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Obesity is becoming increasingly prevalent in China and worldwide and is closely related to the development of hypertension. The pathophysiology of obesity-associated hypertension is complex, including an overactive sympathetic nervous system (SNS), activation of the renin–angiotensin–aldosterone system (RAAS), insulin resistance, hyperleptinemia, renal dysfunction, inflammatory responses, and endothelial function, which complicates treatment. Sodium–glucose cotransporter protein 2 (SGLT-2) inhibitors, novel hypoglycemic agents, have been shown to reduce body weight and blood pressure and may serve as potential novel agents for the treatment of obesity-associated hypertension. This review discusses the beneficial mechanisms of SGLT-2 inhibitors for the treatment of obesity-associated hypertension. SGLT-2 inhibitors can inhibit SNS activity, reduce RAAS activation, ameliorate insulin resistance, reduce leptin secretion, improve renal function, and inhibit inflammatory responses. SGLT-2 inhibitors can, therefore, simultaneously target multiple mechanisms of obesity-associated hypertension and may serve as an effective treatment for obesity-associated hypertension. [ABSTRACT FROM AUTHOR]

Context: During the menopausal transition, there is a greater likelihood of the prevalence of various bothersome symptoms, including vasomotor symptoms (VMS) and mood symptoms.Objective: To investigate the association among bothersome VMS and symptoms of anxiety and depression in Chinese women during perimenopause and early in menopause.Design, Patients, Setting, and Interventions: This study included 430 midlife Chinese women who had experienced natural menopause and were followed up for 10 years. A structured questionnaire was provided annually, comprising the VMS Bother Score (range 1-8) from the Menopause-Specific Quality of Life questionnaire, the Hospital Anxiety and Depression Scale, and other physical and behavioral factors.Results: Among the 430 women evaluated, 78.8% had experienced VMS during long-term follow-up. The overall level of VMS bother score was relatively low (1.92 ± 1.32). Both anxiety and depressive symptoms were significantly associated with VMS bother. After adjusting for potential covariates, the association between anxiety or depression symptoms and VMS bother remained highly significant. Menopausal stage, body mass index, general health, follicle-stimulating hormone, and estradiol were independent contributors to VMS. In time-lagged (1-year) models, VMS bother scores significantly predicted the risk of symptoms of both anxiety and depression the following year. In contrast, anxiety symptoms, rather than depressive symptoms, could predict VMS bother the following year.Conclusion: The prevalence of VMS in our cohort was higher than has been previously reported; however, the overall level of bother was relatively low. This study demonstrated a strong relationship between VMS bother and mood symptoms in Chinese women progressing from perimenopause through natural menopause. [ABSTRACT FROM AUTHOR]

Background and purpose Young Chinese male adults have faced increasing psychological stress. Whether this is associated with the increased risk of coronary artery disease (CAD) in young Chinese males remains unclear. This study aimed to evaluate the correlation and underlying mechanisms of perceived stress and CAD in young male patients. Methods A total of 178 male patients diagnosed as young CAD (aged ≤ 55 years) by coronary angiography (CAG) were enrolled, and 181 age-matched non-CAD individuals were set as control group. Traditional cardiovascular risk factors and levels of epinephrine and norepinephrine were measured, and perceived stress status was accessed by Perceived Stress Scale (PSS). Results The PSS score was correlated with levels of epinephrine ( r = 0.45), norepinephrine ( r = 0.41), high-sensitivity C-reactive protein (hs-CRP) ( r = 0.38, p < 0.01), and current smoking ( r = 0.32) (all p < 0.05). Multivariate logistic regression analysis showed that smoking (OR, 3.12; 95%CI, 1.23–7.91), triglycerides (OR, 1.42; 95%CI, 1.04–1.94), hs-CRP (OR, 3.57; 95%CI, 1.65–7.72), and PSS score (OR, 1.81; 95%CI, 1.23–2.66) were independently correlated with CAD in young patients. The association between PSS score and risk of CAD become insignificant (OR, 1.43; 95%CI, 0.96–2.13) when further adjusted for the levels of epinephrine and norepinephrine. Conclusions After adjustment for multiple cardiovascular risk factors, high perceived stress was an independent risk factor for CAD in young Chinese male patients. Abnormal activation of the sympathetic nervous system may play an important role linking perceived stress with the risk of CAD. [ABSTRACT FROM AUTHOR]

background Blood pressure (BP) hyper-reactivity to the cold pressor test (CPT) has been suggested as a predictor of hypertension. We examined whether BP reactivity to the CPT was associated with hypertension incidence among the Genetic Epidemiology Network of Salt Sensitivity (GenSalt) study participants from China. methods A total of 1,961 GenSalt study participants without any antihypertensive treatment completed the CPT at the baseline examination. Hypertension status was assessed at baseline (2003–2005) and 2 follow- up visits (2008–2009 and 2011–2012). results After adjustment for multiple covariates, both systolic BP (SBP) and diastolic BP reactivity to the CPT were significantly associated with hypertension incidence. For example, the multivariable adjusted odds ratios (ORs, 95% CI) of developing hypertension were 0.92 (0.66, 1.29), 1.42 (1.03, 1.97), and 1.45 (1.05, 2.00) for participants with maximum SBP responses of 6.7–12.0, 12.1–19.2, and ≥19.3 mm Hg, respectively, compared to those with responses of <6.7 mm Hg (P for trend = 0.006). Likewise, the multivariable-adjusted ORs (95% CI) of hypertension were 1.12 (0.79, 1.57), 1.62 (1.15, 2.29), and 1.82 (1.30, 2.55) for participants with the area under the curve of SBP responses of 3.0–16.0, 16.1–29.9, and ≥ 30.0 mm Hg·min, respectively, compared to those with responses of < 3.0 mm Hg·min (P for trend = 0.0001). The associations between BP reactivity variables and the risk of hypertension were not different among subgroups of sex, age, and baseline BP levels. conclusions BP hyperreactivity to the cold stimulus may predict the risk of hypertension among Chinese adults. [ABSTRACT FROM AUTHOR]

Resting heart rate (RHR) is an accessible index of sympathetic activity. The objective of this study was to assess the associations between blood pressure (BP) and RHR in children with different waist circumferences (WCs). The data of the Chinese National Survey on Students' Constitution and Health in 2010 were used. A total of 91,762 participates aged 9 to 18 years with complete records were included. RHR was categorised into quintile groups and WC was stratified into small (<−1.035), medium (≥−1.035 and <1.035) and large (≥1.035) groups respectively, after they were converted into age- and sex-specific z-score. Multivariate linear regression revealed that the association between RHR z-score and BP was similar before and after WC was adjusted for. With 1 standard deviation variation in RHR, BP changed from 2.22 (95 % confidence interval (CI): 1.51, 2.93) to 3.58 mmHg (95 % CI: 2.54, 4.62) in small WC group and 1.83 (95 % CI: 1.10, 2.56) to 4.23 mmHg (95 % CI: 3.38, 5.09) in large WC group respectively. Conclusions: This study revealed that BP was positively associated with RHR among children with different WCs, which implied the positive association between sympathetic activity and BP in children regardless of the amount of abdominal fat. [ABSTRACT FROM AUTHOR]

• The first field test and study on the electrocardiogram physiological indicators of fatigue in miners in high-altitude. • ECG signals were collected, and these physiological signals were preprocessed. • We combined linear and nonlinear dynamics with multi-index information fusion to analyse fatigue characteristics. • We proposed sensitive indices to identify miners' fatigue under the condition of high altitude and low oxygen. Fatigue is an important cause of operational errors, and human errors are the main cause of accidents. This study is an exploratory study in China. Field tests were conducted on heart rate variability (HRV) parameters and physiological indicators of fatigue among miners in high-altitude, cold and low-oxygen areas. This paper studies heart activity patterns during work fatigue in miners. Fatigue affects both the sympathetic and parasympathetic nervous systems, and it is expressed as an abnormal pattern of HRV parameters. Thirty miners were selected as subjects for a field test, and HRV was extracted from 60 groups of electrocardiography (ECG) datasets as basic signals for fatigue analysis. Then, we analyzed the HRV signals of the miners using linear (time domain and frequency domain) and nonlinear dynamics (Poincaré plot and sample entropy (SampEn)), and a Pearson's correlation coefficient analysis and t-tests were performed on the measured indices. The results showed that the time-domain indices (SDNN, RMSSD, SDSD, pNN50, RRn, heart rate (HR), R-wave humps (RH)) and the coefficient of variation (CV)) and the frequency-domain indices (low frequency/high frequency (LF/HF), LFnorm and HFnorm) clearly changed after fatigue. These features were selected using a Poincaré plot, sample entropy, Pearson's correlation coefficient and a t -test for further analysis. The fatigue characteristics and sensitivity parameters of miners in a high-altitude, cold and hypoxic environment were obtained. This study provides deep insight into the use of linear and nonlinear fatigue characteristics to effectively and reliably identify miner fatigue. Furthermore, the study provides a reference for clinical studies of acute mountain sickness in high-altitude, cold and hypoxic environments. [ABSTRACT FROM AUTHOR]

Background: Renal denervation (RDN) is as an effective treatment for heart failure (HF), but its effects on cardiac function of patients with HF are not well documented. Here, the aim was to investigate RDN's effect on patients with chronic systolic HF, by conducting a single-center, prospective, randomized, and controlled study., Methods: Sixty patients with chronic systolic HF were randomly assigned to the RDN or control groups, receiving percutaneous catheter-based RDN with radiofrequency ablation and drug treatment, respectively. All patients performed a 6-minute walk test, echocardiography, blood pressure measurement, and biochemical test, at both baseline and in a 6-month follow up., Results: Over 6-month follow up, patients in RDN group showed a decrease in N-terminal pro-B-type natriuretic peptide (440.1 ± 226.5 pg/mL vs. 790.8 ± 287.0 pg/mL, p < 0.001, Cohen's d = 1.14), an increase in left ventricular ejection fraction (39.1 ± 7.3% vs. 35.6 ± 3.3%, p = 0.017, Cohen's d = 0.61), improved New York Heart Association class assessment (p = 0.01, Cohen's d = 0.66), and decreased blood pressures (p < 0.001, Cohen's d = 0.91), without reporting hypotension and syncope amaurosis. No significant between-group difference was observed for glomerular filtration rate and heart rate., Conclusions: Renal denervation which effectively and safely improves patient's cardiac function as well as exercise tolerance, could be considered as an effective treatment for chronic systolic HF.