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Controversies persist about the protective effects of vaccines against acute cardiovascular events. Using electronic medical records from hospitals and influenza vaccine administration data in Beijing, China, we studied individuals vaccinated between January 1, 2016, and December 31, 2018, who experienced at least one acute cardiovascular event within two years. A self-controlled case series design calculated the relative incidence (RI) and 95% confidence interval (CI) of acute cardiovascular events within one year after vaccination. Among 1647 participants (median age: 65 years, 38.43% female), the risk of events 29–365 days post-vaccination was 0.76 times the baseline level (RI: 0.76; 95% CI: 0.68–0.84). The protective effect was more pronounced in younger participants (P = 0.043) and those without cardiovascular history (P < 0.001), while acute respiratory infection (P = 0.986) and vaccination frequency (P = 0.272) had no impact. Influenza vaccines offer protection against acute cardiovascular events for at least one year, suggesting potential for cardiovascular disease prevention. [ABSTRACT FROM AUTHOR]

To investigate the associations between particulate matter (PM) and hospital admissions for stroke and its subtypes among hypertension patients. We proposed a new modifier named high-concentration duration (HCD). Data on daily hospital admissions, air pollution, and meteorological factors were collected from 2014 to 2018 in Beijing, China. We included all patients with hypertension who were admitted to hospitals of secondary-level and above for stroke. Time-series analysis was conducted by fitting a generalized additive model. An interaction term of daily concentration and an HCD stratum indicator were included in the model. Sex subgroup analysis was performed in four age groups to detect vulnerable populations. A total of 358,577 admissions were identified. The PM was significantly associated with stroke admissions in patients with hypertension. The maximum excess risk (ER) (%) per 10 μg/m3 increase in fine particulate matter (PM2.5) was 0.23% (95% confidence interval (CI): 0.15%, 0.31%) for overall stroke, 0.25% (95% CI: 0.16%, 0.33%) for ischemic stroke (IS). The maximum ER (%) per 10 μg/m3 increase in inhalable particle (PM10) was 0.14% (95% CI: 0.06%, 0.23%) for overall stroke, 0.15% (95% CI: 0.06%, 0.23%) for IS. For hemorrhagic stroke, significant associations were also observed among males and patients < 55 years. ER (%) in long-HCD strata was significantly larger than that in short-HCD strata. The effects of PM2.5 were significant in long-HCD strata, but insignificant in short-HCD strata. HCD might be a modifier in the association between air pollution and health effects. While controlling the daily average concentration, it is also important to reduce HCD on a given day. [ABSTRACT FROM AUTHOR]

Air pollution and ischemic stroke (IS) are both vital factors affecting the health of Beijing citizens. This study aims at exploring the associations between air pollution, meteorology, and the hospital admission of IS (IS HA). Information on 476,659 IS inpatients in secondary and higher hospitals in Beijing from 2013 to 2018 were collected. A time-stratified case-crossover design with the generalized additive model and the distributed lag nonlinear model were used. In the single-pollutant models, an inter-quartile range increase in O3, SO2, CO, and NO2 resulted in a significant highest increase in IS HA by 2.23% (95% CI: 1.56%, 2.90%), 1.53% (95% CI: 1.12%, 1.95%), 1.05% (95% CI: 0.70%, 1.40%), and 0.51% (95% CI: 0.24%, 0.79%) on the day of pollution, so did PM2.5 and PM10 by 1.13% (95% CI: 0.68%, 1.59%) and 1.19% (95% CI: 0.74%, 1.64%) at a lag of 0–5 days. There was a nonlinear relationship between meteorology and IS HA. In the multivariate model, the cumulative relative risks with a maximum lag time of 21 days of PM2.5 and NO2 were 1.11 (95% CI: 1.04, 1.19) and 0.88 (95% CI: 0.82, 0.94), while the effects of SO2, O3, and meteorology were insignificant. The findings suggested that particulate pollutants could increase the risk of IS, and the elderly were more sensitive to it, while the results of gaseous pollutants are still discordant. The control of air pollution and the protection of susceptible populations should receive higher attention from policymakers. [ABSTRACT FROM AUTHOR]

Air pollutants' effect on ischemic stroke (IS) has been widely reported. But the effect of high-level concentrations during people's outdoor periods among hypertension patients was unknown. Peak-hour concentrations were defined considering air pollutants' high concentrations as well as people's outdoor periods. We conducted a time-series study and used the generalized additive model to analyze peak-hour concentrations' acute effect. A total of 315,499 IS patients comorbid with hypertension were admitted to secondary and above hospitals in Beijing from 2014 to 2018. A 10 µg/m3 (CO: 1 mg/m3) increase of the peak-hour concentrations was positively associated with IS hospital admissions among hypertension patients. The maximum effect sizes were as follows: for PM2.5, 0.17% (95% confidence interval [CI]: 0.10–0.24%) at Lag0 and 0.22% (95% CI: 0.12–0.33%) at Lag0–5; for PM10, 0.09% (95% CI: 0.05–0.13%) at Lag5 and 0.17% (95% CI: 0.09–0.26%) at Lag0–5; for SO2, 0.87% (95% CI: 0.46–1.29%) at Lag5; for NO2, 0.83% (95% CI: 0.62–1.04%) at Lag0 and 0.86% (95% CI: 0.59–1.13%) at Lag0–1; for CO 1.23% (95% CI: 0.66–1.80%) at Lag0 and 1.33% (95% CI: 0.33–2.35%) at Lag0–5; for O3 0.23% (95% CI: 0.12–0.35%) at Lag0 and 0.20% (95% CI: 0.05–0.34%) at Lag0–1. The effect sizes of PM2.5, NO2, and O3 remained significant after adjusting daily mean. Larger effect sizes were observed for PM2.5 and PM10 in cool season and for O3 in warm season. As significant exposure indicators of air pollution, peak-hour concentrations exposure increased the risk of IS hospital admissions among hypertension patients and it is worthy of consideration in relative environmental standard. It is suggested for hypertension patients to avoid outdoor activity during peak hours. More relevant searches are required to further illustrate air pollutant's effect on chronic disease population. [ABSTRACT FROM AUTHOR]

Background and Purpose: Non-alcoholic fatty liver disease (NAFLD) is becoming the most common liver disease in China. However, the understanding of NAFLD prevalence among Chinese mental disorder inpatients remains insufficient. We aim to investigate the prevalence of NAFLD among mental disorder inpatients in Beijing, China. Methods: In this observational study, we included 66,273 mental disorder inpatients between 2014 and 2018, including inpatients with schizophrenia, bipolar disorder, depressive disorder and other mental disorders. Data were obtained from electronic health records of 19 specialized psychiatric hospitals in Beijing. NAFLD was defined by ICD-10 code, excluding other causes of liver disease. We calculated the overall and annual prevalence rates of NAFLD from 2014 to 2018, and compared NAFLD prevalence between sexes, age groups, mental disorders types, antipsychotics use, and comorbidities. Multivariable logistic regression was used to examine risk factors associated with NAFLD. Subgroup analysis was performed in different mental disorder types. Results: The prevalence of NAFLD was 17.63% (95% CI 17.34–17.92%) in mental disorder inpatients, increasing from 16.88% in 2014 to 19.07% in 2018. The NAFLD prevalence in participants with schizophrenia (22.44%) was higher than that in participants with bipolar disorder (17.89%), depressive disorder (12.62%), and other mental disorders (12.99%). Women had similar or even higher NAFLD prevalence than men after 50 years. Men, 50–59 years (aOR = 1.71), schizophrenia (aOR = 1.56), bipolar disorder (aOR = 1.47), antipsychotics use (aOR = 1.46), hypertension (aOR = 1.50), diabetes (aOR = 1.83), dyslipidemia (aOR = 2.50) were risk factors for NAFLD in mental disorder inpatients. Conclusion: NAFLD was common among Chinese mental disorder inpatients, and increased over years. The prevalence of NAFLD was higher among men, old women, inpatients with schizophrenia, bipolar disorder, antipsychotics, hypertension, diabetes, and dyslipidemia. Fatty liver disease among mental disorder population warrants the attention of psychiatric specialists and health policy-makers. [ABSTRACT FROM AUTHOR]