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Abstract Nocturnal hypertension is highly prevalent among Chinese and Asian populations, which is mainly attributed to high salt intake and high salt sensitivity. Nocturnal hypertension increases the risk of cardiovascular and all‐cause mortality, independent of daytime blood pressure (BP). However, it can usually be detected by 24‐h ambulatory BP monitoring, rather than routine office or home BP measurement, thus is often underdiagnosed in clinical practice. Currently, no specific guidance is available for the management of nocturnal hypertension in China or worldwide. Experts from the Chinese Hypertension League summarized the epidemiologic and pathophysiologic characteristics and clinical phenotype of nocturnal hypertension and provided consensus recommendations on optimal management of nocturnal hypertension, with the goal of maximally reducing the cardiovascular disease risks. In this consensus document, 24‐h ABPM is recommended for screening and diagnosis of nocturnal hypertension, especially in the elderly, patients with diabetes, chronic kidney diseases, obstructive sleep apnea and other conditions prone to high nocturnal BP. Lifestyle modifications including salt intake restriction, exercise, weight loss, sleep improvement, and mental stress relief are recommended. Long‐acting antihypertensive medications are preferred for nocturnal and 24‐h BP control. Some newly developed agents, renal denervation, and other device‐based therapy on nocturnal BP reduction are evaluated.

Abstract The association of blood pressure (BP) classification defined by the 2017 American College of Cardiology/American Heart Association (ACC/AHA) guideline with cardiometabolic multimorbidity (CMM) remains unclear. The present study aimed to investigate this research gap in the Chinese adults. Cross‐sectional data were collected from a population‐based cohort conducted in Southern China. Participants were categorized as having normal BP, elevated BP, stage 1 hypertension, and stage 2 hypertension according to the 2017 ACC/AHA guideline. CMM was defined as having two or more of the following diseases: coronary heart disease, stroke, and diabetes. The relationship between the BP classifications and CMM was examined by multivariate logistic regression. A total of 95 649 participants (mean age: 54.3 ± 10.2 years, 60.7% were women) were enrolled in this study. Multivariable‐adjusted logistic regression models revealed that stage 1 hypertension (odds ratio [OR], 1.35; 95% confidence interval [CI], 1.03–1.78) and stage 2 hypertension (OR, 3.53; 95% CI, 2.82–4.47) were significantly associated with a higher prevalence of CMM compared with normal BP. The association between stage 1 hypertension and CMM were profound in women (OR, 1.76; 95% CI, 1.17–2.67) and in the middle‐aged group (OR, 1.53; 95% CI, 1.02–2.35) compared with men and older individuals, respectively. Our study showed that among Chinese adults, stage 1 hypertension defined by the 2017 ACC/AHA guideline was already associated with higher odds of CMM compared with normal BP, particularly in women and middle‐aged participants. Managing stage 1 hypertension may be an important measure to prevent CMM in Chinese adults.

Abstract To compare the predictive value of mortality between left ventricular hypertrophy (LVH) defined by Chinese thresholds and defined by international guidelines in hypertension individuals and investigate better indexation methods for LVH in Chinese population. We included 2454 community hypertensive patients with Left ventricular mass (LVM) and relative wall thickness. LVM was indexed to body surface area (BSA), height2 7 and height 1 7. The outcomes were all‐cause and cardiovascular mortality. Cox proportional hazards models were used to explore the association between LVH and the outcomes. C‐statistics and time‐dependent receiver operating characteristic curve (ROC) was used to evaluate the value of those indicators. During a median follow‐up of 49 months (interquartile range 2–54 months), 174 participants (7.1%) died from any cause (n = 174), with 71 died of cardiovascular disease. LVM/BSA defined by the Chinese thresholds was significantly associated with cardiovascular mortality (HR: 1.63; 95%CI: 1.00‐2.64). LVM/BSA was significantly associated with all‐cause mortality using Chinese thresholds (HR: 1.56; 95%CI: 1.14‐2.14) and using Guideline thresholds (HR: 1.52; 95%CI: 1.08‐2.15). LVM/Height1.7 was significantly associated with all‐cause mortality using Chinese thresholds (HR: 1.60; 95%CI: 1.17‐2.20) and using Guideline thresholds (HR: 1.54; 95%CI: 1.04‐2.27). LVM/Height2.7 was not significantly associated with all‐cause mortality. C‐statistics indicated that LVM/BSA and LVM/Height1.7 by Chinese thresholds had better predictive ability for mortality. Time‐ROC indicated that only LVM/Height1.7 defined by Chinese threshold had incremental value for predicting mortality. We found that in community hypertensive populations, race‐specific thresholds should be used to classify LV hypertrophy related to mortality risk stratification. LVM/BSA and LVM/Height1.7 are acceptable normalization method in Chinese hypertension.

Abstract The association of adiposity indices with prehypertension remains unclear in the Chinese non‐hypertensive population. This study aimed to compare the association of adiposity indices, including waist circumference (WC), waist‐to‐height ratio, body roundness index (BRI), a body shape index (ABSI), and conicity index (CI), and prehypertension in the Chinese population. We recruited 61 475 participants from a population‐based screening project in Guangdong province, China. Multiple logistic regression analyses were performed to detect the association between the six adiposity indices and prehypertension. Receiver operator characteristic curve (ROC) analysis was used to evaluate the predictive values of adiposity indices to prehypertension. The individuals were divided into two categories by blood pressure (BP) levels: normotension (

Abstract The triglyceride glucose‐body mass index (TyG‐BMI) has been considered an alternative marker of insulin resistance (IR). This cross‐sectional study was designed to mainly investigate the association between TyG‐BMI, triglyceride glucose combined with body mass index, and hypertension in Chinese adults. The relationship between TyG‐BMI and hypertension was examined by multivariate logistic regression and restricted cubic spline model. Multiple logistic regression models were also performed to examine the associations between the individual components of TyG‐BMI (BMI, TyG index, TG and FBG) and hypertension. The incremental ability of TyG‐BMI versus its individual components for hypertension discrimination was evaluated by C‐statistic and net reclassification index. Subgroup analysis was performed to examine potential interactions. A total of 92,545 participants (38.9% men, mean age 53.7 years) were included for final analysis. Logistic regression models showed TyG‐BMI and its individual components were all significantly associated with the odds of hypertension (p for trend

Abstract The study was to compare age‐related alterations in cardiac and arterial structure and function by sex and to explore the impacts of achieved systolic blood pressure (SBP;