ObjectiveTo explore the prevalence and risk factors of hypertension in Anyue County from June 2011 to June 2013.
MethodsUsing stratfied random cluster sampling method, 5 391 people over 15 years of age were selected from 3 residential areas and 3 natural villages to finish a questionnaire and blood pressure measurement.
ResultsThe total prevalence rate of hypertension in Anyue County was 18.77%. The prevalence rates of hypertension in urban areas and rural areas were 21.75% and 16.20%, and the difference was significant (χ2=27.120, P<0.001). In both urban and rural areas, the prevalence rate of hypertension increased with age (χ2=475.634, P<0.001; χ2=394.026, P<0.001). The percentages of awareness, treatment and control in Anyue County were 31.30%, 24.41%, and 9.09%. The percentages of awareness, treatment and control in urban areas were 40.15%, 33.70%, and 11.23% and were 20.68%, 13.65%, and 6.61% in rural areas. There were significant differences in the percentages of awareness, treatment and control between urban and rural areas (χ2=44.475, P<0.001; χ2=54.861, P<0.001; χ2=8.202, P=0.004). The logistic regression analysis showed that age (OR=1.061, P<0.001), diabetes (OR=1.550, P<0.001), hyperlipemia (OR=2.372, P<0.001) and smoking (OR=1.335, P<0.001) were the risk factors for hypertension; and it showed that high level of education was a protective factor for hypertension (OR=0.755, P<0.001).
ConclusionBecause of high prevalence and low percentages of awareness, treatment and control in Anyue County, the prevention and control situation of hypertension are grim. We should focus on the control of smoking, blood lipid and blood glucose.
Perioperative management of 58 hypertensive patients suffering from surgical disease is reported. We emphasize that before operation the blood pressure should be adequately controlled, and heart function promoted. It is safer that the diastolic pressure is controlled under 14 kPa before operation. During operation we strictly observe the change of the blood pressure and manage it in time. Analgesic and antihypertensive agents are used after operation.
ObjectiveTo study the correlation between neck artery vascular sclerosis and homocysteine levels in hypertensive patients.
MethodsA total of 2 132 patients with hypertension participated in the program of "Stroke screening and prevention in Dongying city" were included from Sep. 2012 to Jan. 2013. Questionnaire, physical examination, biochemical blood tests and carotid artery ultrasound were conducted in all included patients. According to the level of homocysteine (Hcy), patients were divided into three groups:716 patients with Hcy level less than 12.3 mm/L were in Group 1, 703 patients with Hcy level 12.3 to 16.5 mm/L were in Group 2, and 713 patients with Hcy level more than 16.5 mm/L were in Group 3. The influence of Hcy levels on carotid atherosclerosis was analyzed.
Results① The prevalence rate for carotid plaques in Groups 1, 2, and 3 were 50.28%, 60.03% and 65.36%, respectively. The prevalence rate for carotid plaques in Group 2 was higher than that in Group 1 with a statistical difference (OR=1.485, 95% CI 1.203 to 1.833, P=0.000). The prevalence rate in Group 3 was also higher than that in Group 1 with a statistical difference (OR=1.866, 95% CI 1.508 to 2.308, P=0.000). ② The prevalence rate for carotid plaques was 62.24% in the rural population, and 52.39% in the urban population. The difference between urban and rural populations was statistically significant (OR=1.500, 95% CI 1.259 to 1.788, P=0.000). ③ Using the presence of carotid plaques as a dependent variable and Hcy level as a covariant, logistic regression analysis found that the plaque formation in Group 2 was 1.491 times than in Group 1 and the plaque formation in Group 3 was 1.752 times than in Group 1. After adjusting the risk factors (gender, age, BMI, TG, TC, LDL-C, HDL-C and blood sugar level), the results showed that the plaque formation in Group 2 was 1.388 times than in Group 1, and the plaque formation in Group 3 was 1.452 times than in Group 1.
ConclusionThere is a correlation between the increased incidence of carotid plaque and homocysteine levels in patients with hypertension. The incidence of carotid plaque in the rural population with hypertension is higher than that in the urban population. In the population with hypertension, high homocysteine level is an independent risk factor for the formation of carotid plaques.
Objective To analyze the causes of missed diagnosis of sleep apnea hypopnea syndrome ( SAHS) . Methods 42 missed diagnosed cases with SAHS from May 2009 to May 2011 were retrospectively analyzed and related literatures were reviewed. Results The SAHS patients often visited the doctors for complications of SAHS such as hypertension, diabetes mellitus, metabolic syndrome, etc. Clinical misdiagnosis rate was very high. Lack of specific symptoms during the day, complicated morbidities, and insufficient knowledge of SAHS led to the high misdiagnosis rate and the poor treatment effect of patients with SAHS. Conclusion Strengthening the educational propaganda of SAHS, detail medical history collection, and polysomnography monitoring ( PSG) as early as possible can help diagnose SAHS more accurately and reduce missed diagnosis.
ObjectiveTo explore and compare the therapeutic effects of neuro-endoscopic and craniotomic hematoma evacuation for hypertensive hematomas in the basal ganglia region.
MethodsEighty-six patients with hypertensive hematomas in the basal ganglia regions treated between January 2010 and September 2014 were divided into neuro-endoscopy and craniotomy groups randomly with 43 in each. Hematoma was removed directly under neuro-endoscope in the endoscopic group, while it was removed under the operating microscope in the craniotomy group. The average operation bleeding amount, residual hematoma after operation, hematoma evacuation rate, the changes of National Institutes of Health Stroke Scale (NIHSS) and Barthel index (BI) scores before operation, 1 and 3 months after operation were compared between the two groups. All data were analyzed statistically.
ResultsThe average amount of operation bleeding was (127±26) mL, postoperative residual hematoma was (6±4) mL, and the hematoma clearance rate was (86±9)% in the neuro-endoscopy group, while those three numbers in the craniotomy group were respectively (184±41) mL, (11±6) mL, and (72±8)%, with all significant differences (P < 0.05). The NIHSS and BI scores were not significantly different between the two groups before surgery (P > 0.05). Seven days, one month and three months after surgery, the NIHSS score was significantly lower, and the BI score was significantly higher in the neuro-endoscopy group than the craniotomy group (P < 0.05).
ConclusionNeuro-endoscopic surgery for hypertensive hematomas in basal ganglia region is proved to have such advantages as mini-invasion, direct-vision, complete clearance and good neural function recovery after surgery, which is a new approach in this field.
ObjectiveTo evaluate the level of arteriosclerosis in patients with hypertension defined by the American Heart Association (AHA) and classical diagnostic criteria. MethodsA total of 3 815 residents were enrolled in 10 communities in north Shanghai. According to the classic diagnostic criteria of hypertension (systolic blood pressure≥140 mmHg and/or diastolic blood pressure≥90 mmHg) and AHA diagnostic criteria (systolic blood pressure≥130 mmHg and/or diastolic blood pressure≥80 mmHg), the population was divided into normal blood pressure group, AHA diagnosis standard hypertension group, and classic methods of diagnosis of hypertension group. The differences in cervical-femoral pulse wave velocity (cf-PWV) and brachial-ankle pulse wave velocity (ba-PWV) among the three groups were compared. SPSS 13.0 software was then used for data analysis.ResultsCompared with the patients who met the standard criteria, patients who met AHA criteria had lower mean ages (70.2±7.4 vs. 71.4±7.9 year, P<0.001), more history of hypertension (48.8% vs. 72.7%, P<0.001) and lower body mass index (24.1±3.5 vs. 24.7±3.9 kg/m2, P<0.001), low-density lipoprotein (3.07±0.92 vs. 3.15±0.97 mmol/L, P=0.033), cf-PWV (8.7±2.7 vs. 9.8±3.0 m/s, P<0.001) and ba-PWV (1 647.7±610.1 vs. 1 797.2±729.7 cm/s, P<0.001). ConclusionsThe degree of arteriosclerosis of patients who meet AHA standards is between that who meet the standard criteria and the normal population. For these patients, blood pressure should be actively controlled to delay the progression of arteriosclerosis.
Hypertension and its associated cardiovascular diseases such as stroke and ischemic heart disease result in a high burden of disease and health losses, making it the most burdensome disease in the world and one of the important public health issues in China. Currently Chinese scholars have carried out a large number of studies on the prevalence of hypertension, including regional and national prevalence studies. However, long-term follow-up studies on incidence of hypertension are relatively few and mostly limited to specific ages and regions. This paper summarizes the prevalence, incidence and epidemiological trend of hypertension in Chinese adults. The hypertension prevalence increased from 5.1% in 1959 to 27.5% in 2018, and presents an overall trend of high in the north and low in the south. The hypertension incidence is at a high level (the cumulative incidence was 33.4% after 22 years-follow-up), but there are few researches on the trend of hypertension incidence in huge region.
ObjectiveTo investigate the clinical efficacy and safety of carvedilol in the treatment of arrhythmia in patients with hypertension complicated with diabetes mellitus.
MethodsWe selected the patients with hypertension complicated with diabetes mellitus who were hospitalized in the Harrison International Peace Hospital Affiliated to Hebei Medical University for treatment from Oct. 2011 to Oct. 2013. The cases were divided into a trial group and a control group. The control group was given routine treatment (eg., hypoglycaemic drugs, angiotensin converting enzyme inhibitors). On the basis of the same treatment of the control group, the trial group was given carvedilol. The efficacy and adverse reaction were observed, recorded and then analyzed between the two groups.
ResultsA total of 140 patients were included (70 cases in each group). With the loss of 10 cases in the control group, the data of 70 cases in the trial group and 60 cases in the control group were finally analyzed. The results showed that the trial group was superior to the control group in the total effectiveness (χ2=8.320, P=0.004) and the dynamic ECG improvement of premature ventricular contraction (χ2=5.333, P=0.014) with significant differences. Both groups were significantly improved in blood pressure and heart beats compared with the situation before treatment (Both P < 0.05), and the trial group was better than the control group with a significant difference. During the treatment, three cases in the trial group had mild gastrointestinal symptoms which spontaneously disappeared later.
ConclusionThe clinical effectiveness of carvedilol for arrhythmia in patients with hypertension complicated with diabetes mellitus is significant. It is safe and effective which is recommended in clinical application.
