Objective To investigate the possible association between serum level of hepatocyte growth factor( HGF) and obstructive sleep apnea hypopnea syndrome( OSAHS) with hypertension.Methods 58 cases of OSAHS without hypertension, 61 cases of OSAHS with hypertension, and 50 normal controls were enrolled. Serum level of HGF was measured by enzyme-linked immunosorbent assay( ELISA) , and the relationships between the serum HGF level and blood pressure( BP) , apnea hypopnea index( AHI) , lowest SaO2 ( LSaO2 ) were analyzed by linear correlation analysis. Results The serum HGF level ( pg/mL) was 761. 46 ±60. 18, 970. 87 ±60. 94, and 487. 34 ±45. 52 in the OSAHS patients without hypertention, OSAHS patients with hypertention, and normal subjects, respectively. Which was significantly higher in the OSAHSpatients than the normal subjects, and highest in the OSAHS patients with hypertension( P lt; 0. 05) . The serum HGF level was positively related to AHI( r = 0. 452, P lt;0. 05) and negatively related to LSaO2 ( r =- 0. 328, P lt;0. 05) in the OSAHS patients without hypertention, positively related to AHI, SBP, DBP( r =0. 670, P lt;0. 01; r =0. 535, P lt;0. 05; r =0. 424, P lt;0. 05) and negatively related to LSaO2 ( r = - 0. 572,P lt;0. 01) in the OSAHS patients with hypertension. Conclusions SerumHGF level increases significantly in patients with OSAHS especialy in OSAHS patients with hypertension, and positively correlates with the severity of OSAHS and hypertension.
Objective To collect and analyze the qualitative studies on patients’ compliance with hypertension management in the community, and to summarize the factors influencing the compliance from the view of patients. Methods Eleven electronic databases and search strategies and words were determined through discussion by experts and the review group. After the selection and critical appraisal of the retrieved studies were performed by two reviewers independently, meta-summary was employed for the results of qualitative studies. Results Five studies were included. The results showed some factors had great impact on the compliance of patients, including patients’ knowledge of hypertension and its treatment, doctor-patient relationship, patients’ financial status, social support, designing of treatment plans, and patients’ individual conditions. Conclusion To improve doctors’ technical competence, building good doctor-patient relationship, strengthening patients’ individualized health education, formulating the proper treatment plan, and making good use of the social support system would promote the compliance with hypertension management in the community.
ObjectivesTo systematically review the influence of nifedipine combined with atorvastatin on hypertension in patients with hypertension.MethodPubMed, EMbase, The Cochrane Library, CBM, CNKI, WanFang Data and VIP databases were electronically searched to collect randomized controlled trials (RCTs) of nifedipine combined with atorvastatin on hypertension in patients with hypertension from inception to November 20th, 2018. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies, then, meta-analysis was performed by using Stata 12.0 software.ResultsA total of 17 RCTs involving 1 838 patients were included. The results of meta-analysis indicated that nifedipine combined with atorvastatin was superior to nifedipine alone on SBP (MD=?8.937, 95%CI?11.913 to ?5.962, P<0.001), DBP (MD=?3.702, 95%CI?6.626 to ?0.778, P=0.013) and total effective rate (RR=1.24, 95%CI 1.07 to 1.44, P=0.003). There was no significant difference between two groups in the incidence of adverse reactions (P>0.05).ConclusionsCurrent evidence shows that nifedipine combined with atorvastatin can significantly improve total effective rate, decrease the level of SBP and DBP, and increasing of dose not increase the incidence of adverse reactions. Due to limited quality and quantity of the included studies, more high quality studies are required to verify above conclusions.
ObjectiveTo analysis the situation of health management service project for patients with hypertension in basic public health service project of Sichuan province from 2015 to 2016, and to provide enhancing suggestions for community prevention of hypertension.MethodsA total of 42 health clinics or community health service centers, 21 counties and 21 cities were extracted each year by method of multistage stratified random sampling from 2015 to 2016. In each institution, we sampled 10 residents, health records of hypertension. Telephone survey was used to judge the accuracy and standard ability of services the patients received according to the national basic public health service specifications, such as personal information, physical examing records, follow up information.The blood pressure of the last follow-up was recorded.ResultsRate of the managed hypertension was from 42.09% to 40.31% (χ2=115.33, P<0.05), rate of the records with accurate information was from 84.29% to 88.79% (χ2=1.94, P=0.16), and rate of the patients received normative services was from 69.49% to 72.33% (χ2=0.54, P=0.57). The control rate of blood pressure was from 82.66% to 85.37% (χ2=0.52, P=0.48). The standardization of the service could obviously improve blood pressure control rates (χ2=22.61, P<0.05).ConclusionProgress has been achieved in health management service of hypertension in Sichuan province from 2015 to 2016, however the standardization of the service is needed to be further enhanced.
ObjectiveTo discuss the relationship between microalbuminuria (MAU) and antioxidant activity of plasma hyper density lipoprotein (HDL) in hypertensive patients, and investigate whether MAU could be a predictor of HDL antioxidant activity. MethodFrom December 2007 to March 2009, sixty consecutive primary hypertensive patients from the inpatient and outpatient departments of West China Hospital and Sichuan Electric Power Central Hospital were included in the study, and 30 healthy volunteers served as controls. MAU, plasma HDL and paraoxonase (PON1) activity were tested. ResultsPON1 activity was lower in hypertensive patients than the controls (P<0.05), and this degree of decline was positively related to MAU (P<0.05). ConclusionMAU reflects PON1 activity in hypertensive patients and can be a predictor to judge plasma HDL function in patients with hypertension.
【Abstract】ObjectiveTo summarize the study on the feasibility of celiac axis ligation. Methods Literatures about celiac axis ligation were reviewed retrospectively. ResultsCeliac axis branches included common hepatic artery， splenic artery， left gastric artery which had many variation and collateral flow between celiac and mesenteric vessels by gastroduodenal artery and pancreaticoduodenal artery. Celiac axis could be possibly ligated without obvious complications in patients who had celiac axis injuries, celiac artery aneurysms, upper gastrointestinal haemorrhage, excision of carcinoma around the celiac axis and portal hypertension. However, gallbladder necrosis or perforation, focal infarction of the liver even higher mortality had also been reported. ConclusionCeliac axis ligation should not be performed routinely, but it is surgically possible and may be a life saving approach in certain circumstances.
Hypertension is a strong risk factor for atherosclerotic cardiovascular disease (ASCVD), heart failure, and microvascular complications. Hypertension is common among patients with diabetes. Recently, the American Diabetes Association (ADA) published a new position statement which updated the assessment and treatment for hypertensive patients with diabetes. This interpretation is intended to help Chinese clinicians to understand the new ADA position statement.
Objective To assess the efficacy and safety of rosiglitazone in treating type 2 diabetes mellitus (T2DM) with essential hypertension (HBP). Methods Such databases as The Cochrane Library (Issue 4, 2009), PubMed (1970 to May 2010), CBM (1978 to May 2010), CNKI (1996 to May 2010), WanFang Database (1999 to May 2010), VIP (1996 to May 2010), and Google Scholar were searched on computer, and the relevant journals such as Chinese Journal of Diabetes Mellitus were also hand researched to investigate references and collect randomized controlled trials (RCTs) about rosiglitazone (experimental group) compared with non-rosiglitazone (control group) in treating T2DM with HBP. The data were extracted according to the inclusion and exclusion criteria by two reviewers independently, the quality of the included studies was assessed according to the Cochrane Handbook for Systematic Reviews of Interventions Version 5.0, and meta-analysis was conducted by using RevMan 5.0 software. Results Among 10 RCTs involving 738 patients, one was in English from Greece, while nine were in Chinese. The average score quality of the included studies was in C level. The results of meta-analyses showed that the experimental group was more effective than the control group in lowering blood pressure levels (SBP: WMD= –17.83 mmHg, 95%CI –27.63 to –8.02; DBP: WMD=–7.81 mmHg, 95%CI –10.18 to –5.44), blood glucose levels (FBG: WMD= –1.66 mmol/L, 95%CI –3.08 to –0.23; PBG: WMD= –2.38 mmol/L, 95%CI – 4.12 to –0.64), triglyceride (TG) levels (WMD= –0.29 mmol/L, 95%CI –0.43 to –0.14), low-density lipoprotein cholesterol (LDL-C) levels (WMD= –0.76 mmol/L, 95%CI –1.02 to –0.50), insulin levels (FINS: WMD= –7.06 mU/L, 95%CI –9.47 to –4.65; PINS: WMD= –98.86 mU/L, 95%CI –116.38 to –81.34), glycosylated hemoglobin (HbA1c) levels (WMD=–0.75%, 95%CI –1.07 to –0.42), and insulin resistance index (HOMA-IR) (WMD= –1.61, 95%CI –2.18 to –1.05); the experimental group was more effective than the control group in increaseing the high-density lipoprotein cholesterol levels (HDL-C) (WMD=0.21 mmol/L, 95%CI 0.12 to 0.30), and insulin sensitivity index (ISI) (WMD=1.64, 95%CI 1.48 to 1.80); the therapeutic effect for hypertension was greater in the experimental group than in the control group (OR=9.35, 95%CI 4.76 to 18.35); there were no significant differences in cholesterol levels (TC) (WMD= –0.22 mmol/L, 95%CI –0.55 to 0.10), body mass index (BMI) (WMD= –0.26 kg/m2, 95%CI –0.86 to 0.33), heart rates (HR) (WMD=0.50 bpm, 95%CI –4.98 to 5.98), and urine albumin excretion (UAE) (WMD= –16.00mg/24h, 95%CI –37.90 to 5.90); additionally, there were also no significant differences in adverse reactions between the two groups, such as edema (OR=3.01, 95%CI 0.62 to 14.54), gastro-intestinal discomfort (OR=1.19, 95%CI 0.63 to 2.24), headache and fatigue (OR=9.79, 95%CI 0.51 to 186.95), and anemia (OR=2.38, 95%CI 0.09 to 59.90). Conclusion To treating patients suffering from T2DM with HBP, the rosiglitazone is much effective than the control group in lowering blood pressure, blood glucose and lipid, reducing insulin resistance and improving β-cell function.
ObjectiveTo investigate the association between CYP11B2 gene polymorphism and left ventricular hypertrophy in Chinese hypertensive patients by the means of meta-analysis. MethodsLiteratures about case control study on the association of CYP11B2 gene polymorphism and left ventricular hypertrophy were searched from January 1980 to December 2012.The electronic databases searched included China national knowledge internet,Chinese biological medicine disk,Vip fulltext database,Wanfang fulltext database and Pubmed.Odds ratio (OR) of CYP11B2 genotype distributions in left ventricular hypertrophy (LVH) patients against NLVH patients were analyzed.RevMan 5.1 software was applied for investigating heterogeneity among individual studies and summarizing effects across studies by proper statistical methods. ResultsSix case-control studies were selected finally.A total of 1 791 hypertensive patients were included.The pooled OR (95% CI) of CC vs.TT+TC genotype was 1.21(0.80,1.81)(Z=0.91,P=0.36),the pooled OR (95% CI) of (TC+CC) vs.TT genotype was 1.16(0.68,1.98)(Z=0.54,P=0.59),and the pooled OR (95% CI) of C vs.T allele was 1.09(0.78,1.54)(Z=0.51,P=0.61). ConclusionThe genotype of CYP11B2 polymorphism is not associated with an increase risk of left ventricular hypertrophy in Chinese hypertensive patients.
ObjectivesTo systematically review the relationship between cadmium exposure and the risk of hypertension.MethodsPubMed, EMbase, The Cochrane Library, CBM, WanFang Data, VIP and CNKI databases were searched online to collect studies of cadmium exposure and hypertension from inception to March 2018. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies. Meta-analysis was then performed by Stata 12.0 software.ResultsA total of 9 studies were included, of which 19 841 cases were patients of hypertension, and 27 578 cases were in the control group. The results of meta-analysis showed that blood cadmium was associated with risk of hypertension (OR=1.23, 95%CI 1.17 to 1.30, P<0.001). However, no significant association was found between urinary cadmium and the risk of hypertension (OR=0.77, 95%CI 0.55 to 1.07,P=0.61). The results of subgroup analysis showed non-smokers (OR=1.19, 95%CI 1.09 to 1.31, P<0.001), males (OR=1.19, 95%CI 1.11 to 1.28,P<0.001), females (OR=1.28, 95%CI 1.18 to 1.40,P<0.001), yellow race (OR=1.26, 95%CI 1.19 to 1.34,P<0.001), and the literatures published after 2010 (OR=1.24, 95%CI 1.17 to 1.31,P<0.001) were associated with risk of hypertension in blood cadmium. The current smokers (OR=0.72, 95%CI 0.56 to 0.93,P=0.013), yellow race (OR=0.65, 95%CI 0.50 to 0.83, P=0.001), and the literatures published before 2010(OR=0.61, 95%CI 0.50 to 0.75, P<0.001) were associated with risk of hypertension in urinary cadmium.ConclusionsBlood cadmium is associated with risk of hypertension and high level of blood cadmium is a risk factor for hypertension. The levels of blood cadmium of non-smokers, males, females, yellow race are associated with risk of hypertension in blood cadmium. Urinary cadmium was not significantly associated with the risk of hypertension. The above conclusions are required to be verified by more high quality studies.