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The investigation aims to explore the relationship between the microstructure and mechanical properties of transient liquid phase‐bonded joints of Inconel 718 (IN718) nickel‐based superalloy, utilizing BNi‐1 and BNi‐2 interlayers with a thickness of 50 μm, produced at 1150 °C for varying durations. Microstructural analysis, facilitated by scanning electron microscopy, and phase analysis, utilizing energy‐dispersive spectrometer, reveal a diverse range of microstructures, including continuous eutectic intermetallic phases and eutectic‐free configurations under different bonding conditions. Additionally, the interfacial diffusion of IN718/BNi‐2 is simulated by molecular dynamics. Notably, higher mass fractions of Cr in the interlayer are found to prolong the time of isothermal solidification. The use of BNi‐2 interlayers, 50 μm in thickness, results in joints achieving isothermal solidification within a remarkably brief 10 min, a significantly shorter duration compared to previous studies. Mechanical tests, encompassing microhardness and uniaxial tensile experiments, are carried out on all samples. The microhardness of the isothermally solidified zone decreases with increasing bonding time. The tensile strength of bonded joints increases with extended bonding time before isothermal solidification completion, followed by a subsequent decline. The highest tensile strength (893.3 MPa) is observed in joints using BNi‐2 interlayer after applying postbond heat treatment, representing approximately 88.5% of the base metal tensile strength. [ABSTRACT FROM AUTHOR]

The senescence of aortic valve interstitial cells (VICs) plays a critical role in the progression of calcific aortic valve disease (CAVD). However, the precise mechanisms underlying the senescence of VICs remain unclear, demanding the identification of a novel target to mitigate this process. Previous studies have highlighted the anti‐aging potential of morusin. Thus, this study aimed to explore the therapeutic potential of morusin in CAVD. Cellular experiments reveal that morusin effectively suppresses cellular senescence and cause a shift toward osteogenic differentiation of VICs in vitro. Mechanistically, morusin activate the Nrf2‐mediated antiaging signaling pathway by downregulating CCND1 expression and aiding Keap1 degradation through Trim 25. This activation lead to the upregulated expression of antioxidant genes, thus reducing reactive oxygen species production and thereby preventing VIC osteogenic differentiation. In vivo experiments in ApoE−/− mice on a high‐fat Western diet demonstrate the positive effect of morusin in mitigating aortic valve calcification. These findings emphasize the antiaging properties of morusin and its potential as a therapeutic agent for CAVD. [ABSTRACT FROM AUTHOR]

Soil infiltration properties (SIPs) are crucial soil hydraulic parameters for hydrological and erosion models as they regulate the movement of water and nutrients within the soil. Tillage practice can significantly impact the hydrological and erosional processes of sloping farmland by changing SIPs through altering soil structure. Nevertheless, knowledge regarding the effects of short‐term conservation tillage on SIPs is unclear, which greatly limits the management of soil and water resources of sloping farmland. This study aimed to clarify the potential impact and underlying mechanisms of short‐term implementation of conservation tillage on SIPs under three typical tillage management types: conventional downslope tillage (DT), conservation contour tillage (CT), and no‐tillage (NT) in the black soil region of Northeast China. SIPs of initial infiltration rate (IIR), steady infiltration (SIR), and hydraulic conductivity (Ks) were determined by a field disc infiltration experiment under pressure heads (h) of −3, −1.5, and 0 cm. The results revealed that short‐term implementation of conservation tillage management degraded SIPs, with a significant difference observed between DT and NT. In comparison to DT, the mean SIPs of IIR, SIR, and Ks of CT decreased by 27.5%, 31.2%, and 28.6%, and the corresponding reduced values of NT were 54.1%, 65.0%, and 65.5%, respectively. SIPs were significantly correlated with soil texture, bulk density (BD), capillary porosity (CP), total porosity (TP), field capacity (FC), saturated water content (SSWC), and organic matter content (SOM). Among these influencing factors, the variations in SIPs among different tillage management and soil layers were primarily influenced by differences in clay and gravel contents, FC, and SSWC and SSWC played the most critical role. These results highlight the substantial impacts and clarify the mechanisms of short‐term conservation tillage on SIPs, which is helpful for understanding the potential effect of short‐term conservation tillage management on hydrology and erosional processes, thereby improving the sustainable utilization of arable land. [ABSTRACT FROM AUTHOR]

In this work, hydrophobic nano‐silica (SiO2) and β‐nucleating agent are incorporated into polypropylene random copolymer (PP‐R) matrix by melt blending. The effect of the content of nano‐SiO2/β‐nucleating agent on the crystallization and mechanical behaviors of PP‐R was investigated in detail. For a nano‐SiO2 content of 0.5 wt% and a β‐nucleating agent content of 0.5 wt%, the tensile strength and impact strength of the composite were in a more balanced position. Regarding isothermal and non‐isothermal crystallization experiments, nano‐SiO2/β‐nucleating agent significantly accelerated the nucleation and growth of crystallites with a synergistic nucleation effect. Also, the crystallization kinetics of PP‐R/nano‐SiO2/β‐nucleating agent, PP‐R/nano‐SiO2 and PP‐R/β‐nucleating agent composites were analyzed and compared using the Avrami equation. The results showed that the PP‐R/nano‐SiO2/β‐nucleating agent composites have better crystallization rate and shorter semi‐crystallization time. This study shows far‐reaching theoretical and practical implications for accelerating the development of new high‐performance PP‐R materials. © 2023 The Authors. Polymer International published by John Wiley & Sons Ltd on behalf of Society of Industrial Chemistry. [ABSTRACT FROM AUTHOR]

Introduction: Studies on the relationship between environmental tobacco smoke (ETS) and gestational diabetes mellitus (GDM) are limited. In this study, we aimed to clarify the association between ETS at different trimesters of pregnancy and the risk of GDM among non‐smoking pregnant women. Methods: A total of 16,893 non‐smoking mothers from the Southwest Birth Cohort, China, were included in the final analyses. Exposure and outcome measures included self‐reported ETS status at different trimesters of pregnancy and GDM diagnosis. Multivariable logistic regression models were constructed to estimate the association between ETS and GDM. Results: The prevalence of ETS exposure was 25.7%. Compared with no ETS, ever ETS had an increased risk of GDM, with an adjusted odds ratio (95% confidence intervals) of 1.21 (1.09, 1.33). The association remained consistent at different trimesters of pregnancy ETS exposure. In the last trimester and with continuous ETS exposure, the risk of GDM increased significantly with the increase in the duration of the exposure. The risk of GDM associated with ever ETS during pregnancy significantly increased in mothers over 30 years old and pre‐pregnancy overweight (P for interaction <0.05). Conclusions: ETS exposure at different trimesters of pregnancy was associated with an increased risk of GDM among non‐smoking pregnant women. These findings emphasise the importance of preventing ETS exposure during pregnancy. [ABSTRACT FROM AUTHOR]

Straw incorporation plays a vital role in regulating runoff and soil erosion of cropland. However, the benefits of straw incorporation to control runoff and soil erosion on croplands under different degradation degrees have not been fully clarified. This study was performed to investigate the benefits of straw incorporation to reduce runoff and soil erosion under different degradation degrees and determine its dominant influencing factors. The event runoff and soil erosion were measured from late May to late September 2022 using 16 runoff plots (9 m in length and 3.3 m in width) in the black soil region of Northeast China. The results showed that straw incorporation significantly reduced runoff and soil erosion on croplands with different degradation intensities. Compared to croplands without straw incorporation, runoff and soil erosion of straw incorporation decreased by 48. 8%, 40.0%, 30.9%, 25.5%, and 55.2%, 48.8%, 40.8%, and 36.5% for croplands of no, light, moderate, and strong degradation intensities, respectively. The roles of straw incorporation in controlling runoff and erosion decreased with rainfall intensity. Compared to light rainfall, runoff reduction ratio and erosion reduction ratio of moderate and heavy rainfalls reduced by 19.5%–61.3% and 27.5%–64.4%. The benefit of straw incorporation to control runoff and erosion was limited on strong degraded cropland or under heavy storm. Moreover, soil hydrological properties and crop growth characteristics decreased by land degradation and improved by straw incorporation, which inevitably affected runoff and soil erosion. Soil bulk density, maximum rainfall intensity of 30‐min, saturated water content, precipitation, rainfall intensity, saturated hydraulic conductivity, and total porosity were the dominant factors affecting the roles of straw incorporation in controlling runoff and erosion on degraded croplands. The results of this study are helpful to prevent land degradation or recover the functions of degraded lands in semi‐humid region. [ABSTRACT FROM AUTHOR]

Background: Associations between adjuvant chemotherapy (ACT) and the improvement in survival for patients with pT2N0M0 non‐small cell lung cancer (NSCLC) who received R0 resection remain controversial. This study aimed to evaluate the value of ACT for patients with pT2N0M0 NSCLCs, and to identify the subgroups who could benefit from ACT. Methods: Multivariable Cox proportional hazards regression models were used to estimate independent prognostic factors. High‐risk factor (HRF) included visceral pleural invasion (VPI), lymphovascular invasion (LVI) and poor differentiation/undifferentiated tumors. Results: Of the 899 patients, 277 (30.8%) patients received ACT. More younger patients (p < 0.001) and male patients (p = 0.007) received ACT. With the increase of pathological tumor size (p < 0.001) and the number of HRFs (p < 0.001), there was a significant rise in the proportion of patients receiving ACT. For all patients, ACT could not improve recurrence‐free survival (RFS) (p = 0.672) and overall survival (OS) (p = 0.306). For patients with pathological stage IIA or radiological pure‐solid tumors, ACT could significantly improve the OS (p = 0.011 and p = 0.037, respectively), and multivariate analysis revealed that ACT was an independent prognostic factor for patients with pathological stage IIA (p = 0.005). ACT could improve the OS significantly in patients with pathological stage IB pure‐solid lung adenocarcinoma (LUAD) (p = 0.043). Conclusion: ACT was valuable for patients with pathological stage IIA (pT2bN0M0) and patients with radiological pure‐solid LUAD of pathological stage IB. A combination of radiological features and pathological subtypes could be helpful when selecting patients with pT2N0M0 NSCLCs for ACT. [ABSTRACT FROM AUTHOR]

During March 2022 to January 2023, two Omicron waves hit Shanghai and caused a massive number of reinfections. To better understand the incidence and clinical characteristics of SARS‐CoV‐2 reinfection in Shanghai, China, we conducted a multicenter cohort study. COVID‐19 patients first infected with BA.2 (March 1, 2022–May 23, 2022) who were quarantined in Huashan Hospital, Renji Hospital, and Shanghai Jing'an Central Hospital were followed up for reinfection from June 1, 2022 to January 31, 2023. Of 897 primary infections, 148 (16.5%) experienced reinfection. Incidence rate of reinfection was 0.66 cases per 1000 person‐days. Female gender (adjusted odds ratio [aOR]= 2.19, 95% confidence interval [CI]: 1.29–3.83) was a risk factor for reinfection. The four most common symptoms of reinfections during the circulation of BA.5 sublineages were cough (62.59%), sore throat (54.42%), fatigue (48.98%), and fever (42.57%). Having received a booster vaccination was not associated with reduced severity of reinfection in comparison with not having received booster vaccination. After matched 1:1 by age and sex, we found that reinfections with BA.5 sublineages had significantly lower occurrence and severity of fever, fatigue, sore throat, and cough, as compared to primary infections with BA.5 sublineages. SARS‐CoV‐2 Omicron reinfections were less severe than Omicron primary infections during the circulation of the same subvariant. Protection offered by both vaccination and previous infection was poor against SARS‐CoV‐2 reinfection. [ABSTRACT FROM AUTHOR]

Serum samples were collected from 54 hepatitis B e antigen (HBeAg)‐positive Chinese patients infected with hepatitis B virus (HBV) subgenotype B2 or C2. They were compared for transmission efficiency using same volume of samples or infectivity using same genome copy number. Adding polyethylene glycol (PEG) during inoculation did not increase infectivity of fresh samples but markedly increased infectivity following prolonged sample storage. Differentiated HepaRG cells infected without PEG produced more hepatitis B surface antigen (HBsAg) and higher HBsAg/HBeAg ratio than sodium taurocholate cotransporting polypeptide (NTCP)‐reconstituted HepG2 cells infected with PEG. They better supported replication of core promoter mutant in contrast to wild‐type (WT) virus by HepG2/NTCP cells. Overall, subgenotype C2 samples had higher viral load than B2 samples, and in general produced more HBeAg, HBsAg, and replicative DNA following same‐volume inoculation. Precore mutant was more prevalent in subgenotype B2 and had reduced transmission efficiency. When same genome copy number of viral particles was inoculated, viral signals were not necessarily higher for three WT C2 isolates than four WT B2 isolates. Using viral particles generated from cloned HBV genome, three WT C2 isolates showed slightly reduced infectivity than three B2 isolates. In conclusion, subgenotype C2 serum samples had higher transmission efficiency than B2 isolates in association with higher viral load and lower prevalence of precore mutant, but not necessarily higher infectivity. PEG‐independent infection by HBV viremic serum samples is probably attributed to a labile host factor. [ABSTRACT FROM AUTHOR]

Recognizing aberrant cytoplasmic dsDNA and stimulating cGAS‐STING‐mediated innate immunity is essential for the host defense against viruses. Recent studies have reported that SARS‐CoV‐2 infection, responsible for the COVID‐19 pandemic, triggers cGAS‐STING activation. cGAS‐STING activation can trigger IRF3‐Type I interferon (IFN) and autophagy‐mediated antiviral activity. Although viral evasion of STING‐triggered IFN‐mediated antiviral function has been well studied, studies concerning viral evasion of STING‐triggered autophagy‐mediated antiviral function are scarce. In the present study, we have discovered that SARS‐CoV‐2 ORF3a is a unique viral protein that can interact with STING and disrupt the STING‐LC3 interaction, thus blocking cGAS‐STING‐induced autophagy but not IRF3‐Type I IFN induction. This novel function of ORF3a, distinct from targeting autophagosome‐lysosome fusion, is a selective inhibition of STING‐triggered autophagy to facilitate viral replication. We have also found that activation of bat STING can induce autophagy and antiviral activity despite its defect in IFN induction. Furthermore, ORF3a from bat coronaviruses can block bat STING‐triggered autophagy and antiviral function. Interestingly, the ability to inhibit STING‐induced autophagy appears to be an acquired function of SARS‐CoV‐2 ORF3a, since SARS‐CoV ORF3a lacks this function. Taken together, these discoveries identify ORF3a as a potential target for intervention against COVID‐19. [ABSTRACT FROM AUTHOR]

Subsurface water flow can cause serious soil erosion on sloping farmland. Sediment transport capacity (Tc) data at different subsurface water flow depths are limited. The objective of this study was to develop a new equation that can accurately determine Tc under subsurface water flow impacts. Subsurface water flows were arranged at three depths: 15, 10, and 5 cm. Three flow discharges (2, 4, and 8 L min−1) and four slope gradients (5°, 10°, 15°, and 20°) were designed to conduct flume scouring experiments. The results indicate that flow velocity, shear stress, and unit energy with linear equations and stream power with power equations can be used to determine Tc, but those using the unit stream power perform relatively poorly under the different subsurface water flow depths. Among these parameters, the shear stress is the preferred predictor of Tc. The addition of prediction parameters, subsurface water flow depth, in response to Tc equations can improve the accuracy of Tc modeling. The power‐exponential equation of shear stress combined with the subsurface water flow depth best described the Tc of rill flow under subsurface water flow impacts. Subsurface water flow can increase the soil erodibility, and thus decrease the critical shear stress, resulting in a lower critical flow velocity at which sediment transport capacity can be achieved. This research provides a new equation for directly determining Tc in subsurface water flow‐impacted rill flow on purple soil slopes. [ABSTRACT FROM AUTHOR]

This study aims to examine the trends and disparities in the combined prevalence of overweight and obesity among children in China by regions and specific groups over the last 30 years. PubMed, Wanfang, CNKI, VIP database, official websites of national governments and professional institutions/associations were systematically searched, for related reports and studies published up until December 2021. Reports based on nationally representative survey data were also examined and included. In mainland China, overweight and obesity decreased in pre‐school children (≤6 years old) and increased in school‐aged children (7–18 years old) between 2010 and 2013 to 2015 and 2017, but long‐term trends predict future increases in both groups. The prevalence of overweight and obesity in primary school students in Hong Kong dropped from 21.4% in 2007–2008 to 17.6% in 2016–2017. In Macao, the prevalence of overweight and obesity in children aged 6–18 years was reported by age stratification; the lowest and highest prevalence was 13.4%, 29.3% and 9.2%, 21.7% for boys and girls in latest survey in 2015, respectively. The prevalence of overweight and obesity in primary, middle and high school students in Taiwan dropped from 28.2%, 27.1% and 31.1% in 2010 to 26.7%, 25.2% and 26.7% in 2013, respectively. Furthermore, in mainland China, the prevalence in rural left‐behind boys and girls was 10.7% and 7.0%, respectively, in 2011, and the prevalence among migrant pre‐school children was about 5.0% around 2010. In summary, the prevalence of overweight and obesity in school‐aged children has increased in mainland China and Macao, but decreased in Hong Kong and Taiwan prior to 2017. The projections suggest that the highest prevalence of overweight and obesity in pre‐school children will be in rural children in the future. These factors need to be considered when formulating and implementing national policies and programmes to fight overweight and obesity. [ABSTRACT FROM AUTHOR]

Most spatial models include a spatial weights matrix (W) derived from the first law of geography to adjust the spatial dependence to fulfill the independence assumption. In various fields such as epidemiological and environmental studies, the spatial dependence often shows clustering (or geographic discontinuity) due to natural or social factors. In such cases, adjustment using the first‐law‐of‐geography‐based W might be inappropriate and leads to inaccuracy estimations and loss of statistical power. In this work, we propose a series of data‐driven Ws (DDWs) built following the spatial pattern identified by the scan statistic, which can be easily carried out using existing tools such as SaTScan software. The DDWs take both the clustering (or discontinuous) and the intuitive first‐law‐of‐geographic‐based spatial dependence into consideration. Aiming at two common purposes in epidemiology studies (ie, estimating the effect value of explanatory variable X and estimating the risk of each spatial unit in disease mapping), the common spatial autoregressive models and the Leroux‐prior‐based conditional autoregressive (CAR) models were selected to evaluate performance of DDWs, respectively. Both simulation and case studies show that our DDWs achieve considerably better performance than the classic W in datasets with clustering (or discontinuous) spatial dependence. Furthermore, the latest published density‐based spatial clustering models, aiming at dealing with such clustering (or discontinuity) spatial dependence in disease mapping, were also compared as references. The DDWs, incorporated into the CAR models, still show considerable advantage, especially in the datasets for common diseases. [ABSTRACT FROM AUTHOR]

Accurately understanding the characteristics of a wetland ecological restoration plant communities and their species diversity relationships is the key to improving wetland management and biodiversity protection. To see the effects of restoration strategies implemented in Xinqiang River National Wetland Park, China, we studied 4 models for ecological restoration, namely protection and conservation (PC), reasonable utilization (RU), restoration and reconstruction (RR) and the building of constructed wetland (CW). We then analyzed the features of the plant communities, species diversity and soil properties, and carried out a correlation analysis between plant communities and the species diversity. Finally, we selected four key communities and analyzed their features and soil properties using a symmetric matrix. Results showed that the soil in the PC model had the highest amount of available phosphorus, available nitrogen and pH value. The soil had higher moisture content in the RU model and CW model than the other 2 models. Based on the correlation analysis, we found that there are obvious common characteristics among different ecological restoration types, that is, the diversity characteristics of tree layer, shrub layer and herb layer have obvious differentiation characteristics. We identified four features of the community characteristics that could improve species diversity: SA, TH, HH and SCD. The results of this study have provided a theoretical basis that there is a coupling relationship between ecological community characteristics and species diversity. The above coupling results have practical significance for maintaining good ecological structure and diversity protection. [ABSTRACT FROM AUTHOR]

Acute hepatopancreatic necrosis disease (AHPND) is a significant deadly infectious disease in the shrimp farming industry, causing serious economic losses globally every year. Because of the rapid progress speed, lack of effective treatment and high mortality rate of AHPND, monitoring with frequent diagnostic tests is vital for a successful prevention. The conventional histopathological diagnosis fell far short of the requirement for efficient monitoring, and the polymerase chain reaction (PCR)‐based molecular diagnostic methods that rely on sophisticated thermocycler and trained personnel are hardly applicable in the field. Combining the recombinase polymerase amplification (RPA) and the lateral flow strips (LFSs), a diagnostic method suitable for on‐site everyday monitoring of AHPND has been established in this study. This RPA‐LFS method targeted the binary toxic photorhabdus insect‐related genes PirA and PirB on a virulence plasmid of the AHPND‐causative Vibrioparahaemolyticus strains. The diagnostic test was completed within 30 min at 37°C and showed good specificity and good sensitivity of 20 fg DNA of the AHPND shrimp or one colony‐forming unit of the causative bacterium per reaction, which was better than the administration‐approved standard AP4 assay. Crude templates from sample boiling could be directly used. Tests of clinical samples showed 100% consistency of this method with the standard AP4 assay. This RPA‐LFS method can be a good choice for on‐site diagnosis of AHPND with quick response time, easy procedure and low demand for resources, and should have significant value for the control of spreading of this dangerous disease in farmed shrimp. [ABSTRACT FROM AUTHOR]

The objective of this study was to investigate the hypoglycemic and hypolipidemic effects of phlorizin on sweet tea in rats with diabetes. Diabetic rat model was established by feeding with HFD (high‐fat diet) and then treating with intraperitoneal injection of STZ (streptozocin). The experiments were divided into therapeutic and preventive experiments. In both experiments, rats were divided into normal, diabetic control, positive control, and phlorizin groups. Symptoms of diabetes, fasting blood glucose (FBG) levels, serum lipid parameters, and pathological changes in the pancreas and liver were evaluated. It was found that the symptoms of diabetes were improved by phlorizin treatment. In addition, phlorizin could decrease FBG, improve serum lipid levels, protect against damaged pancreas islet, and decrease fat deposition in hepatic cells. These effects of phlorizin can be shown only attain to a certain dosage. It can be concluded that phlorizin has the therapeutic and preventive effects on hyperlipidemia and hyperglycemia in diabetes rats. [ABSTRACT FROM AUTHOR]

With the advancement of computational imaging, a large number of spectral imaging systems based on encoding–decoding have emerged, among which phase‐encoding spectral imaging systems have attracted widespread interest. Conventional phase‐encoding systems suffer from severe image degradation and limited light throughput. To address these challenges and achieve video‐rate spectral imaging with high spatial resolution and spectral accuracy, a novel optical system based on diffractive‐refractive hybrid optics is proposed. Here, a diffractive optical element is employed to perform imaging and dispersion functions, while a rear lens is used to shorten the system's back focal length and reduce the size of the point spread function. Meanwhile, convolutional neural network‐based spectral reconstruction algorithms are employed to reconstruct the spectral data cubes from diffraction blurred images. A compact, cost‐effective, and portable prototype has been constructed, demonstrating the capability to acquire and reconstruct 30 spectral data cubes per second, each with dimensions of 1080×1280×43${1080 \times 1280 \times 43}$ in the spectral range of 480–900 nm with a 10 nm spectral interval. The optical system has the potential to broaden the application scope of phase‐encoding spectral imaging systems in various scenarios. [ABSTRACT FROM AUTHOR]

Background The detrimental effects of increased variability in systolic blood pressure (SBP) on cardiovascular disease (CVD) and mortality risk in patients with diabetes mellitus remains unclear. This study evaluated age-specific association of usual SBP visit-to-visit variability with CVD and mortality in patients with type 2 diabetes mellitus. Methods and Results A retrospective cohort study investigated 155 982 patients with diabetes mellitus aged 45 to 84 years without CVD at baseline (2008-2010). Usual SBP variability was estimated using SBP SD obtained from a mixed-effects model. Age-specific associations (45-54, 55-64, 65-74, 75-84 years) between usual SBP variability, CVD, and mortality risk were assessed by Cox regression adjusted for patient characteristics. After a median follow-up of 9.7 years, 49 816 events (including 34 039 CVD events and 29 211 mortalities) were identified. Elevated SBP variability was independently, positively, and log-linearly associated with higher CVD and mortality risk among all age groups, with no evidence of any threshold effects. The excess CVD and mortality risk per 5 mm Hg increase in SBP variability within the 45 to 54 age group is >3 times higher than the 70 to 79 age group (hazard ratio, 1.66; 95% CI, 1.49-1.85 versus hazard ratio, 1.19; 95% CI, 1.15-1.23). The significant associations remained consistent among all subgroups. Patients with younger age had a higher association of SBP variability with event outcomes. Conclusions The findings suggest that SBP visit-to-visit variability was strongly associated with CVD and mortality with no evidence of a threshold effect in a population with diabetes mellitus. As well as controlling overall blood pressure levels, SBP visit-to-visit variability should be monitored and evaluated in routine practice, in particular for younger patients.

Background The relationship between systolic blood pressure (SBP) and cardiovascular disease (CVD) among patients with diabetes mellitus remains unclear. The study aimed to explore age-specific associations between SBP and CVD. Methods and Results A population-based retrospective cohort study was conducted on 180 492 Chinese adults with type 2 diabetes mellitus in 2008-2010, with follow-up to 2017. Age-specific associations (<50, 50-59, 60-69, and 70-79 years) between the average SBP in the previous 2 years and CVD risk were assessed by adjusted Cox proportional hazards regression with age-specific regression dilution ratios and patient characteristics stratified by subgroups. During a median follow-up of 9.3 years (1.5 million person-years), 32 545 patients developed a CVD, with an incidence rate of 23.4 per 1000 person-years. A positive and log-linear association between SBP and CVD risk was observed among the 4 age groups without evidence of a threshold down to 120 mm Hg, but the magnitude of SBP effect on CVD attenuated with increased age. The CVD risk in the age group <50 years was ≈22% higher than the age group 70 to 79 years (hazard ratio [HR], 1.33 [95% CI, 1.26-1.41] versus HR, 1.09 [95% CI, 1.07-1.11]). Each 10-mm Hg higher SBP was associated with 12% (HR, 1.12 [95% CI, 1.10-1.13]), 11% (HR, 1.11 [95% CI, 1.10-1.13]), and 20% (HR, 1.20 [95% CI, 1.17-1.22]) higher risk of all composite CVD events, individual CVD, and CVD mortality, respectively. Conclusions There is a significant log-linear relationship between baseline SBP and the risk of CVD among patients with diabetes mellitus in China. The risk increases from an SBP of 120 mm Hg onward. Age influences this relationship significantly, with younger patients (<50 years) having a greater risk of CVD for a similar rise in SBP as compared with those who are older. These findings suggest that differential target blood pressures stratified by age maybe useful.