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We aimed to explore the status of nutritional and frailty in patients undergoing liver transplantation and the associated influencing factors. Methods: We conducted a follow-up analysis of 44 patients who underwent liver transplantation between 2021 and 2022. We followed up and recorded the nutritional status and risk of weakness at different time-points (days 1, 2, 3, 6, 9, and 12) postoperatively. Patient information regarding demographics, physical examination, medical history, and perioperative blood tests were collected. Binary logistic regression was applied to identify risk factors for weakness after liver transplantation. Results: The cohort comprised 44 liver transplant recipients, with a mean age of 47.66 years (standard deviation=9.49 years). Initial analysis revealed that, compared to the group without nutritional risks, the group with nutritional risks displayed elevated age and preoperative blood ammonia levels one week post-surgery. Moreover, this group had reduced levels of albumin and total bile acid preoperatively. Patients with preoperative nutritional risks were also prone to similar risks 2 weeks postoperatively. Further, a correlation was observed between preoperative pulmonary infections and increased frailty risk 6 days postoperatively. At both 9 and 12 days postoperatively, patients with frailty risk exhibited higher preoperative white blood cell counts and ammonia levels than those without. Multivariable analysis, controlling for confounding factors, indicated a significant association between preoperative nutritional status and nutritional risk 2 weeks postoperatively, as well as a link between preoperative white blood cell count and frailty risk at 12 days postoperatively. Conclusion: There was a significant correlation between preoperative nutritional status and nutritional risk 2 weeks after liver transplantation, and preoperative white blood cell count was an independent risk factor for weakness 12 days postoperatively. Preoperative nutritional management for patients could potentially mitigate the likelihood of adverse clinical outcomes. [ABSTRACT FROM AUTHOR]

Although a high Helicobacter pylori infection rate has been reported in dyspeptic patients, published data for the asymptomatic population are inadequate. We aimed to investigate the prevalence of H. pylori infection and the association between H. pylori infection diagnosed using the noninvasive 13C urea breath test (13C UBT) and risk factors in asymptomatic Chinese individuals. Healthy subjects who underwent hospital health examinations in the hospital health management department from September 2020 to September 2021 were consecutively enrolled. Anthropometric and biochemical characteristics were measured, and all subjects underwent 13C UBT. Univariate and multivariate analyses were used to evaluate the factors associated with H. pylori infection. Of the 5007 participants included, the overall prevalence of H. pylori infection was 35.0% and was similar in men (35.5%) and women (34.2%). The prevalence of H. pylori increased by 84.8% in those aged ≥ 60 years compared with those aged < 30 years (P=0.006), and increased by 30.9% in the obese group compared with the normal weight groups (P = 0.034). Fasting blood glucose (FBG) and albumin levels showed a significant association with the prevalence of H. pylori. The prevalence of H. pylori increased by 6.9% following each 1-unit increase in FBG (P = 0.033) and decreased by 3.7% for each 1-unit increase in albumin (P = 0.012). Moreover, the results of the age stratification showed that albumin level was negatively associated with the prevalence of H. pylori in participants aged < 50 years (OR = 0.952, 95%CI: 0.921–0.985; P = 0.005). However, the prevalence of H. pylori in participants aged ≥ 50 years increased by 66.6% in the impaired glucose group compared to the normal glucose group (P = 0.003). These findings suggest that detailed and strict weight and glucose management is crucial to reduce the prevalence of H. pylori infection. Management strategies should be identified and implemented with regard to these identified factors to reduce the notable economic and healthcare burden in China. [ABSTRACT FROM AUTHOR]

Introduction: Metabolic syndrome (MetS) is a chronic and complex disease associated with all-cause mortality, cardiovascular disease, and type 2 diabetes. The present study aimed to evaluate the prevalence of MetS and its risk factors among middle-aged and older adults in low-income, low-education rural areas with a high incidence of stroke. Methods: This cross-sectional study of the general population was performed from April 2019 to June 2019 in rural areas of Tianjin, China. All eligible residents aged ≥ 45 years and without active malignant tumors, hepatic failure, and severe renal disease underwent routine medical examinations, which included a questionnaire, physical examination, and routine blood and biochemical tests. The modified International Diabetes Federation criteria for the Asian population was used to identify patients with MetS. Results: A total of 3175 individuals (44.8% men, 55.2% women) were included in the final analysis. The prevalence of MetS was 52.8%, with higher prevalence in women than in men (62.4%and 40.9%, respectively). Of the five MetS components, high blood pressure and abdominal obesity were the two most prevalent in both women and men, accounting for 89.3% and 62.0%, respectively, followed by elevated fasting plasma glucose, low high-density lipoprotein cholesterol, and elevated triglycerides. Multivariate logistic regression analysis revealed the following traits to be risk factors for MetS: female sex, self-reported smoking, self-reported snoring, high body mass index, high waist-to-hip ratio, and high serum urate level. Conclusion: The prevalence of MetS was quite high in rural areas with a low-income, low-education population. Implementing preventive and therapeutic interventions based on these risk factors is essential to prevent metabolic abnormalities. [ABSTRACT FROM AUTHOR]

aimed to evaluate nutritional risk in patients with pulmonary tuberculosis and structural lung disease and to identify factors associated with nutritional risk in this population. Methods: We performed a cross-sectional study of patients diagnosed with pulmonary tuberculosis and structural lung disease admitted to The Third People's Hospital of Shenzhen, China between January 1, 2019 and December 31, 2021. We assessed participants' nutritional risk using the Nutritional Risk Screening 2002 tool, and analyzed the relationship between nutritional risk and sociodemographic factors, disease status, and laboratory test results. Results: Of the 415 participants, 53.5% were at nutritional risk on admission to the hospital. Nutritional risk was significantly associated with being unmarried, destroyed lung, and red blood cell (RBC) and lymphocyte counts. Conclusion: Patients with tuberculosis and structural lung disease had a high prevalence of nutritional risk. The main factors associated with nutritional risk were being unmarried, lung cavitation, and low RBC and lymphocyte counts. Patients hospitalized with pulmonary TB should be evaluated for nutritional risk. Moreover, unmarried patients and patients with lung cavitation or low RBC or lymphocyte counts should be closely monitored. [ABSTRACT FROM AUTHOR]

The burden of cognitive impairment and dementia is particularly severe in low- and middle-income countries. Although hypertension is an important risk factor for cognitive impairment, the influence of different hypertension classification on cognitive impairment remains controversial. To explore the impact of hypertension and hypertension classification on cognitive function, this study was based on a low-income population aged over 60 years in northern China. This population-based, cross-sectional study was conducted from April 2014 to January 2015 in rural areas of Tianjin, China. A total of 1,171 participants aged ≥ 60 years were included. Participants were interviewed by professional researchers face-to-face, using the pre-designed questionnaire. Cognitive function was assessed using the Mini-mental State Examination (MMSE). Multivariate regression analysis was used to calculate the odds ratio (OR) value. There was a significant association between hypertension and cognitive impairment (OR, 1.415; 95% CI: 1.005–1.992; P = 0.047) and a significant positive association between stage 3 hypertension (OR, 1.734; 95% CI: 1.131–2.656; P = 0.012) and the prevalence of cognitive impairment. To prevent dementia, clinicians should consider the cognitive function and blood pressure control of low-income individuals aged over 60 years with hypertension in northern China, especially those with stage 3 hypertension. In addition, the inconsistent effects of blood pressure on different cognitive functions should also be considered; special attention should be paid to orientation and concentration. [ABSTRACT FROM AUTHOR]

Introduction: Isolated impaired glucose tolerance (i–IGT) is a subtype of prediabetes in which an individual demonstrates elevated 2-h post-glucose load glucose levels but normal fasting plasma glucose levels. However, few studies have explored the prevalence and risk factors of i–IGT among adults in rural China. Thus, we aimed to explore the prevalence and risk factors of i–IGT among adults ≥ 50 years old in a low-income, rural population in China. Materials and Methods: Individuals aged ≥ 50 years with normal fasting plasma glucose levels were included in the final analysis. Fasting and 2-h venous blood samples were collected to assess the selected parameter measurements. Results: A total of 2175 individuals were included in this study. The i–IGT prevalence was 22.9% and significantly higher among females than among males (P< 0.05). Older age [odds ratio (OR), 1.606; 95% confidence interval (CI), 1.101– 2.342; P=0.014), hypertension (OR, 1.554; 95% CI, 1.152– 2.019; P=0.004), and central obesity (OR, 1.395; 95% CI, 1.099– 1.771; P=0.006) were associated with i–IGT. Moreover, white blood cell (OR, 1.089; 95% CI, 1.009– 1.175; P=0.029), high-sensitivity C-reactive protein (OR, 1.049; 95% CI, 1.020– 1.078; P=0.001), serum uric acid (OR, 1.0003; 95% CI, 1.001– 1.004; P=0.001), triglyceride (OR, 1.540; 95% CI, 1.105– 2.147; P=0.011), and alanine aminotransferase (OR, 1.012; 95% CI, 1.004– 1.021; P=0.004) levels were also linked to i–IGT in the analyzed population. Conclusion: Health promotion education and a standardized approach to managing body weight, BP, and lipid and uric acid levels would benefit this low-income population in rural China for reducing the risk of cardiovascular disease. [ABSTRACT FROM AUTHOR]

Objective: Over the past few decades, the prevalence of hearing impairment (HI) has rapidly increased, making HI one of the most common causes of disability, globally. The burden of HI is particularly heavy in low socioeconomic status populations. Despite extensive research into the range of HI prevalence in low socioeconomic status populations, worldwide, population-based studies have been rare. Thus, we explored HI prevalence and risk factors among low-income, middle-aged and elderly individuals in Tianjin, China. Method: Between September and November 2013, 2351 rural residents in Tianjin, China were recruited into the study. All participants completed questionnaire surveys, physical examinations, laboratory examinations, and hearing tests. HI was measured using pure-tone audiometry, and audiologists determined the final diagnoses.Results: Among the 2351 participants, ≥45 years old, the prevalence of HI was 49.3%, including 54.3% among men and 46.0% among women. Slight HI accounted for the largest proportion of individuals (40.7%). The risk of HI among men was 32.9% higher than among women. Moreover, the risk of HI increased with increasing age. Compared with the 45–54-year-old group, the risk of HI in individuals in the 55–64-year-old, 65–74-year-old, and ≥75-year-old groups were 25.8%, 109.9%, and 373.7% higher, respectively. Moreover, increased with each 1-mmHg SBP, the risk of HI increase 0.7% (95%CI: 1.001–1.013; P = 0.017); while increased with each 1-mmHg DBP, the risk of HI decrease 1.7% (95%CI: 0.973–0.993; P = 0.001) Conclusions: The burden of HI in rural northern China is heavy, especially among elderly men and people with elevated systolic blood pressure (SBP). Addressing HI prevention is critical for reducing the HI burden and improving quality of life. [ABSTRACT FROM AUTHOR]

Aims: Abnormal glucose regulation, which can present as diabetes and prediabetes, has become one of the most common chronic conditions. However, sex differences in the prevalence of and factors associated with abnormal glucose regulation remain unclear. Thus, we aimed to explore sex differences in the prevalence of and factors associated with abnormal glucose regulation in low-income adults in China aged ≥50 years with normal fasting plasma glucose levels. Materials and Methods: A total of 2,175 individuals aged ≥50 years with normal fasting plasma glucose levels were recruited into this study. After an overnight fast of at least 10 h, individuals underwent an oral glucose tolerance test. Fasting and 2-h plasma glucose levels were measured to determine the state of glucose regulation. Results: Women were more likely than men to have isolated-impaired glucose tolerance (i-IGT) overall (24.7% vs 20.8%; P= 0.034), among individuals aged <65 years (21.7% vs 15.9%; P= 0.012). Among men, independent risk factors for i-IGT were an age of ≥65 years, hypertension, and high serum uric acid (SUA) and triglyceride levels; independent risk factors for diabetes mellitus (DM) were an age of ≥75 years and alcohol consumption. Among women, independent risk factors for i-IGT were central obesity and high levels of high-sensitivity C-reactive protein and SUA; independent risk factors for DM were low education and an elevated white blood cell count. Conclusions: Our findings suggest that conventional cardiovascular disease risk factors (i.e., age, hypertension, and dyslipidemia) associated with high risk of developing DM in men, but poor life style (i.e., obesity) and low education attainment in women. It is necessary for delay or stopping the development of DM among low-income adults in China to implement the personalized scheme of prevention DM between men and women, especially highlight control the risk factors in young and middle aged women. [ABSTRACT FROM AUTHOR]

Objectives: China has already entered the aging society, and its aging population is the largest worldwide. Accordingly, several aging-related conditions including hyperuricemia are becoming a public health concern owing to their increasing prevalence in rural areas. However, the sex-specific differences in the risk factors for hyperuricemia among the middle-aged and elderly in rural North China are unclear. Thus, this study aimed to evaluate sex-specific differences in the prevalence of and risk factors for hyperuricemia in low-income adults in rural North China. Methods: This population-based cross-sectional study recruited participants aged ≥50 years from the Tianjin Brain Study between April and August 2019. After excluding those who had cancer, severe psychiatric disturbances, hepatic failure, and serious renal disease (i.e., an estimated glomerular filtration rate (eGFR) of <30 mL/min/1.73 m2), 3119 (1392 men and 1727 women) eligible participants were included. Basic information and blood samples were collected, and data were analyzed using logistic regression models. Results: Hyperuricemia was prevalent in 14.4% (men, 14.2%; women, 14.5%)of the participants, and the prevalence significantly increased with increasing age in both sexes (male, P= 0.034; female, P< 0.001). In multivariate analysis, obesity, metabolic syndrome, and high levels of total cholesterol, 2 h plasma glucose, and blood urea nitrogen were risk factors for hyperuricemia in both men and women. Physical activity was a risk factor in men, while a high white blood cell count was a risk factor in women. A high eGFR was a protective factor in both sexes. Conclusions: Hyperuricemia was highly prevalent in low-income adults in Tianjin, with men and women showing differences in risk profiles and comorbidities. Early management of hyperuricemia according to sex-specific risk factors should be considered in primary care to reduce the prevalence and burden of hyperuricemia in rural China. [ABSTRACT FROM AUTHOR]

Objective: To examine the mean carotid intima-media thickness (CIMT) and potentially relevant determinants of increased CIMT in elders. Method: Stroke-free and cardiovascular disease-free residents aged ≥65 years were recruited in a low-income population in China. B-mode ultrasonography was performed to measure CIMT. Results: A total of 1039 individuals (47.9% men) were recruited. The mean CIMT value was 0.60 (SD: 0.09) mm. The mean CIMT was 24.07 (SEM: 6.52) µm greater in men than in women (P < 0.001) and 28.29 (SEM: 7.47) µm greater in patients with hypertension than in those without hypertension (P < 0.001). Moreover, the mean CIMT increased by 1.53 (SEM: 0.49) µm for each 1-year increase in age (P = 0.002). However, the mean CIMT decreased by 5.55 (SEM: 2.40) μm and 6.45 (SEM: 2.62) μm for every 1-mmol/L increase in triglyceride concentration and the high-density lipoprotein cholesterol: low-density lipoprotein cholesterol ratio, respectively (P < 0.05). However, high triglyceride level was negatively associated with mean CIMT only among individuals without metabolic syndrome (P = 0.036). Discussion: These findings suggest that there is an urgent need to delay atherosclerosis progression and reduce the stroke burden by managing hypertension, especially for men. Moreover, to decrease the stroke burden in rural China, caution is advised regarding lipid-lowering treatment in elderly patients without metabolic syndrome. [ABSTRACT FROM AUTHOR]

Intima-media thickness is a non-invasive arterial marker of early-stage atherosclerosis. Identifying carotid plaque is a superior surrogate endpoint for assessing atherosclerotic lesions. The aim of this study was to investigate the association of carotid intima-media thickness (CIMT) and carotid plaque with lipids among asymptomatic low-income rural residents in China. A total of 3,789 people aged ≥45 years without a history of stroke or cardiovascular disease were recruited to this study. B-mode ultrasonography was performed to measure CIMT and identify carotid plaque for early identification of atherosclerosis. Multivariate analysis was used to assess the association of blood lipid levels with atherosclerosis. The mean CIMT across our cohort was 567 μm. A linear regression analysis showed that low-density lipoprotein cholesterol (LDL-C) and total cholesterol (TC) were risk factors for early-stage atherosclerosis; however, high-density lipoprotein cholesterol and triglycerides protected against early-stage atherosclerosis after adjusting for potential risk factors (P < 0.001). Carotid plaque risk increased by 24 and 62% for each 1-mmol/L increase in TC and LDL-C (P < 0.001). These findings suggest that it is vital to manage and control the dyslipidemia standard levels in China, especially among rural residents, in order to reduce the burden of cardiovascular diseases. [ABSTRACT FROM AUTHOR]

Aims: The prevalence of diabetes mellitus (DM) among adults has reached epidemic proportions worldwide, including China. In China, sex-based differences in the prevalence and risk factors of DM may exist, particularly among low-income individuals. Thus, we assessed these differences in the prevalence of DM and its risk factors in a low-income Chinese population. Materials and Methods: Residents aged ≥45 years without histories of strokes or cardiovascular disease were recruited for this study. Multivariate logistic regression analyses were performed to assess the association of risk factors with DM prevalence. Results: This study included 3,725 participants (41.2%, men; 58.8%, women). The mean age of the women (61.12 years) was higher than that of the men (59.14 years, P < 0.001). There was no significant sex-based difference in DM prevalence (men, 14.1%; women, 14.5%). Overweight, obesity, high triglyceride levels, and hypertension were independent risk factors for DM in both sexes. However, high-density lipoprotein-cholesterol levels were negatively associated with DM risk among men [odds ratio (OR), 0.544; 95% confidence interval (CI), 0.355–0.833; P = 0.005]. Among women, advanced age and high low-density lipoprotein-cholesterol levels were independent risk factors for DM; there was a higher DM risk for women aged 55–74 years than for those aged 45–54 years; however, physical activity was associated with an increased risk of DM (OR, 1.705; 95% CI, 1.195–2.432; P = 0.003). Conclusions: These findings suggest a crucial need to implement individualized blood pressure, weight, and lipid managements in low-income populations in China to reduce the burden of DM, especially among older women. [ABSTRACT FROM AUTHOR]

Association of stroke risk with new blood pressure criterion 2017 is unknown in China. We assessed the association between blood pressure (BP) values and stroke risk in a low-income population in Tianjin, China. Systolic blood pressure (SBP) and diastolic blood pressure (DBP) values were categorized into five strata and strokes were recorded as stroke, ischemic stroke, and hemorrhagic stroke. Stroke risk was analyzed according to blood pressure stratum using Cox regression analysis. Overall, 4,017 residents (age, ≥18 years) were included in this prospective cohort study. Over a 27-year follow-up period (total, 86,515.78 person-years), 638 participants experienced first-ever strokes. The stroke risk was higher among individuals with SBPs ≥140 mmHg or DBPs ≥90 mmHg than among those with SBPs < 130 mmHg or DBPs < 80 mmHg (reference group), after adjusting for covariates. However, hemorrhagic stroke risk increased only in participants with SBPs ≥160 mmHg. The stroke risk increased for individuals < 65-years-old having BP values ≥130/80 mmHg and for individuals ≥65-years-old with BP values ≥160/90 mmHg. To reduce the stroke burden in China, target BP goals must be established for adults, with different targets for the middle-aged and the elderly segments of the population. These results are very important for guiding clinical practice and may be generalized to other developing countries experiencing rapid economic development and where transitions in the spectrum of prevalent diseases have occurred. [ABSTRACT FROM AUTHOR]

The relationship between body mass index (BMI) and stroke type has remained controversial despite studies demonstrating that BMI is related to stroke risk, especially in specific groups. We assessed the age- and sex-associated impacts of BMI on stroke type in a low-income, poorly educated population in China. The association of BMI with stroke type was estimated using Cox regression analyses in this prospective cohort study, after adjusting for sex, age, education level, hypertension, diabetes, smoking, and alcohol drinking status. During the follow-up period, 638 stroke cases occurred among the 3,906 participants included in this prospective study. For men aged <65 years, being overweight was an independent predictor of all stroke subtypes, compared with normal-weight individuals; the hazard ratios (HRs) and 95% confidence intervals (CIs) were 1.98 (1.52–2.58) for total stroke, 1.69 (1.22–2.33) for ischemic stroke, and 3.62 (2.09–6.25) for hemorrhagic stroke, all P < 0.001. Being underweight was also an independent predictor of hemorrhagic stroke (HR, 5.10; 95%CI, 1.80–14.50, P = 0.002). For women <65-years-old, being overweight was a risk factor for total (HR, 1.38; 95% CI, 1.01–1.89; P = 0.044) and hemorrhagic strokes (HR, 2.06; 95% CI, 1.00–4.28; P = 0.050); obesity was a risk factor for total (HR, 2.47; 95% CI, 1.60–3.82) and ischemic strokes (HR, 2.53; 95% CI, 1.54–4.15), all P < 0.001. These findings suggest that weight management should be a high priority for substantially reducing the heavy burden of strokes in rural China among both men and women <65-years-old; men<65-years-old should maintain their weight within a reasonable range. [ABSTRACT FROM AUTHOR]

Although strokes are the leading cause of death and disability in many countries, China still lacks long-term monitoring data on stroke incidence and risk factors. This study explored stroke risk factors in a low-income, rural population in China. The study population was derived from the Tianjin Brain Study, a population-based stroke monitoring study that began in 1985. This study documented the demographic characteristics, past medical histories, and personal lifestyles of the study participants. In addition, physical examinations, including measurements of blood pressure (BP), height, and weight, were performed. Hazard ratios (HRs) were estimated for the risk factors for all subtypes of stroke using multivariate Cox regression analyses. During the study with mean following-up time of 23.16 years, 3906 individuals were recruited at baseline, and during 27 years of follow-up, 638 strokes were documented. The multivariate Cox regression analyses revealed a positive correlation between age and stroke incidence. Limited education was associated with a 1.9-fold increase in stroke risk (lowest vs. highest education level). Stroke risk was higher among former smokers than among current smokers (HR, 1.8 vs. 1.6; both, P < 0.05). Moreover, stroke risk was significantly associated with sex (HR, 1.8), former alcohol drinking (HR, 2.7), baseline hypertension (HR, 3.1), and overweight (HR, 1.3). In conclusion, this study identified uncontrollable (sex and age) and controllable (education, smoking, alcohol drinking, hypertension, and overweight) risk factors for stroke in a low-income, rural population in China. Therefore, it is critical to control BP and weight effectively, advocate cessation of smoking/alcohol drinking, and enhance the education level in this population to prevent increase in the burden of stroke in China. [ABSTRACT FROM AUTHOR]

Background: At the global level, dementia is the leading cause of dependence and disability among the elderly. Although the preponderant prevalence in women has been identified, the sex differences in risk factors were unclear. We aimed to evaluate the sex differences in the prevalence of nonvascular cognitive impairment and the risk factors among the elderly in rural China screened with the Mini-Mental State Examination (MMSE). Methods: Between 2014 and 2015, a population-based cross-section study was conducted to collect basic information among the elderly aged 60 years and over. Those participants with the previous history of stroke or heart disease were excluded in this study. Nonvascular cognitive impairment was assessed using the MMSE scores. Results: The prevalence of cognitive impairment was 32.4% overall, 25.6% in men and 38.1% in women. In the multivariate analysis, older age and lower education were risk factors both in men and in women; older, large waist circumference was a protective factor for cognitive function in men; higher blood pressure was the risk factor in women. Conclusion: These findings suggest that it is crucial to manage and control hypertension and improve educational attainment in order to reduce the prevalence and burden of nonvascular cognitive impairment among low-income residents, both men and women, in rural China. [ABSTRACT FROM AUTHOR]

This study aimed to evaluate the prevalence of cognitive impairment and the distribution of its risk factors among residents aged ≥60 years without cardiovascular and cerebrovascular diseases in rural areas of northern China screened with the Chinese version of the Mini-Mental State Examination (MMSE). Between 2012 and 2013, a questionnaire survey was conducted to collect basic information from participants. Cognitive function was assessed using the MMSE. In the univariate analysis, risk factors for cognitive disorders were female sex, low education and central obesity, while drinking was found to be a protective factor. In the multivariate analysis, risk factors were old age (odds ratio [OR], 1.888; 95% confidence interval [CI]: 1.256-2.838; P = 0.002 for the 70-year-old group compared with the 60-year-old group; OR, 3.593; 95% CI, 2.468-5.230; P < 0.001 for the ≥75-year-old group compared with the 60-year-old group), low education (OR, 3.779; 95% CI: 2.218-6.440; P < 0.001 for the illiterate group compared with the group with ≥9 years of education; OR, 1.667; 95% CI, 1.001-2.775; P = 0.05 for the group with less than primary school compared with the group with ≥9 years of education), and higher blood pressure (BP; OR, 1.655; 95% CI: 1.076-2.544; P = 0.002 for individuals with stage III hypertension compared with those with normal BP). These findings suggest that it is crucial to manage and control level of BP, and improve educational attainment in order to reduce the prevalence and burden of cognitive impairment among low-income residents in rural China. [ABSTRACT FROM AUTHOR]

Aims/Introduction Carotid intima-media thickness ( CIMT) is an established predictor of cardiovascular disease and stroke. We aimed to identify the association between CIMT and blood glucose, as well as the risk factors associated with increased CIMT in a low-income Chinese population. Materials and Methods Stroke-free and cardiovascular disease-free residents aged ≥45 years were recruited. B-mode ultrasonography was carried out to measure CIMT. Results There were 2,643 participants (71.0%) in the normal group, 549 (14.7%) in the impaired fasting glucose group and 533 (14.3%) in the diabetes mellitus group. The determinants of increased CIMT were older age; male sex; low education; hypertension; smoking; high levels of systolic blood pressure, fasting blood glucose and low-density lipoprotein cholesterol; and low levels of diastolic blood pressure, triglycerides and high-density lipoprotein cholesterol, after adjusting for covariates. Age and hypertension were the common risk factors for increased CIMT in all three groups. Furthermore, male sex, smoking and high low-density lipoprotein cholesterol level were positively associated with the mean CIMT in the normal group; high triglycerides levels were negatively associated with the mean CIMT in the impaired fasting glucose group; and alcohol consumption was an independent risk factor for mean CIMT in the diabetes mellitus group. Hypertension was the greatest risk factor for increased CIMT. Conclusions These findings suggest that it is crucial to manage and control traditional risk factors in low-income populations in China in order to decelerate the recent dramatic increase in stroke incidence, and to reduce the burden of stroke. [ABSTRACT FROM AUTHOR]

Background: Data on long-term trends in the prevalence and clustering of cardiovascular disease (CVD) risk factors among women in China are rare, especially among low-income women. The aim of this study was to investigate the secular trends in the prevalence of CVD risk factors among low-income women in northern China. Materials and Methods: The prevalence and clustering of CVD risk factors, including hypertension, diabetes, obesity, current smoking status, and alcohol consumption, were assessed and compared in women aged 35-74 years in northern China in 1991 and 2011. Results: The age-adjusted prevalence of cardiovascular risk factors among women was significantly higher in 2011 than in 1991, with increases of 31% (53.6% vs. 41.1%) for hypertension, 148% (20.9% vs. 8.4%) for obesity, 256% (11.7% vs. 3.3%) for diabetes, and 1634% (4.5% vs. 0.3%) for alcohol consumption. Over the 21-year period, there were significant differences in the prevalence of clustering of ≥1, ≥2, and 3 risk factors in all age groups. The greatest increase was observed among women aged 35-44 years, with a 7.3-fold increase in the prevalence of clustering of three risk factors. Simultaneously, the prevalence of clustering of ≥1 risk factors among women aged 35-44 years was 1.7-fold higher in 2011 than in 1991; the prevalence of clustering of ≥2 risk factors was raised by 5.5-fold among elderly women. Conclusions: Our findings suggest that it is crucial to emphasize the prevention and control of cardiovascular risk factors among young women in rural China to reduce the burden of CVDs. [ABSTRACT FROM AUTHOR]

Studies show inconsistent associations between low-density lipoprotein cholesterol (LDL-C) and stroke outcome. We assessed these associations among patients with first-ever acute ischemic stroke (AIS) in China. Patients with first-ever AIS were categorized into 3 groups: normal LDL, marginally elevated LDL and high LDL - according to the LDL-C values on admission. The outcome measures that were investigated in each group included mortality, dependence and recurrence of vascular events. Patients with high LDL-C had higher mortality rates than did those with normal LDL-C at both 12 and 36 months, but this difference disappeared after adjustment for covariates. There was no difference between groups in mortality at 3 months and dependency or recurrence at 3, 12 or 36 months. LDL-C level was associated with long-term mortality after stroke, but was not an independent prognostic factor. [ABSTRACT FROM AUTHOR]