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Objective: To investigate the possible association between AT1R gene polymorphisms and major adverse cardiovascular and cerebrovascular events (MACCEs) in hypertension patients combined with or without coronary artery disease (CAD) in Xinjiang., Methods: 374 CAD patients and 341 non-CAD individuals were enrolled as study participants and all of them have a hypertension diagnosis. AT1R gene polymorphisms were genotyped by SNPscan™ typing assays. During the follow-up in the clinic or by telephone interview, MACCEs were recorded. Kaplan-Meier curves and Cox survival analyses were used to explore the association between AT1R gene polymorphisms and the occurrence of MACCEs., Results: AT1R gene rs389566 was associated with MACCEs. The TT genotype of the AT1R gene rs389566 had a significantly higher probability of MACCEs than the AA + AT genotype (75.2% vs. 24.8%, P = 0.033). Older age (OR = 1.028, 95% CI: 1.009-1.0047, P = 0.003) and TT genotype of rs389566 (OR = 1.770, 95% CI: 1.148-2.729, P = 0.01) were risk factors of MACCEs. AT1R gene rs389566 TT genotype may be a predisposing factor for the occurrence of MACCEs in hypertensive patients., Conclusion: We should also pay more attention to the prevent of MACCEs in hypertension patients combined with CAD. Especially those elderly hypertensive patients carrying AT1R rs389566 TT genotype requires avoidance of unhealthy lifestyle, better management of blood pressure control and reduce the occurrence of MACCEs., (© 2023. The Author(s).)

The present study was conducted to investigate the prevalence, awareness, treatment, control, and associated risk factors of hypertension among rural population in Xinjiang Province in Northwest China. The Cardiovascular Risk Survey study was conducted on a representative sample of the Northwest China adult population. A four-stage stratified cluster random sampling scheme was adopted to recruit representative samples. The data were collected by trained staff. Multivariable logistic regression models were used to identify the associated risk factors. Overall, 8295 study participants aged 35-101 years were enrolled. The overall hypertension prevalence was 35.01%. The prevalence of hypertension in Han, Uygur, and Kazak population was 36.84%, 33.32%, and 52.57%, respectively. The hypertension awareness, treatment, control, and control among treated participants were 56.1%, 44.7%, 10.9%, and 24.3%, respectively. Multivariate logistic regression showed that age, body mass index, central obesity, ethnic, and drinking status were identified as risk factors for hypertension. Hypertension was found to be highly prevalent in rural adults in Xinjiang, China, especially in Kazak population. Although the levels of awareness, treatment, and control have improved, it was still lower than developed countries. Effective measures should be adopted to promote the prevention and control of hypertension., (Copyright © 2017 American Society of Hypertension. Published by Elsevier Inc. All rights reserved.)

Background: Ethnic differences in non-invasive measurements of carotid atherosclerosis are being increasingly reported, but the association between carotid atherosclerosis and different subtypes of hypertension in adult populations is not fully understood in different ethnicities. We aimed to investigate the association of carotid atherosclerosis with different subtypes of hypertension in different ethnicities in Xinjiang, a northwestern province in China., Methods: A total of 14,618 participants (5,757 Hans, 4,767 Uygurs, and 4,094 Kazakhs) from 26 villages of seven cities in Xinjiang were randomly selected from the Cardiovascular Risk Survey conducted during 2007 and 2010. A standard questionnaire, a physical examination and biochemical tests were employed., Results: The mean common carotid intima-media thickness (CIMT) for the 14,618 participants was 0.86±0.003 mm. The CIMT gradually increased with age. Men (0.92±0.005 mm) had a higher CIMT than women (0.81±0.004 mm). The Uygur participants (0.82±0.006 mm) had a lower CIMT than the Han (0.88±0.005 mm) and Kazakh participants (0.88±0.005 mm). The overall prevalences of carotid intimal thickening and carotid plaques were 12.4% and 9.7%, respectively. The prevalence of CIMT varied for the different subtypes of hypertension. Multivariate logistic regression analysis showed different risk factors for abnormal CIMT in different ethnicities. The associations between abnormal CIMT and the different subtypes of hypertension within different ethnic backgrounds were also different. The risk factors for abnormal CIMT included systolic-diastolic hypertension (SDH) in Han participants (OR: 1.323, 95% CI: 1.100-1.590), SDH (OR: 1.426, 95% CI: 1.160-1.753) and isolated-systolic hypertension (ISH) (OR: 1.844, 95% CI: 1.470-2.313) in Uygur participants, and isolated-diastolic hypertension (IDH) (OR: 1.536, 95% CI: 1.170-2.016) in Kazakh participants., Conclusion: There was an ethnic difference in the prevalence of abnormal CIMT in Xinjiang, a northwestern province in China. The associations between abnormal CIMT and the subtypes of hypertension varied among the different ethnic groups. Among the studied populations, Han participants with SDH, Uygur participants with SDH and ISH, and Kazakh with IDH were more likely to suffer carotid atherosclerosis than those with other subtypes of hypertension. Participants with different ethnic backgrounds had different sets of risk factors for abnormal CIMT.

Background: To determine whether TG/HDL-C ratio, which has been shown to be an indicator of the metabolic syndrome (MetS) and insulin resistance (IR), can predict cardiovascular risk factors in the Chinese Han population in Xinjiang., Methods: The cardiovascular risk survey (CRS) was conducted from October 2007 to March 2010. A total of 14,618 representative participants were selected using a four-stage stratified sampling method. A total of 5757 Han participants were included in the study. The present statistical analysis was restricted to the 5595 Han subjects who had complete anthropometric data. The sensitivity, specificity, and distance on the receiver operating characteristic (ROC) curve in each TG/HDL level were calculated. The shortest distance in the ROC curves was used to determine the optimal cutoff of the TG/HDL-C ratio for detecting cardiovascular risk factors., Results: The prevalence of hypertension, hypercholesterolemia, and hypertriglyceridemia was higher with higher TG/HDL-C ratio for both men and women. The TG/HDL-C ratio was positively associated with systolic blood pressure, diastolic blood pressure, and serum concentrations of total cholesterol. The optimal TG/HDL-C ratio cutoffs for predicting hypertension, dyslipidemia, diabetes, and ≥2 of these risk factors for Han adults in Xinjiang were 1.3, 1.3, 1.4, and 1.4 in men and 0.9, 1.0, 1.0, and 1.1 in women, respectively., Conclusions: The evaluation of TG/HDL-C ratio should be considered for one of cardiovascular risk factor predictors among Han adults in Xinjiang.

Objective: To assess the status of the cardiovascular disease associated risk levels among hypertensive population of Han, Uygur and Kazakh ethnicities, in Xinjiang Uygur Autonornous Region, to guide hypertension prevention and treatment in different ethnicities., Methods: Four stages random cluster sampling method was used, and all the data was collected from Xinjiang local residents aged over 18 between October 2007 and March 2010., Results: A total of 14 618 subjects completed this survey, in which 2 654 Han, 1 612 Uygur and 2034 Kazakh people diagnosed with hypertension was included in this research. Most of them were"grade 1 hypertension", and the percentage of grade 3 hypertension was Han (19.1%), Uygur (17.3%) and Kazakh (32.3%), respectively. Majority hypertensive people accompanied with 1 risk factor. The risk proportions of low, medium, high and very high in hypertension population of different ethnicities were Han (19.4%, 34.6%, 46.1%), Uygur (17.7%, 37.6%, 44.7%), Kazakh (12.5%, 38.0%, 49.4%) respectively. In Han, Uygur and Kazakh ethnicities, the percentage of high risk and very high risk was highest in hypertensive men aged over 60 years old.The percentages of hypertension awareness were 42.0%, 45.6%, 46.5% and percentages of medicine therapy were 29.6%, 23.4%, 25.2% for Han, Uygur and Kazakh ethnicities, respectively., Conclusions: Hypertensive people among Han, Uygur and Kazakh ethnicities in Xinjiang are mainly under high risk and very high risk situation of cardiovascular disease, especially in men aged ≥60. The percentage of hypertension awareness and medicine therapy in high risk and very high risk population is the highest, while percentage of awareness in medium risk population is low.

Objectives: Little is known about isolated diastolic hypertension (IDH) among different ethnicity groups. We aimed to investigate the prevalence and risk factors for IDH among the major ethnicity population i.e. Han, Uygur and Kazakh in Xinjiang, northwestern part of China., Methods: In total, 14,618 adult participants (7,799 males, 6,819 females) were recruited from the Cardiovascular Risk Survey conducted during 2007 and 2010. Blood pressure, body mass index and standard lipid profile and fasting glucose level from plasma were measured., Results: The overall prevalence of IDH was 10.8% in the Han, 4.5% in the Uygur and 8.7% in the Kazakh populations. When stratified by gender, IDH prevalence was 9.8% in men and 6.8% in women (P<0.001). The prevalence of IDH also varied significantly with age and it was highest in those aged 35-44 yrs old (9.7%) and lowest in those over 75 yrs old (4.1%, P<0.001). Multivariate logistic regression analysis showed that overweight (OR = 1.179, 95%CI: 1.015-1.369) or obesity (OR = 1.202, 95%CI: 1.015-1.424), smoking (OR = 1.362, 95%CI: 1.156-1.604) and high total cholesterol (TC) hyperlipidemia (OR = 1.237, 95%CI: 1.074-1.423) were significantly associated with a higher prevalence of IDH. Identified risk factors for IDH differed among ethnicity groups with male gender, young age (35-44 yrs old), more coffee or tea consumption and high TC hyperlipidemia in the Han; smoking and often coffee or tea consumption in the Uygur and male gender and overweight or obesity in the Kazakh populations., Conclusions: IDH prevalence in the Han population is higher than that in the Uygur and Kazak populations in Xinjiang, northwestern part of China. Male gender, middle age, overweight or obesity, smoking and high TC hyperlipidemia appear to be relevant risk factors of IDH in adults. Different ethnicity background had different sets of risk factors for IDH.

Objective: With the development of genome-wide association studies (GWAS) concerning hypertension, a growing number of susceptibility genes related to hypertension have been revealed. Subsequently, several studies have investigated the association between CYP17A1 rs1004467 heritable variation and hypertension; however, the results have been inconsistent. In this study, a meta-analysis was performed to assess the association between the CYP17A1 rs1004467 polymorphism and hypertension risk., Methods: The PubMed, ISI Web of Science and Embase databases as well as China Wanfang, Weipu and the Chinese Journal Full-text Database were used to retrieve all publications from 2005 to 2013 related to case-control studies that reported a link between the risk factors for hypertension and the CYP17A1 polymorphism. All association studies were identified, and a meta-analysis was conducted using the RevMan 5.0 estimate for odds ratios (ORs) to determine whether the A allele predicts hypertension outcomes., Results: Three articles including five studies (totaling 4495 patients and 3529 controls) were identified. The overall effect suggested that rs1004467 was significantly associated with hypertension (OR=1.22, 95%CI 1.08-1.38, p=0.001)., Conclusions: The present meta-analysis confirmed the significant association between a polymorphism of the CYP17A1 gene and hypertension susceptibility. The CYP17A1 A allele should be considered a risk factor for hypertension., (© The Author(s) 2015.)

Objectives: To estimate the current prevalence and epidemiology of isolated systolic hypertension (ISH) among adult populations from different ethnic groups in Xinjiang province and to further establish a theoretical basis for developing personalized therapeutic strategies for hypertensive populations., Methods: To analyze the prevalence and risk factors of ISH in different ethnic groups in Xinjiang province, a cluster sampling method was adopted to conduct a cross-sectional study on people aged 35 years and older from the Han, Uygur and Kazakh populations in the Urumqi, Kelamayi, Hetian, Zhaosu, Fukang, Tulufan and Fuhai., Results: A total of 14,618 adults were surveyed with a response rate of 88.80%. The overall prevalence of ISH was 11.95% (men: 10.84% vs women: 12.92%); the prevalence of ISH in women was significantly higher (χ(2) = 15.06, p = 0.00) than that in men. The prevalence varied significantly with age (χ(2) = 822.71, p = 0.00) and increased in the elderly (χ(2) = 769.59, p = 0.00). A logistic regression analysis revealed that age, obesity, diabetes and dyslipidemia are major risk factors for ISH; patients with hypertension combined with obesity or diabetes are at a high risk of ISH., Conclusions: The prevalence of ISH in Xinjiang is higher than average and exhibits a gender difference. There is a trend of increased prevalence with increasing age. Populations with obesity, diabetes or dyslipidemia, and patients who have hypertension combined with obesity and/or diabetes, should be aware of early preventive interventions.

Objective: The present study examined the association between uric acid levels and high blood pressure in a multiethnic study of Chinese children and adolescents., Methods: The participants were divided into four different groups according to the uric acid quartiles. Three logistic regression models were conducted to investigate the relationship between the high blood pressure and uric acid levels. Model 1 adjusted age, sex and ethnicity. Model 2 adjusted age, sex, ethnicity, total cholesterol, high-density lipoprotein, low-density lipoprotein, triglycerides, estimated glomerular filtration rate, fasting glucose and waist circumference. Model 3 adjusted all the confounding factors in model 2 except the waist circumference and BMI. The concentrations of uric acid in high blood pressure participants and normotensive participants were compared with or without adjustment for confounding factors., Results: A total of 3778 participants aged 10-15 years from the Xinjiang Congenital Heart Disease Survey were included in the present study. The percentages of the high blood pressure in the four different uric acid quartiles were 7.4, 8.6, 9.6 and 11.8%, respectively. In model 1, 2 and 3 of the logistic regression, the participants in the third and fourth uric acid quartiles had significantly higher chance of suffering the high blood pressure when compared with the participants in the first uric acid quartile [odds ratio 1.608, 1.587, 1.597, P = 0.005, 0.015, 0.015, respectively, between participants in the first quartile and the third quartile; odds ratio 1.981, 1.945, 1.810, P = 0.001, 0.002, 0.007, respectively, between participants in the first quartile and the fourth quartile). The concentrations of serum uric acid were 220.7 μmol/l in high blood pressure participants and 204.1 μmol/l in normotensive participants (P = 0.024). After adjustment for confounding factors, the concentrations of serum uric acid were 219.7 vs. 204.5 μmol/l in one model (P < 0.001) and 219.3 vs. 204.5 μmol/l in the other model (P < 0.001)., Conclusions: Among Chinese children and adolescents, increasing levels of serum uric acid are associated with high blood pressure.

Background: Prevalence of cardiovascular disease (CVD) risk factors have been scarcely studied in Xinjiang, a multi-ethnic region., Methods: Multi-ethnic, cross-sectional cardiovascular risk survey study in Xinjiang, including individuals of Uygur (n = 4695), Han (n = 3717) and Kazakh (n = 3196) ethnicities, aged 35-74 years. Analyses involved 11,608 participants with complete data enrolled between October 2007 and March 2010., Results: There were differences in age-standardized prevalence of CVD risk factors between the three groups (all P < 0.001). Hypertension, obesity and smoking rates were higher among Kazakh (54.6%, 24.5%, and 35.8%, respectively). Dyslipidemia prevalence was higher among Uygur (54.3%), and diabetes prevalence was higher among Hans (7.1%). Age-standardized prevalence of adverse CVD risk profiles was different across different ethnicities. Compared with the Han participants, the Uygur and Kazakh had more CVD risk factors (P < 0.001). Compared with the Han participants, the adjusted odds ratios of 1, 2, and ≥3 risk factors profiles for Kazakh and Uygur participants were higher (all P < 0.001)., Conclusions: The present study showed the pervasive burden of CVD risk factors in all participant groups in the Xinjiang region. Three major ethnic groups living in Xinjiang had striking differences in the prevalence of major CVD risk factors and adverse risk profiles. Ethnic-specific strategies should be developed to prevent CVD in different ethnic groups, as well as to develop strategies to prevent future development of adverse CVD risk factors at a younger age.

Objective: The current overweight and central adiposity guidelines based on Western populations were not consistent with many studied based on the Asian populations. Uighur people live in Xinjiang Uighur Autonomous Region which is located in the center of Asia. Their overweight and central cutoffs were largely unknown. We aimed to identify cutoffs for body mass index (BMI; in kg/m(2)) and waist circumference (WC; in cm) for categorization of overweight and central adiposity among Uighur adults in Xinjiang., Methods: 4767 Uighur participants were selected from the Cardiovascular Risk Survey (CRS) which was carried out from October 2007 to March 2010. The age of the participants were from 35 to 101 years old with the mean age of 50.09 years. Anthropometric data, blood pressure, serum concentration of serum total cholesterol, triglyceride, low density lipoprotein (LDL), high density lipoprotein (HDL) and fasting glucose were documented. The prevalence, sensitivity, specificity and distance on the receiver operating characteristic (ROC) curve of each BMI and waist circumference values were calculated., Results: The prevalence of hypertension, hypercholesterolemia and hypertriglyceridemia were higher with higher BMI for both men and women. The prevalence of hypertension and hypercholesterolemia were higher with higher waist circumference for both men and women. In women, the prevalence of hypertriglyceridemia was noticed to increase as the waist circumference increased. The shortest distance in the receiver operating characteristic curves for hypertension, dyslipidemia, diabetes, or ≥ 2 of these risk factors suggested a BMI cutoff of 26 and a waist circumference cutoff of 90 cm for both men and women., Conclusions: Higher cutoffs for BMI and waist circumference are needed in the identification of Uighur patients at high risk of cardiovascular disease.

Objective: To investigate the prevalence and distribution pattern of hypertension in Xinjiang adult population., Methods: A total of 15,061 adults at 35 years old or over were surveyed. Four-stage selected random sampling was employed to analyze the prevalence and distribution pattern of self-reported congestive hypertension in different groups of nationality, age and gender. The sampled adult population was collected from 7 localities (Urumqi, Ke lamayi, Fukang, Turfan Basin, Hetian, Altay, Yili Hazakh autonomous prefecture) in 23 municipalities and 5 autonomous counties in Xinjiang. The proportion of male to female was 50% each., Results: The prevalence of hypertension was 36.21% (male: 38.70% vs female: 34.22%). The Prevalence of hypertension was 33.42%, 28.50% and 48.69% in Han, Uygur and Hazakh populations respectively. The prevalence of hypertension was higher in Hazakh than Han people (χ2=29.36, P<0.01). The males had a higher frequency of hypertension than the females (χ2=20.01, P<0.01). The risk of hypertension increased substantially with age. The analysis of multiple logistic regression revealed that age (OR=1.06), alcohol consumption, obesity (OR=3.12) and levels of triglyceride (OR=1.30) and cholesterol (OR=1.32) and serum glucose (OR=1.41) were risk factors of hypertension. The corresponding relative hazards were age, alcohol consumption, obesity and levels of triglyceride and cholesterol and serum glucose for Han; the risk factors were similar in Uygur except serum glucose. Age, obesity and levels of triglyceride were only for Hazakh., Conclusion: There is still a higher prevalence of hypertension in Xinjiang. The prevalence of hypertension increases substantially with age and there is difference between different nationalities.