Higher Systolic Blood Pressure Research Articles

Association of scalloped tongue with blood pressure among community-dwelling Japanese: The Toon Health Study.

In traditional East Asian medicine, scalloped tongue, characterized by dental indentations, indicates fluid retention and may be associated with hypertension. Few epidemiological studies have examined the association between scalloped tongue and blood pressure. Therefore, we aimed to examine this association in the Japanese general population. This study included 1,681 individuals, aged 30-84 years, who had participated in the Toon Health Study. The scalloped tongue was assessed using tongue images and we classified them into two groups: scalloped and non-scalloped. Systolic blood pressure (SBP) and diastolic blood pressure (DBP) were measured and hypertension was defined as SBP ≥ 140 mmHg, DBP ≥ 90 mmHg, or the use of antihypertensive medication. Multivariable-adjusted Poisson regression analyses were used to examine the association between scalloped tongue and blood pressure after adjusting for potential confounders including age, sex and body mass index. Of the participants, 326 (19.6%) had scalloped tongue and 624 (51.6%) had hypertension. The multivariable-adjusted means of SBP were 126.6 mmHg and 129.7 mmHg in the non-scalloped and scalloped tongue groups (p < 0.01), respectively. The respective means of DBP were 76.5 mmHg and 78.0 mmHg (p = 0.02). The multivariable-adjusted prevalence ratios (95% confidence intervals) for hypertension and the highest quartile of SBP and DBP for scalloped tongue were 1.21 (1.04-1.41), 1.50 (1.23-1.84), and 1.25 (1.03-1.53), respectively, compared to the non-scalloped tongue group. The present study found that participants with scalloped tongue had higher SBP and DBP, even after adjusting for potential confounding factors.

Macular ganglion cell complex layer thickness measured with spectral-domain OCT in a large population-based cohort study

PurposeTo establish the normal GCC thickness profile in the general population using SD-OCT in different macular sectors. Determining the systemic and ophthalmic factors associated with GCC thickness and further identifying the potential risk factors were the secondary objectives.MethodsParticipants in the population-based cohort study had to be at least thirty years old. Every participant had a routine ophthalmological examination. Using SD-OCT, the GCC thickness was determined. To assess the relationship between GCC thickness and systemic and ocular characteristics, mixed linear models were used. R V.4.1.1 was the statistical analysis program utilized.ResultsTwo thousand four hundred ninety subjects, average age 56.60 ± 10.39 years, were collected in this analysis. GCC average thickness measured was 95.57 ± 7.47 μm. The GCC thickness of the superior (95.46 ± 7.87 μm) was the thinnest, and the inferior subfield (95.68 ± 7.66 μm) was thickest. In the multivariate regression analysis, a thinner GCC was majorly linked to being older (P < 0.001), current smoking (P < 0.001), no diabetes (P = 0.014), and a larger vertical cup disc ratio (VCDR) (P < 0.001). When the data was divided by age, a thinner GCC was also connected to female (P < 0.001), current smoking (P = 0.006), having high systolic blood pressure (SBP) (P = 0.002), lower low-density lipoprotein (LDL) (P = 0.002), higher triglycerides (TG) (P = 0.029), higher best corrected visual acuity (BCVA) (P < 0.001), and a larger vertical cup disc ratio (VCDR) (P = 0.002). Stratified by axial length (AL), a thinner GCC was associated with advanced age (P < 0.001), female (P = 0.005), and a larger VCDR (P = 0.001).ConclusionsOur study provides benchmarks for GCC thickness, distribution, and linked ocular and systemic factors among middle-aged individuals in rural China, emphasizing the strong correlation between GCC thickness and multiple ocular and systemic variables. Additionally, our findings underscore the importance of establishing global normative databases to address ethnic variations in GCC thickness and the distinctiveness of related ocular and systemic factors.

Clinical implications of a history of pre-eclampsia in women with type two diabetes mellitus.

The consequences of pre-eclampsia (PE) are not limited to pregnancy; a single episode predisposes mothers to serious future health outcomes. Little is known about how PE impacts the course of type 2 diabetes (T2D) and associated microvascular diseases. The Scottish Care Information for Diabetes data for individuals with diabetes in NHS Tayside and Fife was linked with Scottish maternity morbidity records. A nested case-control study compared BMI, HDL cholesterol, systolic blood pressure(SBP) and HbA1c measures at T2D diagnosis between women with prior pregnancies from 1921 to 2022 affected or unaffected by PE using linear regression and adjusted for the other aforementioned variables. Cox regression models assessed how a PE history influenced the risk of future microvascular complications following T2D diagnosis. In total, 6055 women were eligible: 726 (12%) had a PE-pregnancy and 5329 (88%) had only PE-free pregnancies, with ~20 years between pregnancy and T2D diagnosis. At T2D diagnosis, women with a PE history had higher BMI (38.3 kg/m2 vs. 35.7 kg/m2, p < 0.001), higher SBP (139 mmHg vs. 135 mmHg, p < 0.001), lower HDL cholesterol (1.18 mmol/L vs. 1.21 mmol/L, p = 0.002) and were diagnosed 3.2 years earlier (p < 0.001). A PE history was associated with increased microvascular disease risk (HR 1.26 95% CI 1.12-1.42, p < 0.001): diabetic retinopathy (HR 1.22 95% CI 1.07-1.38, p = 0.003); chronic kidney disease (HR 1.35 95% CI 1.06-1.71, p = 0.016); diabetic proteinuric kidney disease (HR 2.45 95% CI 1.03-5.81, p < 0.001). Women with a PE history were ~5 years younger when they developed cardiovascular disease (55.7 years vs. 60.6 years, p < 0.001) and all-cause death (60.1 years vs. 65.6 years, p < 0.0001). At T2D diagnosis, women with a PE history are younger, with more severe clinical presentations and increased risk of developing T2D microvascular complications. This highlights the crucial need for changes to the long-term care of this high-risk group, with aggressive risk-factor management and continued clinical assessment.

Impact of antihypertensive administration strategy on time to thrombolysis in acute ischemic stroke.

Impact of antihypertensive administration strategy on time to thrombolysis in acute ischemic stroke.

Systematic Review of Prehospital Prediction Models for Identifying Intracerebral Haemorrhage in Suspected Stroke Patients

Introduction: The prompt prehospital identification of intracerebral haemorrhage (ICH) may allow very early delivery of treatments to limit bleeding. Current prehospital stroke assessment tools have limited accuracy for the detection of ICH as they were designed to recognise all strokes, not ICH specifically. This systematic review aims to evaluate the performance of prehospital models in distinguishing ICH from other causes of suspected stroke. Methods: We adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Following a predefined strategy, we searched three electronic databases via Ovid (MEDLINE, EMBASE, and CENTRAL) in July 2023 for studies published in English, without date restrictions. Subsequently, data extraction was performed, and methodological quality was assessed using the Prediction Model Risk of Bias Assessment Tool. Results: After eliminating duplicates, 6194 records were screened for titles and abstracts. After a full-text review of 137 studies, 9 prediction studies were included. Five of these described prediction models were designed to differentiate between stroke subtypes, three distinguished between ICH and ischaemic stroke, and one model was developed specifically to identify ICH. All studies were assessed as having a high risk of bias, particularly in the analysis domain. The performance of the models varied, with the area under the receiver operating characteristic curve ranging from 0.73 to 0.91. The models commonly included the following as predictors of ICH: impaired consciousness, headache, speech or language impairment, high systolic blood pressure, nausea or vomiting, and weakness or paralysis of limbs. Conclusions: Prediction models may support the prehospital diagnosis of ICH, but existing models have methodological limitations, making them unreliable for informing practice. Future studies should aim to address these identified limitations and include a broader range of suspected strokes to develop a practical model for identifying ICH. Combining prediction models with point-of-care tests might further improve the detection accuracy of ICH.

Prognosis of primary aldosteronism achieved incomplete surgical remissionand changes in plasma aldosterone, plasma renin activity and biochemical indicators

Background and Purpose: Some primary aldosteronism (PA) patients with spontaneous hypokalemia achieved incomplete remission after surgical treatment. In this study, we aim to construct a nomogram to predict surgical benefits for PA patients with typical symptoms, which may help doctors assess prognosis and develop treatment plans. Methods: This retrospective cohort study enrolled 162 patients between January 2017 and January 2024. Baseline characteristics, clinical indicators, and biochemical results were compared among patients with different clinical and biochemical outcomes. A nomogram was developed and internally validated with risk factors selected from univariate and multivariate logistic regression analyses. Results: Respectively, complete clinical and biochemical success was achieved in 69 patients (42.6%) and 129 patients (79.6%). Five risk factors for incomplete remission were used to develop a nomogram. The area under the receiver operating characteristic curve (AUC) was 0.856 (0.788-0.924) in the training dataset and 0.726 (0.580-0.872) in the validation dataset. The calibration curve showed good agreement, and the decision curve analysis demonstrated clinical utility of this model. Conclusions: PA patients with older age, higher systolic blood pressure, lower plasma aldosterone, more than 5 years of hypertension, and an adrenal gland mass on the left side or both sides had more probability to achieve incomplete remission after the surgery.

Prevalence, incidence, and risk factors of diabetic retinopathy and macular edema in patients with early and late-onset type 2 diabetes mellitus.

To compare the prevalence, incidence, and factors of diabetic retinopathy (DR) and macular edema (DME) in patients with early-onset (EOD) and late-onset diabetes (LOD). Participants with type 2 diabetes mellitus (T2DM) were recruited from a community-based study conducted in southern urban China. Participants were followed up for 2 years. The prevalence and incidence of DR and DME were compared between EOD (≤40 years) and LOD (>40 years) groups, and potential factors were evaluated using multivariate logistic regression. Among 2,703 participants, 173 (6.4%) with EOD had a higher prevalence of DR than 2,530 (93.6%) with LOD (27.8% vs 15.5%, P < 0.001). Participants with EOD had a higher incidence of DR, although this difference was not statistically significant (EOD: 8.1% vs LOD: 3.6%, P = 0.12). Insulin use and higher HbA1c levels were significantly associated with DR in both EOD and LOD groups (both P < 0.05). Additionally, longer diabetes duration, higher systolic blood pressure, and the presence of albuminuria independently associated with the presence of any DR in LOD patients (all P < 0.05). For DME, HbA1c level was a significant association in EOD, while in LOD, age, BMI, insulin use, and albuminuria were significant factors (all P < 0.05). A higher prevalence of DR was observed among patients with early-onset T2DM in urban southern China. Timely diagnosis of DR and regular eye care services are needed for early-onset T2DM.

Reducing Hypertension through Volunteering? Investigating the Potential Causal Link between Volunteering Frequency and Blood Pressure by Gender, Race, and Age Groups.

This project examined the relationship between volunteering and changes in systolic and diastolic blood pressure by gender, race, and age groups as potential effect modifiers. Using the Health and Retirement Study (2006-2016, N=18,847), this study assessed the link between volunteering and blood pressures within each stratum of gender, race/ethnicity, and age groups. The combined effects of volunteering and each of the effect modifiers estimated by the relative excess risk due to interaction (RERI) and ratio of prevalence ratios (RPR). Individuals volunteering 201+ hours annually had a lower likelihood of clinically high diastolic (PR=0.85, 95% CI: 0.72, 0.98, P=0.042) and systolic (PR=0.98, 95% CI: 0.97, 0.99, P=0.038) blood pressure. Moderate level of volunteering was predictive of low systolic blood pressure. The combination of volunteering 201+ hours and being female was protective against high diastolic blood pressure (RERI=-0.09, 95% CI: -0.13, -0.03, P=0.026). Given the effect modification, frequent volunteering has an anti-hypertensive effect for the general population of adults 50 and older.

Comparative analysis of stroke burden between ages 20–54 and over 55 years: based on the global burden of disease study 2019

BackgroundStroke remains one of the major diseases threatening human health and life worldwide. Therefore, it is urgent to investigate the stroke burden in different age groups.MethodsWe described the disease burden of three subtypes of stroke, namely intracranial haemorrhage (ICH), subarachnoid haemorrhage (SAH), and ischaemic stroke (IS), among people aged 20 ~ 54 years and > 55 years from 1990 to 2019, based on data from Global Burden of Disease Study 2019 and calculated the estimated annual percentage changes (EAPC) for age-specific incidence, disability-adjusted life-years (DALYs), mortality and prevalence rates. Joinpoint regression analyzes showed the critical years of trend inflexion points. Decomposition and health inequality analyses determined the impact of different epidemiological factors on stroke burden. Population-attributable fractions were calculated for deaths and DALYs due to risk factors.ResultsFrom 1990 to 2019, the incidence of ICH and SAH decreased by 11.32% and 10.45%, respectively, in the 20–54 age group globally, while the incidence of IS increased by 14.95%. Meanwhile, the incidence of stroke in the > 55 years group showed an overall decreasing trend. The burden of adverse outcomes, including death and DALYs, varied by stroke subtype, with the rates of mortality and DALYs decreasing significantly less in IS than in ICH and SAH. In addition, the decline in mortality and DALYs rates was consistently greater in the over 55 years age group than in the 20–54 years age group. Notably, the prevalence of ICH, SAH, and IS increased by 20.55%, 11.50%, and 7.38% in the 20–54 years age grouper group, respectively, whereas in the elderly group, there was only a mild increase of IS in the over 55 years group. What is more, stroke burden showed a negative correlation with regional development. Furthermore, high systolic blood pressure was a common contributor to stroke burden in both age groups. The difference is that a high body mass index affects people aged 20–54 years more, while abnormal fasting blood glucose affects older people more.ConclusionThe stroke burden in people 20–54 years of age is increasingly becoming a global health problem, particularly the incidence of IS in lower economic development areas.Clinical trial numberNot applicable.

Trends and Projections of Burden of Ischemic Heart Disease in China Versus Other G20 Countries: A Comparative Study Based on the 2021 Global Burden of Disease Database

Objective: This study aims to analyse the burden of ischemic heart disease (IHD) in China and other G20 countries from 1990–2021 and predict the burden for the next decade. Methods: Using data from the Global Burden of Disease (GBD) 2021 study, we evaluated the age-standardised rates (ASRs) of incidence, prevalence, mortality and disability-adjusted life years (DALYs) by estimated annual percentage change (EAPC). The Bayesian age-period-cohort (BAPC) model was used to forecast the incidence, mortality and DALY rates of IHD in China from 2021–2040. Results: The ASRs of incidence, mortality and DALYs of IHD in China increased with EAPCs of 0.66 (95% CI: 0.50, 0.82), 0.97 (95% CI: 0.63, 1.31) and 0.51 (95% CI: 0.24, 0.78), respectively. Compared with other G20 countries, China was ranked 14th for the ASR of incidence in 1990 and then rose to 7th in 2021. The ASR of prevalence for IHD in China jumped from 8th in 1990 to 5th in 2021, and both the ASR of mortality and DALYs for IHD in China ranked 7th in 2021. The top five risk factors affecting mortality in China in 2021 were high systolic blood pressure, dietary risk, air pollution, high LDL cholesterol and tobacco. Over the next 20 years, the ASR of incidence, mortality and DALYs for IHD will increase continuously in males. Conclusion: The burden of IHD is expected to increase steadily in China, highlighting the urgency for early monitoring and preventative strategies, particularly focusing on the elderly and male populations.

Serum Growth Differentiation Factor 15 is Negatively Associated with Leukocyte Telomere Length.

Serum Growth Differentiation Factor 15 is Negatively Associated with Leukocyte Telomere Length.

Predictors of Poor Sleep Quality in Heart Failure Patients: A Cross-sectional Multivariable Analysis of Clinical, Demographic, and Psychosocial Factors

Background: Sleep quality is crucial in heart failure (HF) patients, yet its associations with clinical, demographic, and psychosocial factors remain underexplored. This study examined these relationships to identify predictors of poor sleep quality. Study Design: A cross-sectional study. Methods: This cross-sectional was conducted on 354 HF patients at Shahid Chamran Heart Hospital, Isfahan, Iran (September 2023-2024). Pittsburgh Sleep Quality Index (PSQI) and Hospital Anxiety and Depression Scale (HADS) were used to evaluate sleep quality, anxiety, and depression, respectively. Random forest (RF) modeling and ordinary least squares (OLS) regression identified predictors of poor sleep quality. Results: Poor sleep quality (PSQI&gt;7) was observed in 18% of patients who were older (70.00±6.30, P&lt;0.001) and had lower ejection fraction (EF) (23.75±12.79%, P&lt;0.001). This group also had higher systolic blood pressure (BP 140.67±12.50 mmHg, P=0.014). Complex medication regimens, including angiotensin-converting enzyme (ACE) inhibitors, beta-blockers, and diuretics, were associated with poor sleep (P&lt;0.001). Moreover, depression (HADS-depression: 5.36±0.70, P&lt;0.001) and anxiety (HADS-anxiety: 4.84±1.32, P&lt;0.001) were correlated with poor sleep. The RF model had an area under the curve of 0.79, and OLS regression (R2=0.280) highlighted New York Heart Association (NYHA) class and medication type as significant predictors. Conclusion: Overall, poor sleep quality in HF patients was related to older age, reduced cardiac function, higher blood pressure (BP), complex medication regimens, and increased anxiety and depression. Accordingly, multidimensional management strategies are needed to improve sleep outcomes.

Sex Difference in the Association Between Regional Adipose Tissue and Left Ventricular Hypertrophy.

Background: Left ventricular hypertrophy (LVH) is a key predictor of cardiovascular disease. This study aimed to investigate the correlation between LVH and regional adipose tissue deposits, including visceral adipose tissue (VAT), subcutaneous adipose tissue (SAT), and epicardial adipose tissue (EAT), and sex-related differences in these correlations. Methods: A total of 416 individuals (median age 66 years, range 20-95), without structural heart disease or a history of hypertension and coronary artery disease, underwent echocardiography and abdominal computed tomography. Statistical analyses included logistic and linear regression to assess the associations between adipose tissue measures and LVH. Results: LVH was associated with older age, higher systolic blood pressure, and increased EAT thickness. EAT thickness was independently associated with LVH in women (OR 1.21, 95% CI 1.03-1.44, p = 0.024) but not in men. Scatter plot analysis revealed a positive correlation between EAT and left ventricular mass index (LVMI) in women (r = 0.366, p < 0.001) and a negative correlation in men (r = -0.153, p = 0.038). Conclusions: VAT and SAT showed no significant associations with LVMI or LVH in either sex. These findings suggest that EAT, but not VAT or SAT, is linked to cardiac remodeling in a sex-specific manner.

The correlation between inflammatory factors and renal function impairment in patients with proliferative diabetic retinopathy undergoing vitrectomy

Objective: To investigate the correlation between inflammatory factors and renal function impairment in patients with proliferative diabetic retinopathy (PDR) undergoing pars plana vitrectomy. Methods: The clinical data of patients with PDR who underwent vitreoretinal surgery at Beijing Tongren Hospital, Capital Medical University, from July 2019 to January 2021 were retrospectively analyzed. Using a estimated glomerular filtration rate (eGFR) cut-off value of<60 ml·min-1· (1.73 m2)-1, the cohort was stratified into two groups: renal impairment group and non-renal impairment group. The differences between the two groups were compared, and a multivariate logistic regression model was used to examine the factors associated with renal function injury. Results: A total of 923 patients aged (51.5±11.6) years were enrolled in the study, including 537 males and 386 females. There were 151 patients (16.4%) and 772 patients (83.6%) in renal impairment group and non-renal impairment group, respectively. Compared with the non-renal impairment group, the renal impairment group had higher systolic blood pressure (SBP), neutrophil count, high-sensitivity C-reactive protein (hs-CRP), homocysteine, triglycerides, total cholesterol, and complement C4 levels (all P<0.05). However, glycated hemoglobin (HbA1c), lymphocyte count, serum albumin, high-density lipoprotein cholesterol (HDL-C), and complement C3 levels were lower in the renal impairment group (all P<0.05). Multivariate logistic regression analysis demonstrated that elevated hs-CRP (OR=1.041, 95%CI: 1.002-1.082), reduced complement C3 (OR=0.996, 95%CI: 0.995-0.998), and elevated complement C4 (OR=1.007, 95%CI: 1.005-1.010) were inflammatory-related factors associated with renal impairment in patients with PDR. Other related factors included SBP (OR=1.015, 95%CI: 1.002-1.028), serum albumin (OR=0.842, 95%CI: 0.806-0.879), and homocysteine (OR=1.098, 95%CI: 1.064-1.132). Conclusion: There is a correlation between inflammatory factors (such as hs-CRP, complement C3, and complement C4) and the occurrence of renal function impairment in PDR patients undergoing vitrectomy.

Association between spatial social polarisation and high blood pressure in older adults

BackgroundUsing data from the Cardiovascular Health Study (CHS) and the REasons for Geographic And Racial Differences in Stroke (REGARDS) study, we investigate the association between socioeconomic polarisation and blood pressure...

Modifiable dementia risk factors in Chilean adults are distinctively associated with social determinants of health. Cross-sectional study

BackgroundIn Latin America, dementia cases will double by 2050. For effective prevention in this region, it is crucial to comprehend the distribution of dementia risk factors within the local population and to assess their association with social determinants of health (SDH). Our objective was to explore the association between different modifiable dementia risk factors within the Chilean population in a cross-sectional study.Methods3379 dementia-free subjects ≥ 45 years old from the 2016–2017 Chilean National Health Survey were analyzed and stratified into four groups by sex and age, searching for clusters using six continuous variables that had been related to dementia risk (years of education, systolic blood pressure, body mass index (BMI), units of alcohol consumption, physical activity, and depressive symptoms).ResultsThree clusters of individuals shared similar risk factors in each sex/age group. A cluster with high cardiometabolic risk was present in all sex/age groups, characterized by high systolic blood pressure (HSBP) in men midlife and by HSBP associated with high BMI (HSBP/HBMI) in women and in men later-life. A depressive cluster and a physically inactive cluster were present in 3⁄4 of the sex/age groups. Additionally, there was a cluster that was relatively healthy but had a risk of excessive alcohol consumption in men later-life and a low risk one in women midlife. The HSBP/HBMI and depressive clusters presented a high proportion of multiple dementia risk factors. Lower levels of education (and lower family income) were associated with the HSBP and HSBP/HBMI cluster; in contrast, higher levels of education were associated with clusters with lower risk.ConclusionIn Chile, subpopulations with more disadvantages SDH have a high prevalence of cardiometabolic risk factors. Subpopulations with depression and those with high cardiometabolic risk have a higher accumulation of dementia risk factors. These results highlight that tailored programs improving healthcare accessibility for those with more disadvantages SDH and multidisciplinary interventions for high-risk populations are needed for effective dementia prevention.

Association of outdoor artificial light at night on blood pressure and hypertension: Insights from a population-based survey

Artificial light at night (ALAN) is a growing environmental issue associated with negative health outcomes. Yet, there is a dearth of evidence concerning its effect on blood pressure (BP), especially in Ghana. This study examined the associations between ALAN, blood pressure, and hypertension. The study used data from 13,784 participants in the 2014 Ghana Demographic and Health Survey (GDHS). VIIRS Nighttime Day/Night Band dataset within the Google Earth was used to assess ALAN. Data on BP were obtained from the 2014 GDHS. Linear and logistic mixed effects models were used to analyze the data. Findings showed that higher ALAN score was associated with higher systolic blood pressure (SBP), diastolic blood pressure (DBP), and higher odds of hypertension. We observed higher percentages of SBP, DBP, and hypertension among the majority ethnic populations compared to the minority. Public health interventions should aim to reduce ALAN exposure to benefit human health.

Differences in prevalence and risk factors of diabetic retinopathy among rural and urban residents with diabetes in South China: a cross-sectional study

ObjectiveTo determine the prevalence of diabetic retinopathy (DR) and associated risk factors among rural and urban people diagnosed with type 1 or type 2 diabetes mellitus (PwDM) in southern China.DesignThis...

Penetrating Cardiac Injury: A 20-Year Retrospective Analysis at a High-Complexity University Center.

Penetrating cardiac injury, though infrequent, is associated with substantial mortality. In 2005, our research team conducted a comprehensive retrospective analysis of penetrating cardiac injuries managed at our facility from 1990 to 2003. Now, two decades later, we conducted the present study on penetrating cardiac injuries attended in our hospital over the last 20 years. This is a retrospective analysis of medical records and trauma database data, with a focus on survivors of penetrating cardiac trauma, excluding those deceased upon arrival. Out of 1,093 cases, 25 had penetrating cardiac injuries with an overall mortality rate of 36%. Hemorrhage was the leading cause of death, and survival was correlated with higher systolic blood pressure upon admission and the level of consciousness. The study highlights the need for rapid intervention and emphasizes the importance of managing bleeding and supporting hemodynamics. It also points to areas for improvement in emergency care and the benefits of interdisciplinary collaboration.

Disentangling the effects of various risk factors and trends in lung cancer mortality

Lung cancer is a leading cause of mortality in oncological classifications, yet the impact of various risk factors on lung cancer mortality (LCM) in non-smokers remains unclear. This study aims to weigh out the diverse impact of multiple risk factors on LCM rates and identify trends in LCM rates worldwide. We initially employed Random Forest Tree (RFT) and Gradient Boosting Regression (GBR) to identify common primary factors influencing LCM. After eliminating four common primary factors, a comparative analysis between partial and Pearson correlations was conducted to filter out significant factors in the correlations between risk factors and LCM rates across 204 countries from 2005 to 2019. The findings show that excluding the impacts of occupational exposure to arsenic, smoking, residential radon, occupational exposure to silica, occupational exposure to asbestos, high systolic blood pressure, secondhand smoke, child wasting, and alcohol use had a considerably greater impact on LCM than particular matter pollution (PM2.5). Furthermore, a Multiple Joinpoint Regression analysis identified increasing trends of LCM rates in the 142 countries (e.g., China and India); decreasing trends in 38 countries (e.g., Denmark and Norway), and stable trends in 24 countries (e.g., Sudan, Mali, and Australia). This research suggests that in addition to considering the effects of occupational exposure to arsenic, smoking, residential radon, and occupational exposure to silica on LCM rates, occupational exposure to asbestos, high systolic blood pressure, secondhand smoke, child wasting, and alcohol use should be considered in lung cancer prevention strategies, especially in countries with increasing trends of LCM rates.