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Background-Coronary atherosclerosis and cognitive impairment are both age-related diseases, with similar risk factors. Coronary artery calcium (CAC), a marker of coronary atherosclerosis, may play a role in early detection of individuals prone to cognitive decline. This study aimed to investigate the relationship between CAC and cognitive function, and the capability of CAC to identify participants with a high risk of dementia in a Chinese community-based population. Methods-A total of 1 332 participants, aged 40-80 years and free of dementia from a community located in Beijing were included. All participants completed neurocognitive questionnaires and noncontrast CT examinations. Cognitive performance tests (including verbal memory, semantic fluency, executive function, and global cognitive function tests), the Cardiovascular Risk Factors, Aging, and Incidence of Dementia (CIDE) risk score, and the CAC score (CACS) were evaluated by questionnaires and CT. A CAIDE score ≥ 10 was considered to indicate a high risk of dementia in late-life. Participants were divided into three groups according to CACS (0, 1-399, ≥ 400). Results-After adjusting for risk factors, CACS was significantly associated with verbal memory ( r = -0.083, P = 0.003) and global cognitive function ( r = -0.070, P = 0.012). The prevalence of a high risk of dementia in the subgroups of CACS = 0, 1-399, and ≥ 400 was 4.67%, 13.66%, and 24.79%, respectively ( P < 0.001). Individuals with CACS ≥ 400 had a higher risk of CAIDE score ≥ 10 [OR = 2.30 (1.56, 4.56), P = 0.014] than those with CACS = 0. The receiver-operating characteristic curves showed that the capability of CACS to identify participants with a high risk of dementia was moderate (AUC = 0.70, 95% CI: 0.67-0.72, P < 0.001). Conclusions-CAC, a marker of subclinical atherosclerosis, was significantly associated with cognitive performance in verbal memory and global cognitive function. CAC had a moderate capability to identify participants with a high risk of dementia, independent of age, education, and other risk factors. [ABSTRACT FROM AUTHOR]

Abstract: Objective: To evaluate the impact of cerebrovascular disease mortality on life expectancy (LE) in China in 2010 compared with 2005, and to identify the high-risk population (age, sex, and region) where cerebrovascular disease mortality has had a major impact on LE. Methods: LE and cause-eliminated LE were calculated by using standard life tables which used adjusted mortality data from the Death Surveillance Data Sets in 2005 and 2010 from the National Disease Surveillance System. Decomposition was used to quantitate the impact of cerebrovascular disease in different age groups. Results: LE in China was 73.24 years in 2010, which was higher in women and urban residents compared with men and rural residents. The loss of LE caused by cerebrovascular disease mortality was 2.26 years, which was higher in men and rural residents compared with women and urban residents. More than 30% of the loss of LE were attributed to premature death from cerebrovascular disease in people aged <65 years. Compared with 2005, LE in 2010 increased by 0.92 years. The reduction of cerebrovascular disease mortality in urban residents contributed 0.45 years to the increase of LE, but the increase of cerebrovascular disease mortality caused a 0.12-year loss of LE in rural residents. Conclusion: Cerebrovascular disease mortality had a major impact on LE in China, with a significant difference between urban and rural residents. LE is likely to be further increased by reducing cerebrovascular disease mortality, and special attention should be paid to reducing premature deaths in people aged <65 years. [Copyright &y& Elsevier]

Abstract: Objective: We aimed to analyze the impact of cardiovascular disease (CVD) deaths on life expectancy (LE) in Chinese population and estimate the percentage reduction in CVD mortality needed to increase LE by 1 year from the current level, a national target of health improvement. Methods: We used life tables, cause-elimination life tables, and age decomposition of LE with corrected mortality data from the National Disease Surveillance System in 2010. Results: LE at birth of Chinese people was 73.24 years in 2010. Women had a longer LE than men, and urban population had a longer LE than rural population. CVD deaths resulted in a 4.79-year LE loss and premature deaths in people aged 25 to 64 years were responsible for a substantial part of LE loss from CVD. Death from ischemic heart disease and cerebrovascular diseases accounted for 69.2% of LE loss from CVD deaths and death from cerebrovascular diseases was the largest contributor. In rural men, 51.1% LE loss from CVD deaths was caused by cerebrovascular diseases. If there were no changes in mortality rates for all other diseases, a 27.4% reduction in CVD mortality would increase LE by 1 year in Chinese population. Conclusion: There is a considerable impact of CVD deaths on LE. A 1-year LE increase in the future requires at least a 27.4% reduction in CVD mortality from the current level. Targeting the rural population and tackling cerebrovascular diseases are important for reaching the national goal of health improvement. [Copyright &y& Elsevier]

Objective: There are still a high proportion of patients with ST-segment elevation myocardial infarction (STEMI) missing out early reperfusion even in the primary percutaneous coronary intervention (PCI) era. Most of them are stable latecomers, but the optimal time to undergo delayed PCI for stable ones remains controversial., Methods: We investigated all STEMI patients who underwent delayed PCI (2-28 days after STEMI) during 2007-2010 in Beijing and excluded patients with hemodynamic instability. The primary outcome was major adverse cardiovascular events (MACEs)., Results: This study finally enrolled 5,417 STEMI patients and assigned them into three groups according to individual delayed time (Early group, 55.9%; Medium group, 35.4%; Late group, 8.7%). During 1-year follow-up, MACEs occurred in 319 patients. The incidence of MACEs were respectively 7.1%, 5.6% and 6.7% among three groups. The Medium group had less recurrent myocardial infarction plus cardiac death (hazard ratio, 0.525; 95% confidence interval, 0.294-0.938, P = 0.030) than Late group and less repeat revascularization (hazard ratio, 0.640; 95% confidence interval, 0.463-0.883, P = 0.007) than Early group in pairwise comparisons. We depicted the incidence of major adverse cardiovascular event (MACE) by delayed time as a quadratic curve and found the bottom appeared at day 14., Conclusions: The delayed PCI time varied in the real-world practice, but undergoing operations on the second week after STEMI had greater survival benefit and less adverse events for whom without early reperfusion and hemodynamic instability.

Objective: Several studies have examined the relationships between dietary potassium and sodium and hypertension, but few have evaluated the association between serum potassium or sodium and risk of incident hypertension. We therefore investigated the associations between serum potassium and sodium and risk of incident hypertension in a Chinese community-based population., Methods: A total of 839 normotensive individuals without cardiovascular disease from the Chinese Multi-Provincial Cohort Study who took part in the baseline examination in 2007-2008 and the follow-up survey in 2012-2013 were included in this study. Odds ratios (OR) and 95% confidence intervals (95%CI) for baseline serum potassium and sodium in relation to the risk of new-onset hypertension were evaluated using multivariate logistic regression models., Results: During five years of follow-up, 218 (26.0%) individuals progressed to hypertension. Logistic regression adjusting for multiple confounders showed that every 1 mEq/L increment in baseline serum potassium level was associated with a 75% increased risk of hypertension (OR: 1.75; 95%CI: 1.01-3.04; P = 0.04). Compared with adults with serum potassium level of 4.20-4.79 mEq/L, adults with level ≥ 4.80 mEq/L had an 84% increased risk of hypertension (OR: 1.84; 95%CI: 1.14-2.96; P = 0.01). There was no significant association between serum sodium and risk of hypertension (OR: 0.96; 95%CI: 0.89-1.04; P = 0.33)., Conclusions: Baseline serum potassium level, but not baseline serum sodium level, was positively related to the risk of incident hypertension in the Chinese population.

Objective: To evaluate the impact of cerebrovascular death on the life expectancy of Chinese residents in recent years and explore the difference in the subgroups., Methods: Life expectancy and cause-elimination life expectancy were calculated by standard life table techniques using the adjusted mortality data from the Death Surveillance Data Sets in 2005 and 2010 provided by the National Disease Surveillance System. Decomposition method was used to quantitatively evaluate the impact of cerebrovascular disease., Results: The life expectancy of Chinese residents was 73.23 years old in 2010. The loss of life expectancy caused by cerebrovascular death was 2.26 years in 2010, with about 97% of that came from the elimination of deaths in the residents aged over 40 years old. Compared with 2005, the reduction of cerebrovascular deaths contributed to a total of 0.04 years increase in the life expectancy of Chinese residents in 2010, with 0.45 years for urban residents. However, for the rural residents, cerebrovascular death increased and caused 0.12 years decrease of life expectancy., Conclusions: The impact of cerebrovascular death on the life expectancy of Chinese residents is still great. Significant difference is showed between the urban and rural areas with reduction in the urban but increase in the rural. The life expectancy is likely to be further increased by reducing cerebrovascular death in the Chinese residents aged over 40 years old.

Objective: To evaluate the prediction value of blood lipid levels on the newly-identified carotid plaque in middle-aged and elderly Chinese population., Methods: All study subjects were recruited from two cohorts from 2002 to 2007 [the People's Republic of China/United States of America collaborative study (USA-PRC study) and the Chinese multi-provincial cohort study (CMCS)]. The baseline examination including cardiovascular disease risk factors and B-mode ultrasound of carotid artery was performed in 2002 and the second examination was made in September to October, 2007. The relationship between baseline lipids and carotid plaque incidence was analyzed in a total of 2000 subjects aged 47 to 79 years (mean 63 years)., Results: (1) During these 5 years, the prevalence of carotid plaque increased from 30.3% to 62.2% and from 21.5% to 51.5% for men and women, respectively. The newly-identified carotid plaque incidence was 41.8% for men and 34.1% for women. (2) The incidence of artery plaque significantly increased in both sexes in proportion to increase of baseline total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), non-high-density lipoprotein cholesterol (non-HDL-C), and total to high-density cholesterol ratio (TC/HDL-C) levels (P < 0.05 or P < 0.01). (3) Cross-stratification analysis of LDL-C, triglyceride (TG) and HDL-C for carotid plaque incidence indicated the existence of conjoint effects between LDL-C and HDL-C, LDL and TG, as well as between TG and HDL-C, on the increased incidence of carotid plaque. (4) Multi-factorial analysis showed that higher LDL-C, non-HDL-C and TC/HDL-C were independent risk factors for development of new carotid plaque [OR = 1.44 (95%CI = 1.07 - 1.94), OR = 1.45 (95% CI = 1.08 - 1.96), OR = 1.59(95% CI = 1.14 - 2.23) in men;OR = 1.47 (95% CI = 1.13 - 1.92), OR = 1.35 (95% CI = 1.04 - 1.75), OR = 1.64 (95% CI = 1.20 - 2.23) in women]., Conclusions: The prevalence of carotid plaque increased rapidly in this cohort between 2002 and 2007. Elevated LDL-C, non-HDL-C and TC/HDL-C levels were independent predictors of newly developed carotid plaque.

Objective: To describe the distribution characteristics of carotid atherosclerosis and to analyze its association with cardiovascular risk factors in middle-aged and elderly Chinese., Methods: In 2007, the second cross-sectional examination for cardiovascular risk factors and B-mode ultrasound imaging on carotid arteries were performed in a Chinese population consisting of 2681 subjects aged 43-81 years old from two cohorts participants of the People's Republic of China/United States of America collaborative study (USA-PRC study) and the Chinese multi-provincial cohort study (CMCS). The association of cardiovascular risk factors with intima-media thickening (ITM) and plaque of carotid arteries was analyzed., Results: (1) The mean intima-media thickening (Mean-IMT) of carotid artery was 0.68 mm, the maximal intima-media thickening (Max-IMT) was 1.07 mm. (2) The prevalence rate of carotid plaque was 60.3% in all subjects. As for the different sites of carotid arteries, the plaque prevalence rate at carotid bulb was 61.2% for male and 51.6% for female (chi2 = 23.44, P < 0.01), and at the internal carotid artery was 24.7% for male and 12.2% for female (chi2 = 69.57, P < 0.01), at the common carotid artery was 20.9% for male and 13.8% for female (chi2 = 23.18, P < 0.01). (3) After adjusting for age and other cardiovascular risk factors, the Mean-IMT and Max-IMT increased with elevated levels of systolic blood pressure, plasma glucose and low density lipoproteins cholesterol (LDL-C) (all P < 0.05). Hypertension, diabetes, smoking and high LDL-C (P < 0.05) were independent predict factors for the risk of carotid plaque., Conclusion: The carotid atherosclerosis was common in middle and older age Chinese and was positively associated with classical cardiovascular disease risk factors.

Objective: To study the correlation between obesity and clustering of major risk factors on cardiovascular disease in the elderly., Methods: A cross-sectional study was conducted. Data from 546 elderly aged 60-90 were analyzed for the relationship between obesity and clustering of risk factors for cardiovascular diseases, with descriptive statistical methods, chi2 test, logistic regression and ROC curve., Results: (1) The positive rates of the four major risk factors and clustering appeared an upward trend along with the BMI and/or the WC. The overall positive rate of clustering of risk factors among the total 546 elderly people was 59.5%, and 52.5% in males, 65.7% in females. (2) As compared with females, males had a higher growth rate of clustering with the elevating of BMI and WC, and odds ratios of the highest-level groups were 13.579 and 2.876 in males and females, respectively. (3) Both BMI and WC were independent influencing factors for male (P < 0.05), and logistic regression coefficients were 0.196 and 0.074 for BMI and WC, respectively. Only WC appeared to be the independent influencing factor for females (P < 0.05), while BMI was not (P = 0.537), with logistic regression coefficient as 0.060 for WC. (4) The combination equation of male's BMI and WC was CE(BMI + WC) = 0.726 x BMI + 0.274 x WC, with the optimum cut-off value as 41.59, and the sensitivity and the specificity were 0.785 and 0.598, respectively., Conclusion: Four major risk factors for cardiovascular diseases were often related to obesity while control of BMI and WC were of great significance to the primary prevention of cardiovascular disease. The combined equation of BMI and WC could be used to predict the risk of clustering.