
Rationale and objectiveSalt reduction remains a global challenge and different salt reduction strategies have been studied in China. This study is to systematically evaluate evidence from randomised controlled trials (RCT) in China and inform the effective salt reduction strategies.DesignSystematic review and meta-analysis.Data sourcesMEDLINE, Embase, Cochrane Central Register of Controlled Trials, Wanfang Data and the China National Knowledge Infrastructure databases through October
more » ... ility criteriaRCTs conducted in China with at least 4 weeks' duration of study and blood pressure (BP) reported.Data extraction and synthesisData were screened, extracted and appraised by two independent reviewers. The quality of study was assessed using a modified Cochrane Collaboration's risk of bias tool. The primary outcome was the difference in BP change from baseline to the end of study between interventions and control. The effects were pooled using a random effects model and associated factors were explored by a meta-regression.ResultsWe identified 24 studies involving 10 448 participants, including 8 studies on health education (4583 participants), 2 studies on salt restriction diet (162 participants), 1 study on salt restriction spoon (50 participants) and 13 studies on salt substitute (5653 participants). Six studies on salt substitute and three studies on health education were identified with high quality. Pooled results from the six studies showed that salt substitutes significantly reduced systolic BP (−5.7 mm Hg; 95% CI −8.5 to −2.8) and diastolic BP (−2.0 mm Hg; 95% CI −3.5 to −0.4). The School-EduSalt study showed that the school-based health education significantly reduced systolic BP among parents (−2.3 mm Hg; 95% CI −4.5 to −0.04).ConclusionsAmong four salt reduction strategies studied in China with RCT design, only salt substitute was proved effective in lowering BP by the pooled effect from multiple studies with high quality. More well-designed studies are warranted for other strategies.
doi:10.1136/bmjopen-2019-032941 pmid:32071177 pmcid:PMC7044858 fatcat:azby5r7ozjdevkcz6fy6mczwcu

Lifetime risk of stroke in young-aged and middle-aged Chinese population

Ying Wang, Jing Liu, Wei Wang, Miao Wang, Yue Qi, Wuxiang Xie, Yan Li, Jiayi Sun, Jun Liu, Dong Zhao
2016 Journal of Hypertension  
Objective: Stroke is a major cause of premature death in China. Early prevention of stroke requires a more effective method to differentiate the stroke risk among young-aged and middle-aged individuals than the 10-year risk of cardiovascular disease. This study aimed to establish a lifetime stroke risk model and risk charts for the youngaged and middle-aged population in China. Methods: The Chinese Multi-Provincial Cohort Study participants (n ¼ 21 953) aged 35-84 years without cardiovascular
more » ... sease at baseline were followed for 18 years (263 016 person-years). Modified Kaplan-Meier method was used to estimate the mean lifetime stroke risk up to age of 80 years and the lifetime stroke risk according to major stroke risk factors for the population aged 35-60 years. Results: A total of 917 participants developed first-ever strokes. For the participants aged 35-40 years (98 stroke cases), the lifetime stroke risk was 18.0 and 14.7% in men and women, respectively. Blood pressure most effectively discriminated the lifetime stroke risk. The lifetime risk of stroke for the individuals with all risk factors optimal was 8-10 times lower compared with those with two or more high risk factors at age 35-60 years at baseline. Conclusion: In young-aged and middle-aged population, the lifetime stroke risk will keep very low if major risk factors especially blood pressure level is at optimal levels, but the risk substantially increases even with a slight elevation of major risk factors, which could not be identified using 10-year risk estimation.
doi:10.1097/hjh.0000000000001084 pmid:27512963 pmcid:PMC5106079 fatcat:4f2emmethzbd5lkjjxd6kmbpcu
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