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Background The mean systolic blood pressure (SBP) for US adults increases with age. Determining characteristics of US adults ≥65 years with normal blood pressure (BP) may inform approaches to prevent this increase. Methods We analyzed US National Health and Nutrition Examination Survey 2011–2018 data (n = 21,581). BP was measured up to 3 times and averaged. Normal BP was defined as SBP <120 mm Hg and diastolic BP (DBP) <80 mm Hg among participants not taking antihypertensive medication. Those with SBP ≥120 mm Hg, DBP ≥80 mm Hg, self-reporting having hypertension or taking antihypertensive medication were categorized as having elevated BP or hypertension. Results The prevalence of normal BP was 57.8%, 25.3%, 11.2%, and 5.0% among US adults who were 18–44, 45–64, 65–74, and ≥75 years, respectively. After multivariable adjustment, in US adults ≥65 years of age, normal BP vs. elevated BP/hypertension was more common among those with moderate and no vs. heavy alcohol consumption (prevalence ratio [PR] 3.03; 95% confidence interval [CI] 1.25–7.36 and 2.53; 95% CI 0.96–6.65, respectively), ≥150 vs. <150 minutes of physical activity per week (PR = 1.44; 95% CI 1.01–2.05), overweight and normal weight vs. obesity (PR = 1.88; 95% CI 1.22–2.90 and 2.94; 95% CI 1.89–4.59, respectively), and a high Dietary Approaches to Stop Hypertension score (PR = 1.43; 95% CI 1.00–2.05). US adults ≥65 years with normal BP vs. elevated BP/hypertension were less likely to have good or fair/poor vs. excellent/very good self-rated health, diabetes, albuminuria, atherosclerotic cardiovascular disease, and heart failure. Conclusions Among US adults ≥65 years, normal BP was associated with healthy lifestyle factors and a lower prevalence of adverse health conditions. [ABSTRACT FROM AUTHOR]

A meta-analysis of randomized clinical trials is performed to qualify the relationship between folic acid supplementation and risk of cardiovascular diseases (CVD) and all-cause mortality among persons with preexisting vascular disease. Folic acid supplementation is ineffective in the secondary prevention of CVD or all-cause mortality among persons with prior history of vascular disease.

The relationship between body mass index (BMI) and mortality in Chinese adults is examined. The study indicates that both obesity and underweight are associated with increased mortality from all causes in the Chinese adult population and it also supports the use of a single common recommendation for defining overweight and obesity among all racial and ethnic groups.

The major causes of death and amendable risk factors were examined in a nationally representative cohort of numerous men and women of 40 years and above in China. Findings suggested that the major causes of death among Chinese adults were vascular disease and cancer, which could be reduced by controlling hypertension, terminating smoking, increasing physical activity, and good food habits.

Objectives. We estimated the prevalence of cigarette smoking and the extent of environmental tobacco smoke exposure (ETS) in the general population in China. Methods. A cross-sectional survey was conducted on a nationally representative sample of 15 540 Chinese adults aged 35-74 years in 2000-2001. Information on cigarette smoking was obtained by trained interviewers using a standard questionnaire. Results. The prevalence of current cigarette smoking was much higher among men (60.2%) than among women (6.9%). Among nonsmokers, 12.1% of men and 51.3% of women reported exposure to ETS at home, and 26.7% of men and 26.2% of women reported exposure to ETS in their workplaces. On the basis of our findings, 147 358 000 Chinese men and 15 895 000 Chinese women aged 35-74 years were current cigarette smokers, 8 658 000 men and 108 402 000 women were exposed to ETS at home, and 19 072 000 men and 55 372 000 women were exposed to ETS in their workplaces. Conclusions. The high prevalence of cigarette smoking and environmental tobacco smoke exposure in the Chinese population indicates an urgent need for smoking prevention and cessation efforts.

Light to moderate alcohol consumption may reduce the risk of a stroke but heavy alcohol consumption appears to increase the risk of stroke. This was the conclusion of researchers who analyzed 35 studies on this topic. All of the studies compared people who drank alcohol with people who did not.

Background Not having a healthcare visit in the past year has been associated with a higher likelihood of uncontrolled blood pressure (BP) among individuals with hypertension. Methods We examined factors associated with not having a healthcare visit in the past year among US adults with hypertension using data from the US National Health and Nutrition Examination Survey 2013–2018 (n = 5,985). Hypertension was defined as systolic BP (SBP) ≥140 mm Hg, diastolic BP (DBP) ≥90 mm Hg, or antihypertensive medication use. Having a healthcare visit in the past year was self-reported. Results Overall, 7.0% of US adults with hypertension reported not having a healthcare visit in the past year. Those without vs. with a healthcare visit in the past year were less likely to be aware they had hypertension (45.0% vs. 83.9%), to be taking antihypertensive medication (36.7% vs. 91.4%, among those who were aware they had hypertension), and to have controlled BP (SBP/DBP <140/90 mm Hg; 9.1% vs. 51.7%). After multivariable adjustment, not having a healthcare visit in the past year was more common among US adults without health insurance (prevalence ratio [PR]: 2.22; 95% confidence interval [CI] 1.68–2.95), without a usual source of healthcare (PR: 5.65; 95% CI 4.16–7.67), who smoked cigarettes (PR: 1.34; 95% CI 1.02–1.77), and with heavy vs. no alcohol consumption (PR: 1.55; 95% CI 1.16–2.08). Also, not having a healthcare visit in the past year was more common among those without diabetes or a history of atherosclerotic cardiovascular disease, and those not taking a statin. Conclusions Interventions should be considered to ensure all adults with hypertension have annual healthcare visits. [ABSTRACT FROM AUTHOR]

Objective: There are few studies testing the amount of weight loss necessary to achieve initial remission of type 2 diabetes mellitus (T2DM) following bariatric surgery and no published studies with use of weight loss to predict initial T2DM remission in sleeve gastrectomy (SG) patients.Research Design and Methods: With Cox proportional hazards models we examined the relationship between initial T2DM remission and percent total weight loss (%TWL) after bariatric surgery. Categories of %TWL were included in the model as time-varying covariates.Results: Of patients (N = 5,928), 73% were female; mean age was 49.8 ± 10.3 years and BMI 43.8 ± 6.92 kg/m2, and 57% had Roux-en-Y gastric bypass (RYGB). Over an average follow-up of 5.9 years, 71% of patients experienced initial remission of T2DM (mean time to remission 1.0 year). With 0-5% TWL used as the reference group in Cox proportional hazards models, patients were more likely to remit with each 5% increase in TWL until 20% TWL (hazard ratio range 1.97-2.92). When categories >25% TWL were examined, all patients had a likelihood of initial remission similar to that of 20-25% TWL. Patients who achieved >20% TWL were more likely to achieve initial T2DM remission than patients with 0-5% TWL, even if they were using insulin at the time of surgery.Conclusions: Weight loss after bariatric surgery is strongly associated with initial T2DM remission; however, above a threshold of 20% TWL, rates of initial T2DM remission did not increase substantially. Achieving this threshold is also associated with initial remission even in patients who traditionally experience lower rates of remission, such as patients taking insulin. [ABSTRACT FROM AUTHOR]