中青年体检人群体质量指数与血糖和血脂及血压相关性分析

目的:探讨体质量指数(BMI)与血压、血脂、血糖等指标的相关性。方法:对2019年1月-2020年12月在体检中心进行健康体检的1952例中青年人群资料进行回顾性分析,比较不同性别人群的肥胖、超重比例及高血压、高血糖、高脂血症发病情况,并根据BMI不同分为体质量低下组、正常组、超重组、肥胖组,分析BMI与年龄、腰围、空腹血糖、血脂、血压的相关性。结果:男性的超重率、肥胖率均高于女性,男性的高血糖、高血压、血脂异常检出率也均高于女性,差异具有统计学意义(P<0.001);不同BMI组之间年龄、腰围、血压、空腹血糖、血脂比较,差异均有统计学意义(P<0.001)。随着BMI的增高,年龄、腰围、空腹血糖、血压、血脂是超重、肥胖的重要影响因素,且呈递进关系。结论:男性超重、肥胖人数比例大于女性,超重和肥胖与腰围、血压、血脂、空腹血糖相关,BMI增加会使血糖、血脂、血压升高。     

汕头地区干部人群体重指数与血压血脂尿酸血糖水平关系的调查分析

目的调查分析汕头地区干部体检人群的体重指数(BMI)的分布情况及其与血压、血脂、尿酸和空腹血糖水平的关系。方法对2003年我院预防保健科处厅级干部健康体检资料完整的1124例进行分析，按BMI分为肥胖组和非肥胖组，比较两组之间血压、血脂、尿酸和血糖水平情况，比较BMI和血压、血脂、尿酸、血糖水平的相关关系。结果BMI与血压、血脂、尿酸、血糖之间存在正相关关系(P＜0．01)。肥胖组的血压、血脂、尿酸、血糖的水平高于非肥胖组。结论肥胖影响血压、血脂、尿酸和血糖，与心血管疾病危险因素密切相关．控制体重对预防心脑血管疾病有重要意义．     

科技干部771名体重与血脂、血尿酸、血压、血糖的调查

目的　了解汕头沿海地区知识分子的体重与血脂、血尿酸、血压、血糖的水平及其关系 ,为制定合理的预防心脏血管疾病的措施提供依据。方法　对 771名科技干部的体检资料进行整理分析 ,将他们按体重指数 (BMI)分为肥胖组和非肥胖组 ,比较两组之间血脂、血尿酸、血压、血糖的水平 ;进一步按性别、年龄分组比较 BMI和血脂、血尿酸、血压、血糖的水平及相关关系。结果　在 771例中 ,肥胖组的血脂、血尿酸、血压、血糖的水平显著高于非肥胖组 (P<0 .0 5及 0 .0 0 0 1 ) ,BMI与血脂、血压、血糖、血尿酸、年龄之间存在正相关关系 (P<0 .0 1 )。男性肥胖者比例高于女性(P<0 .0 1 )。肥胖对男性的代谢影响较女性大 ;不论是否肥胖 ,男性血清尿酸显著高于女性 (P<0 .0 0 0 1 )。结论　肥胖影响血脂、血尿酸、血糖代谢及血压 ,与心脑血管危险因素密切相关 ,降低体重对预防心脑血管疾病有重要意义     

Selenium and risk factors for cardiovascular disease in New Zealand

Blood selenium (Se) concentrations and glutathione peroxidase (GSHPX) activities were measured in 118 men (39 +/- SD 15 yr) and 112 women (42 +/- 16 yr) randomly selected from the total respondents (1192) to health survey in Milton, a low soil-selenium area in Otago. GSHPx activities were marginally lower for men (11.9 +/- 3.2 units/g Hb) than for women (12.9 +/- 3.8 units/g Hb). Blood, erythrocyte and plasma selenium concentrations were about the same for both sexes and means for all subjects (61 +/- 15; 73 +/- 19; 49 +/- 12 ng Se/ml) were almost identical with a control group of Otago blood donors. No differences in blood levels could be associated with smoking, use of oral contraceptives, arthritis and/or rheumatism, or anti-hypertensive drugs. No relationship was found for the men or women between any of the parameters of selenium status and any of the parameters of risk factors for cardiovascular disease measured in the health survey: age, Quetelet's index, total skinfolds, systolic and diastolic pressure, pulse rate, plasma lipids and lipoprotein lipid concentrations. Moreover no relationship was found for the subgroups (36% group) of men and of women with plasma selenium below 45 ng Se/ml. This study indicates that if selenium is important it does not operate through the risk factors of cardiovascular disease as presently understood.     

Risk factors for coronary heart disease in New Zealand and Sweden: Dunedin and Uppsala compared.

OBJECTS: to compare men and women over the age of 35 years in Dunedin (New Zealand) and Uppsala (Sweden) in respect of anthropometric values, dietary habits and certain coronary heart disease risk factors in view of known differences in coronary mortality between the two countries. METHODS: one hundred and ninety-five Dunedin and 94 Uppsala residents were chosen randomly from the respective populations, in the former city by electoral roll, in the latter by use of unique personal number. Measurements of height, weight, waist/hip ratio, blood pressure, blood lipids were made and dietary and smoking habits assessed. RESULTS: the Swedes were taller and leaner than the New Zealanders. Blood pressure and smoking habits were not significantly different but total blood cholesterol levels were lower in Uppsala men and women. Blood triglycerides were higher in Dunedin women but high density lipoprotein cholesterol levels tended to be lower in men and women in Uppsala. CONCLUSIONS: it was found by analysis of variance that the blood lipid level differences between the two populations could be explained by body mass index. Correction of lipid values for the waist/hip ratio partly explained the higher cholesterol values in Dunedin but diet differences may also have been contributory. The differences in coronary mortality between the population of New Zealand and Sweden are compatible with the view that our blood cholesterol findings reflect the different levels of risk.     

Environmental and genetic determinants of intima-media thickness of the carotid artery

1. The aim of the present study was to investigate carotid intima-media thickness (CIMT) in relation to anthropometric, environmental and genetic factors, as well as cholesterol and blood pressure levels. 2. The study sample was composed of 89 families, with no documented cardiovascular disease, consisting of 369 subjects (aged from 10 to 54 years) from the Stanislas cohort. 3. Carotid intima-media thickness was measured by B-mode ultrasonography. Fifteen genetic markers, including genes involved in lipid metabolism, the regulation of blood pressure, thrombosis, platelet function and endothelial cell adhesion, were studied by multiplex assay. 4. The effects of gender, age, smoking, alcohol, body mass index, cholesterol, blood pressure and genetic factors were studied using ANOVA and bivariate and regression analyses. 5. Segregation analysis was also performed to estimate the contribution of genetic and environmental factors to CIMT variability. 6. Carotid intima-media thickness values were not affected by age or by gender up to 18 years of age. Thereafter, CIMT values increased sharply in men and remained significantly higher than in women. 7. Approximately 30% of CIMT variability was attributable to genetic factors. Associations between CIMT and polymorphisms in the apolipoprotein CIII, cholesteryl ester transfer protein, methylene tetrahydrofolate reductase and fibrinogen genes were observed and explained approximately 20% of CIMT variation in men. 8. In women, none of the studied polymorphisms was associated with CIMT variation. 9. Our study gives new perspectives for understanding CIMT variability in healthy middle-aged subjects.     

Utilization of cardiovascular drugs (blood pressure lowering drugs, lipid lowering drugs and nitrates) and mortality from ischaemic heart disease and stroke An ecological analysis based on Sweden's municipalities

Objective: To perform an ecological study in an effort to generate questions concerning the preventive impact of various cardiovascular drugs on mortality from stroke and ischaemic heart disease (IHD) in the community, and to explore the association between sales of nitrates and mortality from stroke and IHD. Methods: Out-patient drug utilization (sales) of blood pressure lowering drugs, lipid lowering drugs and nitrates were categorized in four groups of equal size by quartiles and compared with mortality from IHD and stroke, using the group of municipalities with the lowest utilization as reference, from 1989 to 1993 in 283 of Sweden's 288 municipalities, by Poisson regression. Adjustments were made for population size, age and gender proportions, the utilization rate of cardiovascular drugs other than the tested drug group and location of the municipality. Results: Compared with the group of municipalities with the lowest sales and adjusting only for population size, mortality from IHD and stroke increased with the extent of utilization of blood pressure lowering drugs and nitrates. In contrast, mortality decreased with increased utilization of lipid lowering drugs. After further adjustments by percentage of men, age structure, geographical location (mid-points) of the municipalities, and, as a proxy for cardiovascular disease, the sales of cardiovascular drugs other than the tested drug group, the increased risk associated with blood pressure lowering drugs disappeared, and there was a dose-response association between sales of diuretics and old antihypertensives and decreasing mortality, sales of nitrates continued to be associated with an increased risk, and the low mortality risk associated with sales of lipid lowering drugs persisted. Conclusion: Lipid lowering drugs may have a preventive impact in the general population, but the preventive impact of blood pressure lowering drugs, with the exception of diuretics and old antihypertensives, may be low in many municipalities. The safety of nitrates needs more investigation at the individual level. Received: 16 April 1998 / Accepted in revised form: 10 November 1998     

血清脂联素监测对原发性高血压患者的意义

目的评价脂联素在原发性高血压(EH)发生、发展中的作用;分析血清脂联素水平与心血管危险因素之间的关系。方法①选择潍坊医学院附属医院门诊及住院的EH患者60例,以及体质量指数(BMI)、年龄、性别匹配的健康体检者60例。②用酶联免疫吸附测定(ELISA)法检测血清脂联素浓度;进行24h动态血压监测(ABPM)及常规的临床和实验室指标的检测。结果①EH患者血清脂联素水平明显低于BMI、年龄、性别匹配的正常对照者(P<0.01)。②EH患者lg(脂联素浓度)与BMI、腰臀比(WHR)、年龄、24h平均收缩压、24h平均舒张压、24h平均动脉压均呈负相关。回归分析显示,常规心血管危险因素中只有24h平均动脉压、BMI、年龄是血清脂联素水平的独立预测因子。结论①EH患者血清脂联素浓度低于正常对照,低脂联素血症与EH的发生、发展有一定关系。②EH患者的脂联素浓度与年龄、BMI、WHR、24h平均收缩压、24h平均舒张压、24h平均动脉压均呈负相关。24h平均动脉压、BMI、年龄是EH患者血清脂联素水平的独立影响因素。     

How can hypertensive patients be better treated? The contribution of combination therapy

Recent studies demonstrated that target blood pressure (BP) in treated hypertensive patients should be below 140 mmHg for systolic blood pressure (SBP) and below 90 mmHg for diastolic blood pressure (DBP). However, population studies from several countries have demonstrated that in clinical practice the proportion of controlled hypertensive patients is less than 30%. In order to elucidate these questions in France we analysed a large population of 145,000 subjects examined at the Centre d'Investigations Préventives et Cliniques in Paris (IPC). Among those with high BP at the time of their IPC visit, only 20% received an antihypertensive treatment. Among those receiving an antihypertensive treatment, less than 27% (24% in men and 30% in women) presented with BP values less than 140 mmHg for SBP and less than 90 mmHg for DBP. This analysis also showed that 72% of hypertensive patients presented with at least one modifiable associated cardiovascular risk factor and that more than 30% of hypertensive men and more than 25% of hypertensive women presented with at least two associated risk factors. The use of combination therapies could help to increase the percentage of well-controlled hypertensive subjects. It has been shown that in order to reach this BP level, combination therapy should be used in more than two-thirds of the treated subjects. The trandolapril-verapamil combination is the first fixed combination of an angiotensin-converting enzyme inhibitor and a non-dihydropyridine calcium-channel blocker. Administered once daily, this combination reduces BP more than a classic monotherapy. The effects of the trandolapril-verapamil combination on risk factors are either neutral (metabolic parameters), or even beneficial (reduction in heart rate).     

Heart disease and diabetes risk factors in Pacific Islands communities and associations with measures of body fat.

AIMS: To describe the prevalence of obesity and other coronary heart disease and Type 2 diabetes risk factors by age and ethnic group in Pacific Island communities and to determine the associations between these risk factors and body mass index. METHODS: Cross-sectional data from commuity-based intervention projects were combined to provide anthropometric, blood sample and blood pressure data on 1,175 Pacific Islands people (467 men, 708 women) aged 20 years and over from church communities in South, Central and West Auckland. Self-reported data on diabetes status and leisure-time physical activity were also collected. RESULTS: Based on an ethnic-specific mass index (BMI) cut-off (> 32 kg/m2), 45% of men and 66% of women were obese. The age-standardised prevalence of known diabetes was 12%. Men and women aged 40-60 years had the highest risk factor levels and were the most sedentary. Tongans had higher risk factor levels than Samoans. In men, BMI and waist circumference were associated (p<0.05), in the direction of greater disease risk, with blood pressure and concentrations of total cholesterol, HDL-cholesterol, LDL-cholesterol, triglycerides, and blood glucose. In women, these associations were similar but less consistent. CONCLUSIONS: While these data are not representative for all Pacific people living in New Zealand, they do show an extremely high prevalence of obesity and significant associations between obesity and other cardiovascular risk factors. These communities warrant a very high priority as part of public health efforts to address New Zealand's growing obesity epidemic.     

青岛市某健康体检人群体重指数及其相关危险因素分析

目的了解青岛市城市常住人口健康体检人群体重指数(BMI)及其相关危险因素。方法对37 155名健康体检者测量BMI、血压、血脂、血糖、血尿酸,按BMI值分为超重/肥胖组和非超重/肥胖组,比较两组之间血压、血脂、血糖、血尿酸水平情况,分析BMI分布状况及与血压、血脂、血糖、血尿酸等的相互关系。结果青岛驻地城市健康体检人群超重/肥胖检出率41.2%,其中男性47.2%,女性41.5%。在20⁶0岁,超重/肥胖人群的血压、血脂、血糖、血尿酸水平显著高于非超重/肥胖的人群(P<0.01)。BMI与血压、血脂、血糖、血尿酸、年龄、危险因素聚集之间存在正相关关系(P<0.01)。高血压、高血脂、高血糖、高尿酸血症及危险因素聚集的检出率均随着BMI的增高而上升。结论青岛市健康体检者超重/肥胖人群检出率较高。超重/肥胖可引起高血压、高血脂、高血糖、高尿酸血症。应该对健康体检者进行超重/肥胖相关知识的普及,以降低慢性病的发病率。     

Increased blood pressure variability in menopause

Blood pressure variability represents an independent risk factor for cardiovascular diseases. To detect possible blood pressure variability changes from fertile to menopausal status, we enrolled consecutively 219 women: 104 fertile women (46.6 +/- 3.4 years) and 115 menopausal women (53.9 +/- 3.98 years). We evaluated for each patient the body mass index (BMI), 24 h, daytime, night-time systolic and diastolic mean blood pressure values and blood pressure variability data by means of an Ambulatory Blood Pressure Monitoring device. We found a significant higher mean age, body mass index, systolic and diastolic 24 h, day and night-time blood pressure variability in menopausal women when compared to fertile women. Age and BMI were significantly correlated to most blood pressure variability data with the Spearman Rank test. The multivariate logistic regression with dichotomic variables showed that the menopausal status is independently correlated to 24 h systolic (p < 0.0005) and diastolic (p < 0.05) variability, systolic (p < 0.05) and diastolic (p < 0.05) daytime pressure variability and systolic night-time pressure variability (p < 0.05). Furthermore, we found independent correlations between age 24 h systolic (p < 0.05) and night-time diastolic blood pressure variability (p < 0.05), while the BMI was indepententely correlated to BMI 24h diastolic (p < 0.01), daytime systolic (p < 0.01) and diastolic (p < 0.05) blood pressure variability. These data show a significant increase of blood pressure variability in menopausal women when compared to fertile women, even after exclusion of confounding factors, such as aging and BMI. Menopausal status, aging and BMI increase may all, independently, contribute to the enhanced blood pressure variability we found in menopausal women.     

社会牙周治疗需要指数与血脂的相关性研究

目的 了解社会牙周治疗需要指数与血脂水平的关系.方法 1 879名来大庆油田总医院进行健康体检者被纳入本项研究.所有实验对象均取静脉血检测胆固醇、甘油三酯、高密度脂蛋白胆固醇,低密度脂蛋白胆固醇.牙周状况采用牙周治疗需要指数评价.校正了性别、吸烟情况、血糖、年龄、体重指数、舒张压等影响因素后,对牙周治疗需要指数与血脂水平进行相关性分析.结果 牙周治疗需要指数与血清总胆固醇、低密度脂蛋白存在正相关,且具有统计学意义.牙周治疗需要指数与血清高密度脂蛋白、甘油三脂不存在统计学意义的相关关系.结论 牙周病的严重程度与血清总胆固醇、低密度脂蛋白的水平有关,牙周病对血脂水平的影响可能是其促成动脉粥样硬化的病变基础.     

Gender differences in the effects of angiotensin receptor blockers on cardiovascular disease

Women tend to develop hypertension later as they transition into menopause, and during and after menopause the development of hypertension in women is independent of age and body mass index (BMI) but is related to menopause itself. One of the mechanisms of hypertension development in postmenopausal women is believed to be the lack of estrogen leading to vasoconstriction due to both renin-angiotensin-aldosterone (RAA)-sensitive and sodium-sensitive pathways. Nowadays, we have many medications of antihypertensive therapy, including angiotensin converting enzyme (ACE) inhibitor and angiotensin receptor blocker (ARB) in addition to diuretics, beta-blockers, calcium channel blockers. The present review summarizes gender differences in the effects of ARB on blood pressure lowering and cardiovascular outcomes from the published reports of large-scaled, randomized clinical trials and its substudy on sex-specific difference. Many antihypertensive drugs have been developed, and the benefit of blood pressure lowering therapy for the prevention of cardiovascular disease would be expected not only in men but also in women as indicated in the large-scaled clinical studies with ARB.     

Age, adiposity, blood pressure and blood lipids in a rural New Zealand population.

Multiple regression analysis of data on age, blood pressure, adiposity and blood lipids from a rural New Zealand population of over 1200 adults has been undertaken. The results show that rises in blood lipids over time in the population are independent of age and correlate significantly with adiposity. Thus plasma cholesterol and triglycerides correlate with adiposity (expressed as Quetelet's index or skinfold thickness) in men whereas significant correlation in women was only between adiposity and plasma triglycerides. Systolic and diastolic blood pressure in men was strongly correlated with their plasma triglycerides, but not cholesterol, when the effect of age and adiposity was removed. In women however only a weak correlation was observed between plasma triglycerides and systolic blood pressure. The significance of the findings is discussed.     

Effect of 17-beta-estradiol administration during adriamycin-induced cardiomyopathy in ovariectomized rat

The incidence of cardiovascular diseases in humans differs in relation to the age of the patient. Although women suffer less than men from cardiovascular disorders during 15-55 years, after this period the incidence is equivalent in both sexes. This data suggests a cytoprotective effect of estrogens against cardiovascular disease. The estrogens, especially 17-beta-estradiol, are important antioxidant molecules with potential cytoprotective properties during oxidant/antioxidant disbalance induced by oxidative stress. Oxidative stress is often the underlying mechanism during vascular alterations and cardiac damage. The present study evaluated the role of ovariectomy and/or 17-beta-estradiol administration on antioxidant status and lipid peroxidation during cardiac injury induced by adriamycin. Different parameters were measured, including hemodynamic response (arterial pressure and cardiac frequency), lipid peroxidation products (malondialdehyde), protein carbonylation, antioxidant status (reduced glutathione, glutathione peroxidase, superoxide dismutase and catalase), and cardiac injury (creatinine kinase, lactate dehydrogenase, aspartate and alanine aminotransferase). Our study showed that 17-beta-estradiol reduced all of the parameters related to oxidative stress and cardiac injury in ovariectomized rats treated with adriamycin.     

Impact of physical and physiological factors on arterial function

1. Arterial function measurements are increasingly used as surrogate markers of cardiovascular disease and it is important to define which non-pathological factors may influence these measurements. 2. The present study examined the influence of gender, height, body mass index (BMI), waist : hip ratio, heart rate and arterial pressure on pulse wave velocity (PWV), systemic arterial compliance (SAC) and central pressure augmentation index (AI) in 285 normal subjects, 98 males and 187 females, aged 50-82 years. 3. There were significant gender differences in PWV (higher in men), SAC (higher in men) and central pressure AI (lower in men). 4. Both SAC and AI were correlated with height in men and women and height largely accounted for gender differences. 5. Systemic arterial compliance was positively, whereas AI was negatively, correlated with BMI. 6. Both PWV and AI were significantly correlated with heart rate and central pulse pressure. 7. These findings may have implications for cardiovascular disorders. Reduced central arterial compliance and increased central pressure augmentation are potential mediators for the increased cardiovascular risk of short stature. A slow heart rate may contribute to increased central arterial pressure with potentially adverse consequences in older subjects.     

血压、血脂、血糖及肾功能不同水平对老年高血压心血管事件的影响

目的 探讨血压、血脂、血糖及肾功能不同水平对老年高血压心血管事件的影响.方法 选取老年高血压患者448例,以血压(收缩压SBP 140 mm Hg,舒张压DBP 80 mm Hg,脉压PP 60 mm Hg)、血脂(总胆固醇TC 5构.72 mmol/L)、血糖(空腹血糖FPG 7.0 mmol/L)及肾功能(估算肾小球滤过率eGFR 60 ml·min-1·1.73-2)为界值分为低、高水平组.结果 2年随访期间统计冠心病事件52.90%(237/448),脑卒中事件24.11%(108/448),心血管死亡6.70%(30/448).高SBP、DBP、PP、TC、FPG组患者冠心病事件、脑卒中事件与心血管死亡发生率明显高于低SBP、DBP、PP、TC、FPG组(P<0.05),低eGFR组上述指标明显高于高eGFR组(P<0.05).结论 血压、血脂、血糖及肾功能不同水平与老年高血压心血管事件的发生具有紧密关系,控制上述指标于正常范围在改善疾病预后状况中具有重要的意义.     

Prevalence and implications of uncontrolled systolic hypertension

Risk of cardiovascular disease (CVD) increases incrementally with blood pressure, even within the high-normal range. In the general population, 27% of CVD in women and 37% in men is attributable to hypertension. A high percentage of these hypertension-related events occur in those with high-normal blood pressure and mild hypertension; about one-fourth of CVD events in elderly women and one-third in elderly men in the Framingham Study occurred in persons who had blood pressures of 140-159 mm Hg systolic and/or 90-95 mm Hg diastolic. The average systolic blood pressure (SBP) at which coronary heart disease occurs is rather modest (141 mm Hg), as is the pulse pressure (59-63 mm Hg). Of the CVD events in elderly participants in the Framingham Study, 24% in men and 36% in women occurred in persons receiving treatment for hypertension. There is a growing recognition of the importance of the systolic component of blood pressure. About 65% of hypertension in the elderly is isolated systolic hypertension (ISH), and CVD risk increases with pulse pressure. Pulse pressure is not simply a marker for stiff diseased arteries; treatment of ISH in trials promptly reduces the CVD risk, indicating that the pulse pressure generated by the stiff artery is the culprit. Analysis of data from clinical trials indicates that greater reliance should be placed on systolic pressure in evaluating the CVD potential of hypertension. Hypertension, including ISH, seldom occurs in isolation from other risk factors and overt CVD. Risk varies widely depending on the burden of accompanying risk factors. This makes global risk assessment mandatory for evaluating risk and the urgency and nature of treatment required. Evidence incriminating systolic pressure as the dominant blood pressure determinant of CVD has not been translated into clinical practice. Most of the uncontrolled hypertension observed in the Framingham Study is concentrated in those with ISH. This also extends to African-Americans, people with diabetes mellitus and the elderly. When should SBP be considered controlled? Substantial evidence supports the value of treating ISH with SBP exceeding 160 mm Hg. Trial data are not yet available to support recommendations to treat lesser elevations of ISH or pulse pressure per se, but since one-half of patients with mild ISH have two or more additional risk factors, most are candidates for treatment. In such patients, ISH should be considered controlled when their global CVD risk is reduced to below the average for their age.     

心血管疾病相关危险因素分析

目的探讨心血管疾病的相关危险因素。方法比较不同年龄段、不同BMI指数和不同生活习惯的人群中肥胖、高血压、高血糖和血脂异常的发生率。结果不同的年龄、BMI和生活习惯人群中心血管疾病的发生率,差异有统计学意义（P〈0.05）。结论重视健康的生活方式,注重饮食结构的调整,制定合理的运动计划,养成规律的作息习惯,可促进心血管疾病的防治。