Chinese Hypertension Research Articles

Effect of BMI and Its Optimal Cut-Off Value in Identifying Hypertension in Uyghur and Han Chinese: A Biethnic Study from the China National Health Survey (CNHS).

Objective The effect of adiposity on hypertension among Uyghur Chinese is not clear. This study aimed to compare the effect of BMI and its optimal cut-off value in identifying hypertension in Uyghur and Han adults in China. Methods By using a multistage stratified sampling method, 3072 Uyghur and 3195 Han adults underwent questionnaire interview, physical examination, and biochemical tests. Age- and sex-standardized prevalence of hypertension was calculated. Adjusted odds ratios for adiposity associated with hypertension were estimated. ROC analyses were used for assessing the ethnic and sex specific optimal BMI cut-off values in identifying hypertension. Results Both in Uyghur and Han, increased BMI was consistent with the elevated systolic and diastolic blood pressure. Although more Uyghur were overweight/obese, their standardized prevalence of hypertension (17.87%) was lower than that of Han (20.28%). Han adults had 1.42 times odds than Uyghur of hypertension. The adjusted ORs of overweight and obesity were 2.67 and 6.04 in Uyghur and 2.74 and 7.58 in Han. In male, the optimal cut-off values of BMI identifying hypertension in Uyghur and Han were 24.6 kg/m2 and 24.9 kg/m2 , respectively, but the correspond values in Uyghur and Han females were 27.2 kg/m2 and 25.0 kg/m2. Conclusions Adiposity had strong effect on hypertension, but this effect was less strong in Uyghur female than in Han female.

A3963 Prevalence of isolated systolic hypertension in middle-aged Chinese

Objectives: To investigate the prevalence and risk factors of isolated systolic hypertension in untreated middle-aged Chinese. Methods: All employees and retired workers at a factory in Dali were invited to take part in our study in May to July, 2010, and participants without antihypertensive treatment and younger than 60 years were included in the present analyses. Standard questionnaire was used to collect information on smoking and drinking habits, family history of hypertension, and diabetes mellitus. Isolated systolic hypertension was diagnosed as office systolic blood pressure ≥140 mmHg and diastolic blood pressure < 90 mmHg in untreated participants. Results: One thousand two hundred and eight participants included 490 women and 905 normotensive participants. The prevalence of isolated systolic hypertension, isolated diastolic hypertension, and systolic diastolic hypertension were 3.4%, 3.0%, and 18.7%, respectively. Isolated systolic hypertension was prevalent in participants with older age and short stature. In logistic analysis, old age and short stature were significant risk factors for isolated hypertension. Indeed, a 10 years increase of age and a decrease of 5 cm of body height was associated with a 2.56 (1.62, 4.03) and then 1.46 (1.05, 2.04) times higher risk of isolated systolic hypertension. In further analyses, we found a significant interaction between age and body height in relation to pulse pressure. Only in those aged 50 to 60 years participants, lower body height was associated with a higher pulse pressure, a marker of arterial stiffness. Conclusion: Isolated systolic hypertension was prevalent in middle-aged Chinese and associated with older age and lower stature. More attention is needed to pay for this special subtype of hypertension in Chinese.

A2369 The association of simple renal cyst with hypertension in a Chinese population

Objectives: To investigate the epidemiology of simple renal cyst and its association with hypertension in Chinese. Methods: All employees and retired workers of a factory in Dali were invited to take part in our study in May to July, 2010. Simple renal cyst was diagnosed using abdominal ultrasonic examination. Standard questionnaire was used to collect information on smoking and drinking habits, family history of hypertension, and diabetes mellitus. Results: One thousand and thirty-five participants included 105 (6.8%) patients with simple renal cyst. Patients with simple renal cyst were older, had more men, higher body mass index, systolic and diastolic blood pressure, and higher serum uric acid, and had more hypertensive patients and patients with kidney stone (P < 0.05). Sex (OR 1.80, 95%CI 1.09–2.96, P = 0.02), age (OR 1.06, 95%CI 1.04–1.08, P < 0.001), and kidney stone (OR 3.16, 95%CI 1.86–5.35, P < 0.001) were independent risk factors for simple renal cyst. Simple renal cyst was significantly associated with a higher risk of hypertension before adjusted for confounding factors. However, further adjustment for confounding factors, including age, sex, smoking, drinking, body mass index, family history of hypertension, diabetes mellitus, serum uric acid, cholesterol, and triglyceride significantly attenuated the association between simple renal cyst and hypertension (OR 1.18, 95%CI 0.71–1.94, P = 0.53). Conclusion: The prevalence of simple renal cyst was 6.8%, and was common in men and elderly participants. Simple renal cyst was associated with a higher risk of hypertension, but not independently of sex, age, obesity and other traditional risk factors of hypertension.

A0700 Understanding optimal target for BP with aid of ROC curve analysis

Objectives: There is a systematic question, “What is the optimal target for blood pressure (BP) lowering during antihypertensive therapy in adults?” Answers are usually on basis of clinical trials and their results, but their data are always limited. ROC curve analysis is a non-parametric method and can be used for this reference. Methods: Data in this paper come from clinical trials FEVER (The Felodipine Event Reduction Study), CHIEF (Chinese Hypertension Intervention Efficacy Trial) and an epidemiologic study APCSC (Asia Pacific Cohort Studies, Chinese Studies). ROC (receiver operating characteristic)curves were calculated and drown with aid of software SAS 9.2. In this paper high BP is a risk factor (for stroke and all CVD events) and also a marker variable (for ROC). The stroke and CVD are state variables of the ROC curves. These two kinds of variables are on basis of ROC curves. Results: Clearly, relation between CVD (yes/no) and BP is a proper function corresponds to the standard logistic distribution. Some Cut-off points of the curves are used as estimates of BP norms. In the Table,MAX YD: maximum of Youden's index; CROSS: the cross-over point of TPR and TNR; 80%TPR: 80% true positive rate. Conclusion: The cut-off points of ROC curves suggested the optimal target for SBP which varying between 127/76 and 149/88, according different data source and cut-off points.

A4951 The characteristics of ambulatory blood pressure in Chinese hypertensive patients with obstructive sleep apnea

Objectives: To assess the characteristics of ambulatory blood pressure in the Chinese hypertensive patients with obstructive sleep apnea syndrome. Methods: PubMed, Cochrane Library, Embase, Science Citation Index, WanFang data, China National Knowledge Infrastructure database, and VIP were searched form these databases establishment to February 2018. Cross-sectional studies which directly compared Chinese hypertensive patients with and without obstructive sleep apnea (OSA) were included. The ambulatory blood pressure monitoring was used. The following parameters were analyzed: age, body mass index (BMI), apnea-hypopnea index (AHI), 24-h mean systolic blood pressure (SBP), 24-h mean diastolic blood pressure (DBP), day-time SBP, day-time DBP, night-time SBP, night-time DBP, pro-bedtime SBP, pro-bedtime DBP, morning SBP, morning DBP, and the number of patients with non-dippers. Data were extracted and analyzed by Cochrane Collaboration's RevMan 5.3 software. Results: Thirteen studies involving 1080 patients were included. There was no significant difference in age between the two groups, but the BMI in the OSA group was significantly greater than that in the non OSA group (P < 0.05). And AHI of hypertensive patients with OSA was significantly higher than that of patients without OSA (P < 0.05). Compared with hypertensive patients without OSA, all of the blood pressure were significantly increased except the pro-bedtime SBP and the pro-bedtime DBP. Moreover, the number of patients with non-dippers in hypertensive patients with OSA group was significantly more (P < 0.05). Conclusion: Chinese hypertensive patients with OSA not only showed a significant increase in the blood pressure level in each period, but also represented a higher proportion of non-dippers patients.

Association of ATP2B1 common variants with asymptomatic intracranial and extracranial large artery stenosis in hypertension patients

ABSTRACTBackground and aims: Genetic factors play an important role in the cervico-cerebral large-artery atherosclerotic stenosis (LAS), and ATP2B1 gene has been associated with the process of atherosclerosis disorders, such as coronary artery disease and arterial stiffness. But there is little information about the relationship between ATP2B1 gene and atherosclerosis in the intracranial arteries. We hereby investigated the association of common variants in ATP2B1 gene with LAS in asymptomatic Chinese hypertension patients. Methods: The stenosis of intracranial and extracranial arteries were evaluated in 899 subjects through computerized tomography angiography from the aortic arch to the skull base. A total of 11 ATP2B1 common variants were genotyped. Multivariate logistic regression was carried out in a dominant model with confounding factors adjusted. Results: rs17249754-A (OR = 0.43, p = 0.0002) and rs1401982-G (OR = 0.47, p = 0.0007) were associated with decreased susceptibility of concurrent extra and intracranial stenosis even after Bonferroni correction. These two minor alleles were also significantly associated with less stenotic arteries and moderate-to-severe stenosis. Conclusion: rs17249754 and rs1401982 were associated with asymptomatic LAS in stroke-free Chinese hypertension patients and might benefit early recognition of LAS patients in clinical practice.

Analysis of the genes involved in Mendelian forms of low-renin hypertension in Chinese early-onset hypertensive patients

The study aimed to analyze genes involved in Mendelian forms of low-renin hypertension in Chinese early-onset hypertensive patients. A panel of nine genes, namely SCNN1B, SCNN1G, WNK1, WNK4, KLHL3, CUL3, nuclear receptor subfamily 3, group C (NR3C)1, NR3C2, and HSD11B2 were screened by targeted resequencing in 260 Chinese early-onset hypertensive patients. Additionally, exon 13 of both SCNN1B and SCNN1G was sequenced in an independent cohort of 506 Chinese early-onset hypertensive patients. About 81 nonrare and 41 rare variants were, respectively, detected in 221 (85.0%) and 39 (15.0%) patients from the cohort of 260. Of the total 766 patients, those with rare variants in exon 13 of either SCNN1B or SCNN1G had a significantly earlier onset of hypertension (24.7 ± 7.5 vs. 29.0 ± 7.7 years, P = 0.015) and lower serum potassium (3.57 ± 0.59 vs. 3.96 ± 0.41 mmol/l, P = 0.007) than those without rare variants. However, other identified rare variants had no effects on clinical expression. Seven patients (0.91%) were diagnosed with Liddle's syndrome, and the Liddle's syndrome prevalence was 1.72% among the 407 patients with hypertension diagnosed before the age of 30. Genetic screening of the probands' relatives identified 10 additional Liddle's syndrome patients. Treatment of Liddle's syndrome patients with amiloride resulted in normalization of both blood pressure and serum potassium. Liddle's syndrome appears to be the most common low-renin Mendelian hypertension in young Chinese hypertensive patients. Sequencing exon 13 of both SCNN1B and SCNN1G is highly advisable in patients with early-onset and low-renin hypertension.

Mitochondrial C4375T mutation might be a molecular risk factor in a maternal Chinese hypertensive family under haplotype C

ABSTRACTHere, we reported a Han Chinese essential hypertensive pedigree based on clinical hereditary and molecular data. To know the molecular basis on this family, mitochondrial genome of one proband from the family was identified through direct sequencing analysis. The age of onset year and affected degree of patients are different in this family. And matrilineal family members carrying C4375T mutation and belong to Eastern Asian halopgroup C. Phylogenetic analysis shows 4375C is highly conservative in 17 species. It is suggested that these mutations might participate in the development of hypertension in this family. And halopgroup C might play a modifying role on the phenotype in this Chinese hypertensive family.

The association between annexin A5 (ANXA5) gene polymorphism and left ventricular hypertrophy (LVH) in Chinese endogenous hypertension patients.

Left ventricular hypertrophy (LVH) is common in endogenous hypertension (EH). We evaluated annexin A5 (ANXA5) promoter polymorphism in a cross-sectional study with a total of 850 EH patients, including 337 EH patients with LVH.Genotyping of ANXA5 promoter single nucleotide polymorphisms (SNPs) was conducted by SNaPshot assays and statistical analyses were performed to quantify its association with LVH.Of all potential SNPs, rs1050606 showed significant association with LVH (P = .008 in dominant and P = .006 in codominant models, respectively). During further analysis of SNPs on ANXA5 promoter region, rs1050606 had the most prominent effect. Furthermore, haplotypes M2 had higher risk of inducing LVH in EH patients compared with M1 (P = .032, OR = 1.42, 95%CI = 1.03–1.94). Patients with ANXA5 promoter haplotype GATGTC were also more susceptible to LVH (P = .022, OR = 1.35, 95%CI = 1.04–1.74). In the luciferase experiment, ANXA5 rs1050606 had the most promoter activity in myocardial cells (P < .001).These results showed that ANXA5 rs1050606 was significantly associated with LVH in Chinese EH patients, likely via influencing ANXA5 expression in serum and in myocardial cells.

Morning hypertension is more common in elderly hypertensive patients with controlled documented office blood pressure in primary care clinics: the Minhang study.

Increased morning blood pressure (BP) has been associated with fatal and nonfatal cardiovascular events, especially in Asians. To detect the control status of home BP, we performed a home BP monitoring study, including elderly patients with hypertension who had controlled documented office BP in Chinese primary care clinics. In 707 participants from Xinzhuang County Hospital in Shanghai, the home BP was measured by a memory-equipped device three times daily for seven consecutive days. The prevalence of uncontrolled hypertension was 51.3% in the morning and 42% in the evening. Uncontrolled morning hypertension was associated with age [odds ratio (OR): 1.074; 95% confidence interval (CI): 1.041-1.108], office SBP (OR: 1.027; 95% CI: 1.015-1.039), office DBP (OR: 1.042; 95% CI: 1.021-1.064), and the number of antihypertensive drugs taken (OR: 1.387; 95% CI: 1.059-1.817), whereas it was inversely associated with the use of long-acting antihypertensive drugs (OR: 0.588; 95% CI: 0.355-0.973). Compared with office BP, the home morning BP showed a more significant association with age and short-acting antihypertensive drugs. The prevalence of uncontrolled home BP is high in elderly Chinese hypertensive patients, especially in the morning, and home BP monitoring might be a feasible method for detecting it. The use of long-acting antihypertensive drugs might help to improve morning hypertension.

The effect of sleep duration and sleep quality on hypertension in middle-aged and older Chinese: the Dongfeng-Tongji Cohort Study

ObjectiveTo examine the independent and combined associations of sleep duration and sleep quality with hypertension in a middle-aged and older Chinese population. MethodsWe included 21,912 individuals aged 62.2 years at baseline from September 2008 to June 2010, and they were followed until October 2013. Sleep duration was self-reported and sleep quality was evaluated with questions designed according to the Pittsburgh Sleep Quality Index. Hypertension was defined as blood pressure ≥140/90 mmHg, or self-reported physician diagnosis of hypertension, or self-reported current use of antihypertensive medication. ResultsIn the cross-sectional analyses, the odds ratio of hypertension prevalence was significantly elevated (OR = 1.13, 95% CI = 1.03–1.24) in those who slept less than 7 h after adjusting for sex, age, body mass index, midday napping, cigarette smoking and sleep quality. It was particularly evident among males (OR = 1.19, 95% CI = 1.01–1.40) and individuals who were thin (OR = 2.00, 95% CI = 1.01–3.93) with full adjustment. The association was also found for sleep duration of 9∼<10 h after adjusting various covariates (OR = 1.14, 95% CI = 1.04–1.27). In addition, impaired sleep quality was only associated with hypertension in obese individuals (OR = 1.25, 95% CI = 1.02–1.50), not in other subgroups. However, no significant association was detected in any category of sleep duration or sleep quality in all models in the prospective analyses, and the results remained unchanged in the subgroup analyses of sex, age and body mass index. ConclusionsThe results of this study provide limited support for association of sleep duration and sleep quality with hypertension in middle-aged and older Chinese. Further studies are needed to confirm the results.

Relation of four nontraditional lipid profiles to diabetes in rural Chinese H-type hypertension population

BackgroundMounting evidence suggested that nontraditional lipid profiles have been recognized as a reliable indicator for unfavorable cardiovascular events. The purpose of this study was to explore the role of nontraditional lipid profiles as potential clinical indices for the assessment of prevalent diabetes in rural Chinese H-type hypertension population.MethodsDuring 2012 to 2013, we conducted a large cross-sectional study of 2944 H-type hypertension participants (≥35 years of age) from rural areas in northeast China. Subjects underwent accurate assessment of lipid profiles, fasting plasma glucose (FPG), homocysteine (Hcy) according to standard protocols.ResultsThe proportion of diabetes showed a graded and linear increase across the quartiles for all four nontraditional lipid parameters. Nontraditional lipid variables were independent determinants of FPG, and its correlation for TG/HDL-C was strongest, whether potential confounders were adjusted or not. Multivariable logistic regression analysis established that the highest triglycerides (TG)/ high-density lipoprotein cholesterol (HDL-C) quartile manifested the largest ORs of prevalent diabetes (OR: 3.275, 95%CI: 2.109–5.087) compared with the lowest quartile. The fully adjusted ORs (95%CI) were 2.753 (1.783–4.252), 2.178 (1.415–2.351), 1.648 (1.097–2.478) for the top quartile of total cholesterol (TC)/HDL-C, low-density lipoprotein cholesterol (LDL-C)/HDL-C, and non-high-density lipoprotein cholesterol (non-HDL-C), respectively. On the basis of the area under receiver-operating characteristic curve (AUC), TG/HDL-C showed the optimal discriminating power for diabetes (AUC: 0.684, 95% CI: 0.650–0.718).ConclusionsNontraditional lipid profiles (TG/HDL-C, TC/HDL-C, LDL-C/HDL-C and non-HDL-C) were all consistently and independently correlated with prevalent diabetes among the H-type hypertension population in rural China. TG/HDL-C was prone to be more profitable in assessing the risk of prevalent diabetes and should be encouraged as an effective clinical tool for monitoring and targeted intervention of diabetes in H-type hypertension adults.

Association of connexin gene polymorphism with essential hypertension in Kazak and Han Chinese in Xinjiang, China.

Essential hypertension (EH) is affected by both genetic and environmental factors. The polymorphism of connexin (Cx) genes is found associated with the development of hypertension. However, the association of the polymorphism of Cxs with EH has not been investigated. This study aimed to investigate the association of the polymorphism of connexin (Cx) genes Cx37, Cx40, and Cx43 with EH in Kazak and Han Chinese in Xinjiang, China. Polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) method and matrix-assisted laser desorption ionization time-of-flight mass spectrometry (MALDI-TOF-MS) were used to analyze the polymorphism of Cx genes in Kazak and Han EH patients as well as their normotensive controls. The results showed that there were no significant differences in the frequencies of different three genotypes (A/A, A/G, and G/G) and A and G alleles of Cx40 rs35594137 and rs11552588 between EH patients and normotensive controls. However, in Kazak EH patients, the frequencies of three genotypes (A/A, A/G, and G/G) of Cx37 rs1630310 were 24.8%, 47.2% and 28.0%, respectively, which were significantly different from those in Han EH patients. In Han EH patients, the frequencies of the three genotypes (C/C, C/G and G/G) of Cx43 rs1925223 were 6.4%, 35.6% and 58.0%, respectively. Frequencies of the other four genotypes had no statistical differences among Kazak and Han EH patients and their normotensive controls. These results suggest polymorphisms of Cx37 rs1630310 and Cx43 rs1925223 genes may be associated with the pathogenesis of EH. Carrying Cx37 rs1630310-A or Cx43 rs1925223-G genotypes may protect against the development of EH.

ADRB2 polymorphisms and dyslipidemia risk in Chinese hypertensive patients

ABSTRACTSingle nucleotide polymorphisms (SNPs) within a β-adrenergic receptor (ADRB2) were shown to be related to lipid traits or hyperlipidemia in different ethnicities, but not in a Chinese population. We performed the present study to investigate the possible relationship between them in a Chinese hypertensive population. Seven hundred and eighty-three hypertensive subjects were enrolled in the hospital-based retrospective research. Using the TaqMan PCR method, three polymorphisms (C-47T, A46G, and C79G) of ADRB2 were detected. For the whole population, no significant statistical difference was found for all serum lipids. Similar findings were seen in men and women subgroups. Subsequently, in the case-control study, we observed that the A46G polymorphism was significantly associated with the elevated risk of hypertriglyceridemia in the dominant model (OR: 1.47, 95%CI: 1.05–2.06, P = 0.025). There are no significant differences in the other four models. With regard to C79G and C-47T, no significant association was seen in this population. In addition, haplotype analysis showed that the TAC haplotype carrying frequent alleles of the three SNPs played a reduced role in hypertriglyceridemia risk and the TGC haplotype carrying rare allele of A46G expressed a significant risk effect. In conclusion, these findings indicated that the ADRB2 SNPs might be a genetic risk factor for dyslipidemia in the Chinese hypertensive patients.

Effect of B Vitamins from Diet on Hypertension

In western populations, a higher level of dietary B vitamins intake has been associated with a lower risk of hypertension. However, data in Chinese is limited, whose B vitamins consumption is low and rates of hypertension are high. To investigate whether the three B vitamins are associated with hypertension in rural Chinese. Cross-sectional survey among 2241 rural Chinese aged 18-80years was conducted in northwestern China in 2010. Blood pressure was measured by trained medical staff and dietary nutrients were assessed with a semiquantitative food frequency questionnaire. 592 cases of hypertension were newly diagnosed. The deficiency proportions were 20.5% for vitamin B-6, 43.9% for folate and 98.5% for B-12. For females, participants in the highest quartile of B-6 intake had a significantly lower risk of hypertension (OR=0.69; 95% CI: 0.50-0.93; p for trend<0.05). For males, the multivariable OR for the same comparison was 0.75 (95% CI: 0.56-0.99, p for trend >0.05). No significant associations were observed between B-12, folate intake and hypertension. For females, the highest quartile of both folate and B-6 intake was associated with a reduced risk of hypertension (OR=0.53; 95% CI: 0.29-0.89), compared with in the middle quartile of both vitamins. Higher intake of vitamin B-6 is independently associated with lower risk of hypertension in Chinese rural adults. Among females with high folate intake, the association between B-6 and hypertension was strongest. Additional studies are warrant to establish the causal inference.

Prevalence, clinical characteristics and echocardiography parameters of non-resistant, resistant and refractory hypertension in Chinese

ABSTRACTObjectives: Refractory and resistant hypertension is defined as hypertension that is uncontrolled despite the use of multiple antihypertensives. The aim of the present study is to evaluate the prevalence, both in young and elderly, and the pattern of left ventricular hypertrophy (LVH) in South-Eastern Chinese patients with refractory, resistant and non-resistant hypertension.Methods: A total of 1455 patients (age 60.3 ± 13.9, male 55.7%) with essential hypertension were recruited. Refractory hypertension was defined as uncontrolled blood pressure (systolic/diastolic, ≥140/90 mm Hg) on ≥5 antihypertensive drug classes. Resistant hypertension was defined as uncontrolled blood pressure (systolic/diastolic, ≥140/90 mm Hg) on 3 or <140/90 mm Hg on ≥4 antihypertensive classes.Results: Among the total population, 1273 (87.4%) patients were considered non-resistant hypertension; 170 (11.7%) with resistant hypertension and 12 (0.8%) with refractory hypertension. The prevalence of the three groups of hypertension were similar between patients age <60 or ≥60. Patients with refractory hypertension had the most dilated LV dimension, greatest left ventricular mass index and highest prevalence of diastolic dysfunction than patients with resistant and non-resistant hypertension. In particular, all patients with refractory hypertension had either concentric or eccentric LVH.Conclusions: In South-Eastern Chinese patients, the prevalence of refractory and resistant hypertension was 0.8% and 11.7%, respectively. Furthermore, no difference was observed in the hypertensive patterns between patients age <60 and ≥60. Importantly, patients with refractory hypertension had the worst LV remodeling with all suffering from either concentric or eccentric hypertrophy.

Gender- and age-specific associations between sleep duration and prevalent hypertension in middle-aged and elderly Chinese: a cross-sectional study from CHARLS 2011–2012

ObjectivesThe impact of gender and age on the association between sleep duration and hypertension is not well known in Asians. The objective of this study was to analyse gender- and...

OS 12-05 THE EFFECT OF INTENSIVE LIFESTYLE INTERVENTION ON BLOOD PRESSURE IN PATIENTS WITH HYPERTENSION, SUB-ANALYSIS FROM CHIEF

Objective: Chinese Hypertension Intervention Efficacy Study (CHIEF) is a multi-center randomized controlled clinical trial. The objective is to evaluate the collective effects of antihypertensive therapy, lipid lowering treatment and lifestyle modification in patients with hypertension. This paper merely present blood pressure lowering effect of intensive lifestyle intervention compared with standard lifestyle intervention. Clinical Trial Registration: Clinical Trials.gov.number NCT 01011660. Design and Method: Patients are eligible for inclusion if they are diagnosed with essential hypertension, aged 50–79 years with at least one cardiovascular risk factor and sign the consent forms. Besides randomized to different antihypertensive drug regimens, patients were randomly assigned to intensive lifestyle intervention group(I) or standard lifestyle intervention group(S) according to the socioeconomic matched community area where they live. After randomization, Patients were followed up at 2- week,1-,2-,3- month and once 3 months thereafter until the final visit at 48- month. Results: 13542 patients from 180 centers in China were randomized into I group or S group. 12552 cases have complete data, with 6028 in I group and 6524 in S group. The baseline characteristics between I group and S group were similar. The mean age was 61.5 years, With 11%, 12% and 18% history of stoke, coronary heart disease and diabetes respectively. 49% patients were male. 91% were taking antihypertensive drugs. The average blood pressure at screening and randomization was 149/89 and 157/93 mmHg respectively. Mean systolic blood pressure reduced by 27.2, 27.6, 27.8 and 27.1 mmHg in I group, and 24.5, 24.9, 25.8 and 25.4 mmHg in S group at 12-,24-,36- and 48- month after different lifestyle modification. Conclusions: Conclusion: Systolic blood pressure reduced to a lower level by intensive lifestyle intervention than standard lifestyle intervention in patients with hypertension.

Mitochondrial tRNA mutations in 2070 Chinese Han subjects with hypertension

BackgroundMitochondria have the profound impact on vascular function in both health and disease. However, mitochondrial genetic determinants for the development of hypertension remain poorly explored. Methods and resultsThe Sanger sequence analysis of 22 mitochondrial tRNA genes were performed in a cohort of 2070 Han Chinese hypertensive and 512 control subjects. This analysis identified 165 variants among 22 tRNA genes. These variants were evaluated for the pathogenicity using the following criteria: (1) present in <1% of the controls; (2) evolutional conservation; (3) potential structural and functional alterations. We identified 47 (5 known and 42 novel/putative) hypertension-associated tRNA variants in 80 hypertensive subjects. These variants could have potential structural alterations and functional significance of tRNAs. By using lymphoblastoid cell lines derived from 6 probands carrying one of 6 represented variants (tRNAAla 5655T>C, tRNAGly 10003T>C, tRNALeu(UUR) 3253T>C, tRNAAsp 7551A>G, tRNAGlu 14692A>G, tRNAThr 15909A>G) and 6 control subjects lacking these variants, we showed marked reductions in the steady-state level of corresponding 5 tRNAs, but not tRNAThr, in mutant cell lines, compared with control cells lines. The various decreases in the activities of complexes I, III and IV were observed in mutant cells carrying one of five tRNA variants, except tRNAThr 15909A>G variant. The deficient respirations were responsible for the decrease in the mitochondrial ATP production and increasing production of reactive oxygen species in mutant cell lines carrying one of five tRNA variants. ConclusionMitochondrial tRNA variants are the important causes of hypertension, accounting for 3.9% cases of 2070 Han Chinese hypertensive subjects. Our findings may provide new insights into the pathophysiology of hypertension that were manifested by mitochondrial dysfunction.

Comparison of visceral and body fat indices and anthropometric measures in relation to untreated hypertension by age and gender among Chinese

BackgroundThe aim of the study was to compare the efficiency of bioelectrical indices (percentage body fat, PBF; visceral fat index, VFI) and various anthropometric measures (body mass index, BMI; waist circumference, WC; waist-to-height ratio, WHtR) on determining hypertension in Chinese. MethodsWe conducted the community-based cross-sectional survey during August of 2013 to August of 2015 in 66 sample sites selected by multistage random sampling method from Henan province. 14,364 residents were included in the study. ResultsIn both genders, VFI and PBF tended to rise with age. However, for each age-specific group, men consistently had significantly greater VFI than women (all P<0.0001) and women had considerably higher PBF (all P<0.0001). The odds ratios and area under the ROC curves (AUCs) for hypertension associated with adiposity indices decreased with age. In younger (15~34year) men and women, VFI had the highest crude (2.43–7.95) and adjusted (2.40–11.63) odds ratio for hypertension. The AUCs for PBF, VFI and WHtR were significantly larger than those for BMI and WC (all P<0.01). Whereas no statistically significant difference were found in AUCs among PBF, VFI and WHtR (all P>0.10). Additionally, VFI and PBF yielded the greatest Youden index in identifying hypertension in men (0.27) and women (0.34), respectively. Optimal cutoffs for VFI/PBF were 11.70/24.45 and 7.55/33.65 in men and women, respectively. ConclusionsVFI and PBF could be better candidates for identifying hypertension in men and women, respectively. Adolescents and young adults should be highlighted in preventing hypertension by control of excess body and visceral fat.