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Objectives: This study aimed to analyze the influencing factors of hospitalization cost of hypertensive patients in TCM (traditional Chinese medicine, TCM) hospitals, which can provide a scientific basis for hospitals to control the hospitalization cost of hypertension., Methods: In this study, 3,595 hospitalized patients with a primary diagnosis of tertiary hypertension in Tianshui City Hospital of TCM, Gansu Province, China, from January 2017 to June 2022, were used as research subjects. Using univariate analysis to identify the relevant variables of hospitalization cost, followed by incorporating the statistically significant variables of univariate analysis as independent variables in multiple linear regression analysis, and establishing the path model based on the results of the multiple linear regression finally, to explore the factors influencing hospitalization cost comprehensively., Results: The results showed that hospitalization cost of hypertension patients were mainly influenced by length of stay, age, admission pathways, payment methods of medical insurance, and visit times, with length of stay being the most critical factor., Conclusion: The Chinese government should actively exert the characteristics and advantages of TCM in the treatment of chronic diseases such as hypertension, consistently optimize the treatment plans of TCM, effectively reduce the length of stay and steadily improve the health literacy level of patients, to alleviate the illnesses pain and reduce the economic burden of patients., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Hou, Cong, Cai, Ba, Chen, Yang and Luo.)

Human cytomegalovirus (CMV) infection is associated with hypertension and has been linked with the pathogenesis of increased arterial blood pressure (BP). Currently, whether CMV infection is associated with the progression of hypertension and hypertensive target organ damage (TOD) remains to be identified. We aimed to examine the relationship between CMV infection and the progression of hypertension and hypertensive TOD, which could provide clues on the possible mediating mechanisms, in the Han Chinese population. A total of 372 patients with hypertension and 191 healthy controls (Han participants from Xinjiang, China) were included in the study. Enzyme-linked immunosorbent assay (ELISA) and qPCR were used to detect CMV infection. C-reactive protein (CRP), tumor necrosis factor-α (TNF-α), and interleukin-6 (IL-6) titers were also analyzed using an ELISA kit. Moreover, cardiovascular disease markers were evaluated by echocardiography, carotid ultrasonography, and tomographic scans. Essential hypertension (EH) patients exhibited a marked increase in CMV IgG antibody, CRP, TNF-α, and IL-6 levels. Higher grade of hypertension and hypertensive TOD had higher CMV IgG antibody and CRP levels. The CMV IgG antibody titers were positively correlated with arterial BP, greater grade of hypertension and hypertensive TOD, and CRP and IL-6 levels. The higher quartile of CMV IgG titer and CRP level were associated with the incidence of hypertension and the progression of hypertension and hypertensive TOD. In the Han Chinese population, high CMV IgG titers are associated with the progression of hypertension and hypertensive TOD. CMV IgG titer >4.25 U could be an independent predictor of hypertension and progression of hypertension, while that >4.85 U could be an independent risk factor for hypertensive TOD. The underlying mechanism may be largely mediated by chronic inflammation.

The proliferation of vascular smooth muscle cells (VSMCs), remodeling of the vasculature, and the renin-angiotensin system (RAS) play important roles in the development of essential hypertension (EH), which is defined as high blood pressure (BP) in which secondary causes, such as renovascular disease, are absent. The calcium-sensing receptor (CaSR) is involved in the regulation of BP. However, the underlying mechanisms by which the CaSR regulates BP are poorly understood. In the present study, the role of the CaSR in EH was investigated using male spontaneously hypertensive rats (SHRs) and rat and human plasma samples. The percentages of medial wall thickness to external diameter (WT%), total vessel wall cross-sectional area to the total area (WA%) of thoracic arteries, as well as the percentage of wall area occupied by collagen to total vessel wall area (CA%) were determined. Tissue protein expression and plasma concentrations of the CaSR, cyclic adenosine monophosphate (cAMP), renin, and angiotensin II (Ang II) were additionally assessed. WT%, WA%, and CA% were found to increase with increasing BP, whereas the plasma concentration of CaSR was found to decrease. With increasing BP, the levels of smooth muscle actin and calponin decreased, whereas those of osteopontin and proliferating cell nuclear antigen increased. The CaSR level negatively correlated with the levels of cAMP and Ang II, but positively correlated with those of renin. Our data suggest that reduced expression of the CaSR is correlated with activation of the RAS, which induces increased vascular remodeling and VSMC proliferation, and thereby associated with EH in the SHR model and in the Han Chinese population. Our findings provide new insights into the pathogenesis of EH.

Objective: To investigate the effect of silent information regulator 1 (SIRT1) gene polymorphisms on ambulatory blood pressure in hypertensive patients., Methods: Three hundred forty hypertensive patients were recruited from January 2013 to January 2015. SIRT1 Tag single-nucleotide polymorphisms (SNPs; rs2273773, rs4746720, and rs7896005) were genotyped using a PCR-direct sequencing method, and the association between the SIRT1 gene SNPs and ambulatory blood pressure was analyzed., Results: After adjusting for confounding factors, patients with the rs2273773/CT+CC genotypes had lower 24-h systolic and diastolic blood pressures; there were no associations between rs4746720 and rs7896005 genotypes and blood pressure., Conclusion: The SIRT1 gene polymorphism (rs2273773) is significantly associated with ambulatory blood pressure level in Han Chinese patients with hypertension.

Background: Hypertension is an important public health issue in China, but there are few studies examining hypertension in ethnic groups in Yunnan, China. This study, Yunnan Minority Eye Study (YMES), was initially designed to determine the prevalence and impact of eye diseases, including hypertension and diabetes mellitus. As a part of YMES, the prevalence, awareness, treatment, and control of hypertension and the associated risk factors among the Yi ethnic population in rural China are reported., Methods: A population-based survey was conducted in 2012 with adult participants over 50 from rural communities in Shilin Yi Autonomous County, Yunnan Province, located in southwest China. A random cluster sampling method was used to select a representative sample. The participants' blood pressure, height, weight, and waist circumference were measured. Hypertension was defined as mean systolic blood pressure ≥140 mmHg and/or diastolic blood pressure ≥90 mmHg, and/or current use of antihypertensive medications., Results: A total of 2208 adults were assessed. The prevalence of hypertension was 38.5%, and the age- and gender-adjusted prevalence was 37.0%. The proportion of patients who were aware of their hypertension among those diagnosed with hypertension was 24.8%. Of those aware of having hypertension, 23.6% took antihypertensive drugs. Among all hypertensive patients, only 7.2% had controlled their hypertension (<140/90 mmHg). Risk factors for hypertension were older age, smoking, alcohol consumption, family history of high blood pressure, overweight, and obesity. Protective factors included being slim and higher education., Conclusions: Hypertension was highly prevalent among this population of the Yi ethnic group in China. The ratio of awareness, treatment, and control of hypertension were considerately low. Hypertension education and screening programs in rural China are recommended to improve the health status of this population.

Background: We aimed to study the association between cytomegalovirus (CMV) infection and hypertension in Kazakh and Han populations from Xinjiang Province, China., Material/methods: We analyzed data on 800 Kazakhs (467 hypertension patients and 333 healthy control participants) and 800 Hans (482 hypertension patients and 318 healthy control participants) aged 18-84 years old. ELISA and real-time quantitative PCR coupled with restriction fragment length polymorphism analysis were applied for determining CMV infection and glycoprotein B (gB) genotypes, respectively., Results: Serologic evidence of CMV infection was obtained for 95.4% and 90.1% of the Kazakhs and Hans, respectively. The CMV seroprevalence rates among the Kazakh and Han participants with hypertension were 96.8% and 89.8%, respectively. Multiple logistic regression analyses revealed statistically significant independent associations between CMV seropositivity and hypertension in Kazakh males and between CMV antibody titers and hypertension in Hans; significant relationships also existed between CMV antibody titers and blood pressure in Hans. In Kazakhs, 3 CMV gB genotypes were identified: gB2 and genotype mixtures gB1+gB2 and gB2+gB3. In Hans, 4 CMV gB genotypes were identified: gB1, gB2, gB1+gB2, and gB2+gB3. Of the 4 studied genotypes, gB2+gB3 showed a significant independent association with hypertension in Kazakh females., Conclusions: CMV infection is associated with essential hypertension in Kazakh males and Hans in Xinjiang. CMV seropositivity is associated with hypertension in Kazakh males, and CMV antibody titers are associated with blood pressure and hypertension in Han males and females. Moreover, the CMV gB2+gB3 genotype mixture is associated independently with essential hypertension in Kazakh females.

Purpose: This study aimed to assess the prevalence, awareness, treatment, and control of hypertension and their associated factors among Bai ethnic population in the rural China., Methods: A population-based survey was conducted in 2010 with a randomly cluster sampling in rural communities in Dali, southwest China. A total of 2133 adults aged 50 or above were interviewed, and their blood pressure, height, weight and waist circumference were measured. Hypertension was defined as a mean SBP≥140 mmHg and/or DBP≥90 mmHg, and/or current use of antihypertensive medications., Results: The prevalence of hypertension was 42.1% (899/2133), and the age- and gender-adjusted prevalence was 40.0%. Among the hypertensive participants, 28.4% (255/899)were aware of their condition, while 24.6% (221/899) took antihypertensive medications, with only 7.5% (67/899) of those achieving blood pressure control (<140/90 mmHg). Risk factors for hypertension were older age, smoking, alcohol drinking, family history of HBP, overweight, and obesity, while protective factors included being lean, and having finished senior high school or above., Conclusions: Hypertension prevalence is high among the population of Bai ethnic group in China, while the associated risk factors of hypertension include overweight/obesity, cigarette smoking, history of hypertension, and older age. The percentages of hypertensive participants aware of their hypertension and those taking antihypertensive medications were low with an incredibly low proportion of hypertensive patients who kept their hypertension under control. It is suggested that health education and hypertension screening programs be carried out in the area for the high blood pressure prevention and control.

Aims: Based on a case-control study, we investigated the relationship between +869T/C and +915G/C gene polymorphisms in transforming growth factor-beta1 (TGF-beta1), protein levels and essential hypertension (EH) in the Kazakh and Han Chinese populations selected from the Boertonggu countryside of Shawan region in the Xinjiang Uygur Autonomous Region of China (n=1600). The polymorphisms of TGF-beta1 and the blood levels were detected using polymerase chain reaction-restriction fragment length polymorphism assays and sandwich ELISA, respectively., Major Findings: An association was found between +869C-allele with higher risk of EH in these two populations. We also found that the CG haplotype of the two polymorphisms was associated with EH in the Kazakh EH patients. The levels of TGF-beta(1) in the blood were positively correlated with diastolic blood pressure both in the Kazakh and Han EH patients. Levels of the TGF-beta1 protein in the Kazakh EH patients were significantly higher than those in the Han EH patients., Principal Conclusion: These results suggest that the TGF-beta1 +869 C allele is potentially a genetic factor of EH in these two ethnicities, the CG haplotype can be a genetic marker of EH in the Kazakh Chinese and the high concentration of TGF-beta1 is possibly associated with EH, especially in the Kazakh population.

Objective: Essential hypertension (EH) was a complex disease resulted from the interaction of cumulative effect of multiple genetic and environment factors. The relationship between the genetic polymorphisms in the transforming growth factor-beta1 (TGF-beta1), the blood levels and EH have been investigated, but the conclusions were different. Therefore, we investigate the relationship between the tagging single nucleotide polymorphisms (tSNPs) (rs1800469, rs2241716, rs11466345, rs2241715, rs4803455) in TGF-beta1 gene, blood levels and EH in the Han nationality population in Xinjiang, to clarity the pattern of linkage disequilibrium (LD) and the feature of the structure of haplotype., Methods: Based on the case-control study,we selected 732 (365 EH patients,367 controls) Han Chinese population from the Boertonggu countryside of Shawan region in the Xinjiang Uygur Autonomous Region of China by random cluster sampling. After questionnaire and physical examination, we collected blood samples, and the blood levels of TGF-beta1 were quantified using sandwich ELISA. The polymorphisms of TGF-beta1 gene in the study groups were detected with SNaPshot system. The case-control study in a large group was carried out separately for each of the tSNP and followed up by haplotypes analyses to determine the relation between tSNPs of TGF-beta1 gene and EH in the Han population., Results: (1) The frequencies of alleles A, G of rs11466345 of TGF-beta1 gene in EH group and control group were as follows: 69.7%, 30.3%, 74.4%, 25.6%, respectively. It was demonstrated that the G allele of the rs11466345 polymorphism occurred at a significantly higher frequency in EH patients than in healthy controls (30.3% vs. 25.6%, P < 0.05). The rs11466345G-allele carriers had a significantly increased risk of EH compared to rs11466345A-allele carrier (OR = 1.261; P < 0.05). The frequencies of genotypes and alleles of the other tSNPs of TGF-beta1 gene had no difference between EH patients and controls (P > 0.05). (2)Except the site of rs11466345, the other tSNPs were in strong LD, and no statistical differences were observed in haplotypes distribution in the followup study between case-control groups (P > 0.05). (3) There were no difference of TGF-beta1 levels between the different genotypes and alleles in tSNPs of TGF-beta1 gene (P > 0.05)., Conclusions: (1) These results suggested that TGF-beta1 gene rs11466345 G allele was likely to be a genetic susceptibility factor for EH in the Xinjiang Han population, the other tSNPs perhaps had no association with EH of in the study groups. (2) Except rs11466345, the other tSNPs were in strong LD, and the haplotypes reconstructed by tSNPs might not be associated with EH in the Han nationality populations. (3) There was no association between the tSNP of TGF-beta1 gene and TGF-beta1 blood levels in the Xinjiang Han nationality population.

To investigate the relationship between 27 bp repeat polymorphism in intron 4 in the endothelial nitric oxide synthase (eNOS4) gene and essential hypertension in the Kazakh Chinese population, 151 patients with essential hypertension and 138 healthy people were selected from the Boertonggu countryside of Shawan region in the Xinjiang uygur autonomous region of China in 2006. The polymorphism of eNOS in the two groups was detected with polymerase chain reaction assays and the genotype frequencies in each group were calculated following the Hardy-Weinberg law. Four and five tandem 27 bp repeats were designated as "a" and "b", respectively. It was found that the frequencies of b/b, b/a and a/a genotypes of the eNOS4 gene were 84.06%, 15.22% and 0.72% in the control group, and 81.46%, 15.89% and 2.65% in the hypertension group, respectively. The frequencies of gene "a" and "b" were 91.67% and 8.33% in the control group and 89.40% and 10.60% in the hypertension group, respectively. It was found that plasma eNOS activity was not associated with genotypes and alleles of eNOS gene. Plasma eNOS activity in the hypertension group was significantly decreased compared with the control group (P<0.01). The results suggest that eNOS4 gene polymorphisms are unlikely to be the major genetic susceptibility factors for essential hypertension in the Xinjiang Kazakh population. However, a positive association between plasma eNOS activity and essential hypertension has been revealed.

Background. Antihypertensive therapy is crucial for preventing stroke in hypertensive patients. However, the efficacy of antihypertensive therapy varies across individuals, partially due to therapy-related genetic variations among individuals. We investigated the association of antihypertensive drug-related gene polymorphism with stroke in patients with hypertension. Methods. Demographic information, medication, and outcome data were obtained from a hypertensive patient management system, and a PCR fluorescence probe technique was used to detect 7 gene polymorphic loci (CYP2D6 ∗ 10, ADRB1, CYP2C9 ∗ 3, AGTR1, ACE, CYP3A5 ∗ 3, and NPPA), and these loci were compared between patients with and without stroke. Logistic regression was performed to analyze the association of these genetic variations with stroke risk in hypertensive patients while controlling for potential factors. Results. The prevalence of stroke in the hypertensive population in Changsha County of Hunan Province was 2.75%. The mutation frequencies of ADRB1 (1165G > C), CYP2D6 ∗ 10, CYP2C9 ∗ 3, AGTR1 (1166A > C), ACE (I/D), NPPA (2238T > C), and CYP3A5 ∗ 3 were 74.43%, 57.23%, 4.26%, 5.71%, 31.62%, 1.17%, and 69.58%, respectively. Univariate analysis revealed that ADRB1 polymorphism was associated with stroke (χ2 = 8.659, P < 0.05), with a higher stroke risk in the CC group than in the GC and GG groups (GC + GG). Multivariate unconditional logistic regression analysis showed that the CC genotype in ADRB1 (vs. the GC + GG genotype) was associated with an increased risk of stroke [odds ratio (OR) = 1.184, P<0.05] in hypertensive patients. No association was observed between CYP2D6 ∗ 10, CYP2C9 ∗ 3, AGTR1 (1166A > C), ACE (I/D), CYP3A5 ∗ 3, and NPPA (2238T > C) polymorphisms and stroke. Conclusions. ADRB1 (1165G > C) gene polymorphism is associated with the risk of stroke in Chinese hypertensive patients. The CC genotype is correlated with a higher risk of stroke than the GC + GG genotype. [ABSTRACT FROM AUTHOR]

Background/Aims: To examine the relationships among blood lead levels, blood pressure and kidney function in a population-based sample of adults in an area of China with lead pollution. Methods: This cross-sectional study included a sample of 1447 adults older than 20 years of age who underwent physical examinations in hospitals within a lead-polluted area of China from January to December 2013. Results: Blood lead levels were high among the local population (152.47µg/L) and did not change with age (P=.182). Overall, changes in both systolic blood pressure (SBP) and diastolic blood Pressure (DBP) were associated with changes in blood lead level (P=.012, P=.001), whereas BUN and CCr did not change along with the blood lead level (P>.05). This relationship was strongest among people 20-45 years of age; in this group, the beta coefficients for SBP and DBP were 0.009 (0.003), P=.001 and 0.005 (0.002), P=.004, respectively. Compared with young men, young women's blood pressures were more affected by blood lead levels (beta for SBP=0.031 for women vs. 0.008 for men; beta for DBP=0.015 for women vs. 0.005 for men). Conclusion: Continuous lead exposure causes increased blood lead levels among local residents. Blood lead levels are positively associated with both SBP and DBP increases among adults aged 20-44 years. The relationships between blood lead levels and SBP and DBP are most pronounced in young women. Chronic saturnism does not increase blood pressure by altering kidney function. These results provide support for continued efforts to control blood pressure in the population living in a lead-polluted region of China, particularly in young women. © 2015 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

Aims. Based on a case–control study, we investigated the relationship between +869T/C and +915G/C gene polymorphisms in transforming growth factor-β1 (TGF-β1), protein levels and essential hypertension (EH) in the Kazakh and Han Chinese populations selected from the Boertonggu countryside of Shawan region in the Xinjiang Uygur Autonomous Region of China ( n=1600). The polymorphisms of TGF-β1 and the blood levels were detected using polymerase chain reaction–restriction fragment length polymorphism assays and sandwich ELISA, respectively. Major findings. An association was found between +869C-allele with higher risk of EH in these two populations. We also found that the CG haplotype of the two polymorphisms was associated with EH in the Kazakh EH patients. The levels of TGF-β1 in the blood were positively correlated with diastolic blood pressure both in the Kazakh and Han EH patients. Levels of the TGF-β1 protein in the Kazakh EH patients were significantly higher than those in the Han EH patients. Principal conclusion. These results suggest that the TGF-β1 +869 C allele is potentially a genetic factor of EH in these two ethnicities, the CG haplotype can be a genetic marker of EH in the Kazakh Chinese and the high concentration of TGF-β1 is possibly associated with EH, especially in the Kazakh population. [ABSTRACT FROM AUTHOR]