The prevalence of cardiovascular disease (CVD) in China is on the rise. It is estimated that there are 330 million people with CVD, including 13 million cases of stroke, 11.39 million cases of coronary heart disease (CHD), 8.9 million cases of heart failure (HF), 5 million cases of pulmonary heart disease, 4.87 million atrial fibrillation, 2.5 million cases of rheumatic heart disease, 2 million cases of congenital heart disease, 45.3 million cases of peripheral arterial disease (PAD), and 245 million cases of hypertension. In 2021, the total number of discharges of patients with cardiovascular and cerebrovascular diseases in China was 27 649 800, accounting for 15.36% of the total number of discharges (including all inpatient diseases) in the same period, including 14 872 300 CVDs, accounting for 8.26%, and 12 777 500 cerebrovascular diseases, accounting for 7.10%. The economic burden of CVD on residents and society still increases, and the inflection point of CVD prevention and treatment has not yet arrived.

Due to the acceleration of population aging and the prevalence of unhealthy lifestyles, the huge population with cardiovascular disease (CVD) risk factors, the burden of CVD continues to increase in China. CVD is still the leading cause of death among urban and rural residents in China. In 2020, CVD accounted for 48.00% and 45.86% of the causes of death in rural and urban areas, respectively, and two out of every five deaths were due to CVD. It is estimated that the number of current CVD patients in China is 330 million, including 13 million cases of stroke, 11.39 million cases of coronary heart disease, 8.9 million cases of heart failure, 5 million cases of pulmonary heart disease, 4.87 million cases of atrial fibrillation, 2.5 million cases of rheumatic heart disease, 2 million cases of congenital heart disease, 45.3 million cases of peripheral artery disease, and 245 million cases of hypertension. The total hospitalization costs were 270.901 billion yuan for CVD in China in 2020. The prevention and treatment of CVD in China still has a long way to go. In general, we should not only do a good job in secondary prevention and treatment of CVD, but also further strengthen the upstream treatment of modifiable risk factors such as hypertension, hyperglycemia and hyperlipidemia starting with both preventive treatment and treatment diseases. In addition, attention should be paid to the allocation and prioritization of health care and public health resources, so as to reach the inflection point of CVD prevention and treatment as early as possible.

Hypertension, type 2 diabetes mellitus (T2DM), and dyslipidemia are collectively referred to as the "three highs", which often coexist in the same individual. It significantly increases the risk of hospitalization, death, and relevant burdens for affected people. It is necessary to jointly control the risk and standardize the treatment of hypertension, T2DM and dyslipidemia. Primary healthcare institutions have become the main battlefield for the prevention and treatment of chronic diseases. Existing clinical evidence provides important insights into the prevention, treatment, and management of the "three highs", although norms, consensus, and guidelines for the co-management of the "three highs" in primary healthcare institutions at domestic and foreign are current not available. Four academic organizations led by Beijing Hypertension Association organized primary healthcare workers and invited experts and scholars from medical fields of cardiovascular diseases, endocrine, pharmacy, and public health services to participate in the consensus. Through widely soliciting clinical practice needs of primary healthcare workers, integrating and evaluating the evidence related to the prevention and treatment of the "three highs" in primary healthcare institutions, the consensus for primary healthcare in the prevention and treatment of the "three highs" including 21 opinions was developed after multiple rounds of discussions, revisions, and voting. The recommended opinions of this consensus aim to improve the awareness and ability of primary healthcare workers in the prevention and treatment of the "three highs", provide scientific strategic support, implement management with primary healthcare characteristics, and lay a solid foundation for comorbidity co-management.

Cardiovascular diseases (CVD) and their risk factors are exerting an increasingly significant impact on public health, and the incidence rate of CVD continues to rise. The economic burden brought by CVD to residents and society is increasing, and it has become a major public health problem, and it is urgent to strengthen the government-led CVD prevention and control work. This article provides an interpretation of essentials from the newly published Report on Cardiovascular Health and Diseases in China (2024) , aiming to offer scientific evidence for CVD prevention, treatment, and the formulation of relevant policies.

Cardiovascular disease is a major chronic disease that seriously endangers human health, and remains a public health problem to be solved in China and even globally.

To explore the epidemic characteristics and disease burden of cardiovascular diseases in China from 1990 to 2019, forecast the incidence of cardiovascular diseases in China from 2020 to 2050, and provide a reference for the formulation of relevant prevention and treatment strategies of cardiovascular diseases.

The 2019 Global Burden of Disease Study (GBD 2019) database was searched to extract and analyze relevant data on cardiovascular disease burden and risk factors in China and globally from 1990 to 2019. The prevalence of cardiovascular diseases was quantified by using the publicly available incidence, prevalence, mortality, and corresponding age-standardized rate (referred to as standardized rate) based on GBD 2019 database, and the burden of diseases was quantified by years lived with disability (YLD), years of life lost (YLL) and disability adjusted life year (DALY), and the ARIMA model was constructed to predict the incidence of cardiovascular diseases in China from 2020 to 2050.

Compared with 1990, the incidence, prevalence and mortality of cardiovascular diseases in China showed an increasing trend by year up to 2019, in which the incidence, prevalence and mortality increased by 93.75%, 99.75% and 57.39%, respectively. The standardized incidence and prevalence of females were higher than those of males, while the standardized mortality was lower than that of males (P<0.05). According to the data in 2019, the overall incidence of cardiovascular diseases in China showed an increasing trend with age, reaching its highest value in the age group of 95 years and above. Incidence trends for both men and women were similar to the overall trend, with slight differences. The overall prevalence also increases with age and is higher in women than men. There is an increasing trend in cardiovascular disease mortality after the age of 45, with males having a higher mortality rate than females at all ages. Compared with 1990, the rates of YLL, YLD and DALY in Chinese men increased by 36.99%, 102.42% and 40.78%, respectively, and increased by 2.79%, 107.13% and 11.50% in women in 2019. According to the data in 2019, the YLL rate, YLD rate and DALY rate of cardiovascular diseases in Chinese population showed an upward trend with the increase of age, with no inflection point. YLL rate and DALY rate of males gradually increased with the progress of population aging and were much higher than females, YLD rate gradually increased in the age group of 55-59 years and was much higher than males. From 1990 to 2019, the global standardized incidence, standardized prevalence and standardized mortality of cardiovascular diseases showed a downward trend by year, while the standardized morbidity and standardized mortality still increased in China, the standardized incidence and prevalence decreased, but that was still higher than the global scale. From the global level, the standardized YLL rate and DALY rate of cardiovascular diseases in China showed a downward trend along with the global level, but the disease burden of cardiovascular diseases in China was higher than the global level after 2000, and the standardized YLD rate increased by year. Risk factors associated with death from cardiovascular diseases mainly included smoking, second-hand smoke, alcohol consumption, low physical activity, high fasting blood glucose, high systolic blood pressure, high BMI, high low density lipoprotein cholesterol and renal insufficiency. From the relevant data in China and globally, high systolic blood pressure (hypertension) was still the primary risk factor for death from cardiovascular diseases, and the number of deaths was increasing by year. High density lipoprotein cholesterol (hyperlipidemia) was the second cause of death from cardiovascular diseases globally and in China in recent years. From 2020 to 2050, the standardized incidence of cardiovascular diseases in China is still on the rise, and it is expected that the standardized incidence of cardiovascular diseases will reach 663.618 per 100 000 by 2050.

The incidence, prevalence and mortality of cardiovascular diseases in China from 1990 to 2019 have shown an increasing trend by year. The disease burden caused by cardiovascular diseases is more severely, and there is no inflection point in the next 50 years. The prevalence and burden of diseases are higher than those of the world. It is expected that the standardized incidence of cardiovascular diseases will reach 663.618 per 100 000 by 2050.

Obesity is the primary risk factor for essential hypertension, and patients with obesity-related hypertension exhibit higher rates of cardiovascular morbidity and mortality. Exercise-induced weight loss has become an effective therapeutic approach for these patients. However, cardiopulmonary function and blood pressure dynamics during different exercise phases in this population remain unclear.

To investigate the characteristics of cardiopulmonary function in obesity-related hypertensive patients across different BMI categories during various exercise stages, and to explore the relationship between cardiopulmonary exercise parameters and conventional left ventricular structural indices.

A total of 625 patients diagnosed with essential hypertension at the General Medicine Department/Hypertension Center/Cardiac Rehabilitation Center of Yan'an Hospital Affiliated to Kunming Medical University from January 2020 to July 2023 were retrospectively recruited. Participants were stratified into three groups based on the BMI: control group (n=209, 18.5 kg/m²< BMI <24.0 kg/m²), overweight hypertension group (n=210, 24.0 kg/m²≤ BMI <28.0 kg/m²), and obesity-related hypertension group (n=206, BMI≥28.0 kg/m²). Systolic blood pressure (SBP), diastolic blood pressure (DBP), oxygen uptake (VO₂), percentage of predicted VO₂ (VO₂%), VO₂ per kilogram (VO₂/kg), oxygen pulse (O₂ pulse), heart rate (HR) during cardiopulmonary exercise testing, and echocardiographic indices such as interventricular septal thickness (IVST), left ventricular end-diastolic diameter (LVEDd), left ventricular mass (LVM), and left ventricular mass index (LVMI) at different exercise phases were recorded.

Peak-exercise SBP was significantly higher in the obesity-related hypertension and overweight hypertension groups compared to the control group (P<0.05). Peak-exercise O₂ pulse, VO₂, and anaerobic threshold VO₂ were significantly higher in the obesity-related hypertension group than those of the overweight hypertension and control groups (P<0.05). Conversely, peak-exercise VO₂/kg, VO₂%, and anaerobic threshold VO₂/kg, VO₂% were significantly lower in the obesity-related hypertension group than those of the overweight and control groups (P<0.05). Peak-exercise O₂ pulse was positively correlated with LVMI and BMI (r=0.098, 0.283; P<0.05). Peak-exercise VO₂/kg and VO₂% were negatively correlated with BMI (r=-0.372, -0.291; P<0.05). Peak-exercise SBP was positively correlated with BMI, LVM, and LVMI (r=0.069, 0.221, 0.151; P<0.05) .

Obesity-related hypertension patients exhibit reduced exercise cardiac function and exercise tolerance compared to normal-weight individuals. Higher BMI is associated with elevated peak-exercise SBP, O₂ pulse, LVM, and LVMI, suggesting abnormal increases in cardiac preload and afterload post-exercise. These physiological changes may contribute significantly to LVMI progression. Integrating cardiopulmonary exercise testing parameters with LVMI provides more precise cardiac function assessment for obesity-related hypertension.

Coronary atherosclerotic heart disease (CHD) is one of the leading causes of mortality worldwide, and research on risk assessment for CHD has been growing annually. However, the issue of data imbalance in these studies is often overlooked, despite its crucial role in enhancing the accuracy of CHD risk identification within classification algorithms.

To investigate the factors influencing CHD and to establish predictive models for CHD risk using two data balancing methods based on five algorithms, comparing the predictive value of these models for CHD risk.

Utilizing cross-sectional survey data from the 2021 Behavioral Risk Factor Surveillance System (BRFSS) in the United States, a cohort of 112 606 participants was identified, featuring 24 variables related to risk behaviors and health status, with self-reported coronary heart disease (CHD) as the outcome measure. Factors influencing the incidence of CHD were explored through univariate analysis and stepwise logistic regression to select pertinent variables for inclusion in the predictive model. A random sample comprising 10% of the participants (11 261 individuals) was drawn and then randomly divided into training and testing datasets at an 8∶2 ratio. To address data imbalance, two over-sampling techniques were employed: random oversampling and the Synthetic Minority Over-sampling Technique (SMOTE). Based on these methods, CHD predictive models were constructed using five different algorithms: K-Nearest Neighbors (KNN), Logistic Regression, Support Vector Machine (SVM), Decision Tree, and XGBoost.

Univariate analysis revealed significant differences (P<0.05) between the CHD and non-CHD groups across all input variables except for rental housing and being informed of prediabetic status. Stepwise Logistic regression identified age, gender, BMI, ethnicity, education level, income level, being informed of hypertension, being informed of prehypertension, being informed of pregnancy-induced hypertension, current use of antihypertensive medication, being informed of hyperlipidemia, being informed of diabetes, smoking status, alcohol consumption within the last 30 days, heavy drinking status, and self-assessed health as factors influencing CHD. The performance of risk models using SMOTE showed overall classification accuracies of 59.2%, 67.4%, 66.2%, 69.2%, and 85.9%; recall rates of 75.2%, 71.4%, 70.5%, 62.9%, and 34.8%; precision of 15.4%, 18.2%, 17.5%, 17.6%, and 28.7%; F-values of 0.256, 0.290, 0.280, 0.275, and 0.315; and AUC values of 0.80, 0.78, 0.72, 0.72, and 0.82, respectively. Using random oversampling, the models achieved classification accuracies of 62.5%, 68.5%, 69.0%, 60.2%, and 70.1%; recall rates of 70.0%, 69.5%, 71.9%, 69.0%, and 67.6%; precision of 15.8%, 18.4%, 19.1%, 14.8%, and 19.0%; F-values of 0.258, 0.291, 0.302, 0.244, and 0.297; and AUC values of 0.80, 0.77, 0.72, 0.72, and 0.83, respectively.

This study not only confirmed known factors affecting CHD but also identified potential impacts of self-assessed health level, income level, and education level on CHD. The performance of the five algorithms was significantly enhanced after employing two data balancing methods. Among them, the XGBoost model exhibited superior performance and can be referenced for future optimization of CHD prediction models. Additionally, considering the excellent performance of the XGBoost model and the convenience and interpretability of stepwise logistic regression, a combined use of these approaches after data balancing is recommended in CHD risk prediction models.

Hypertensive disorders of pregnancy (HDP) is one of the most common complications of pregnancy and one of the leading causes of maternal mortality worldwide. In 2023, the Society of Obstetricians of Australia and New Zealand released the A Summary of the 2023 Society of Obstetric Medicine of Australia and New Zealand Hypertension in Pregnancy Guideline. This article interprets its key contents and proposes suggestions on non-drug intervention measures and refined management processes for HDP in China, in order to provide a new basis for the management of HDP in China.

The ratio of blood urea nitrogen (BUN) to serum albumin (ALB) (BAR) is an emerging biomarker that has been recently recognized to associate with adverse outcomes in a variety of cardiorespiratory disorders. However, the relationship between BAR and carotid plaque in patients with coronary heart disease (CHD) is currently unclear.

To investigate the correlation between BAR and carotid plaque in CHD patients.

Admission medical data of CHD patients hospitalized in six hospitals in Tianjin from January 2014 to September 2019 were retrospectively analyzed. BAR was calculated by dividing BUN by ALB. Logistic regression analysis was used to evaluate the correlation of BAR with the occurrence, number and characteristics of carotid plaque in CHD patients before and after adjusting for confounding factors. Drew a receiver operating characteristic (ROC) curve for diagnosing the risk of carotid plaque occurrence using BAR, and calculate the area under the ROC curve (AUC) .

A total of 10 808 cases of CHD were included. Among them, 8 158 cases suffered from carotid plaque with a prevalence of 75.5%. The data of 10 808 CHD cases were divided into four groups by quartiles of BAR (Q1, Q2, Q3, Q4) for baseline analysis: Q1 ≤ -0.395 4, -0.395 4< Q2 ≤ -0.158 7, -0.158 7 < Q3 ≤0.132 4, and Q4 > 0.132 4. Compared with Q1, the correlation between BAR and carotid plaque formation was more significant in Q4 after multivariate adjustment (OR=1.512, 95%CI=1.273-1.795, P<0.001). The AUC for diagnosing the risk of carotid plaque in CHD patients with BAR is 0.612 (95%CI=0.600-0.624). The correlation between BAR and plaque was more significant in the female population. (OR=1.583, 95%CI=1.260-1.989, P<0.001), the correlation between BAR and plaque was more significant in the older age group (OR=1.810, 95%CI=1.459-2.246, P<0.001). The significant correlation between BAR and carotid plaque was not affected by diseases such as hypertension, hyperlipidemia and diabetes.

High-level BAR is associated with carotid plaque formation, and which is more significant in women and middle-aged and elderly people. High-level BAR is helpful in an early identification of carotid plaque formation in CHD patients, thus avoiding the occurrence of major adverse cardiovascular events (MACEs) .

With the change of lifestyle, atherosclerotic cardiovascular disease (ASCVD) is showing a younger trend as an important component of ASCVD. Snoring as a common health problem related to sleep breathing, which is a characteristic indicator of obstructive sleep apnea-hypopnea syndrome (OSAHS) . However, there are few studies on the correlation between snoring and ASCVD, and it is still necessary to identify this factor to provide scientific basis for early intervention.

To investigate the correlation between snoring frequency and 10-year risk of ASCVD in middle-aged and elderly population.

From 2018 to 2021, a multi-stage stratified cluster sampling method was adopted to investigate the permanent residents aged 35-75 in Jing'an District. General information of the subjects was collected through questionnaire survey, and laboratory tests were used to collect total cholesterol (TC) , triacylglycerol (TG) , low-density lipoprotein cholesterol (LDL-C) , and high-density lipoprotein cholesterol (HDL-C) . Snoring frequency: snoring 1-2 times per week was considered as mild snoring, snoring 3-4 times per week was considered as moderate snoring, and snoring 5-7 times per week was considered as severe snoring; the 10-year risk of ASCVD <5%, 5%-<10%, and≥10% were defined as low-risk group, intermediate-risk group, and high-risk group, respectively. Multilevel ordinal Logistic regression analysis was used to explore the correlation of snoring with the 10-year risk of ASCVD and ASCVD risk factors.

A total of 10 898 residents participated in the study, excluding 1 079 who were unclear about their individual snoring status, for a total of 9 819 residents included in the study. The risk assessment results of ASCVD showed 5 930 in the low-risk group, 1 804 in the intermediate-risk group and 2 085 in the high-risk group. In the general population, Model 1 with multilevel ordinal Logistic regression analysis showed that both moderate and severe snoring were risk factors for the 10-year risk of ASCVD compared with no snoring (P<0.05) . Model 2 adjusted for age based on Model 1, and Model 3 adjusted for hypertension, diabetes, overweight or obesity, smoking, alcohol consumption, and educational factors based on Model 2, the results showed that increasing snoring frequency would cause an increase in the 10-year risk level of ASCVD. After further dividing the total population into males and females by gender, severe snoring was associated with a 10-year risk level of ASCVD compared with the no snoring (P<0.05) , and severe snoring in males has a greater risk than in females, but mild and moderate snoring was not associated with ASCVD risk (P>0.05) . Further analysis of the relationship between snoring and ASCVD risk factors showed that severe snoring was a risk factor for hypertriglyceridemia, hypercholesterolemia, hyper-low-density lipoproteinemia and hypo-high-density lipoproteinemia, and moderate snoring was a risk factor for hyper-low-density lipoproteinemia and hypo-high-density lipoproteinemia compared with no snoring (P<0.05) . Mild snoring was not associated with ASCVD risk factors.

The frequency of snoring is correlated with the 10-year risk and risk factors of ASCVD, and it is concentrated in moderate and severe snoring population. People with mild and moderate snoring should be regarded as the focus of early intervention to promote the early prevention and treatment of ASCVD.

Clinically, patients with cardiovascular disease widely have psycho-psychological problems, which interact with each other and aggravate the disease state. Psycho-cardiology is a discipline formed by the intersection and integration of cardiology and psychology, which emphasizes the attention to cardiovascular diseases and the mental state of patients. Experts from the Psycho-cardiology Group of the Psychosomatic Medicine Society of the Chinese Medical Association formulated Chinese Expert Consensus on the Construction Standardization of Psycho-cardiology Outpatient after reviewing literature and conducting discussions, in order to improve the diagnosis and treatment capacity of psycho-cardiology in China, promote medical institutions at all levels to set up psycho-cardiology outpatient, and continuously improve the medical service system of psycho-cardiology in China.

Cardiometabolic risk factor cluster (CRFC) is a common health issue among aged 55 and over adults. Available studies mainly focus on the distribution of its epidemiological characteristics, but rarely assess the association between CRFC and all-cause mortality risk.

To explore the association between CRFC and all-cause mortality risk among community-dwelling aged 55 and over adults, to provide evidence for developing healthcare interventional programs for this group.

By use of typical sampling, this study selected 1 046 community-dwelling aged 55 and over adults from five urban communities in Wuzhong and Yinchuan cities of Ningxia Hui Autonomous Region during September to November 2011. And sociodemographic questionnaire survey, health check-up, ultrasonic examination, laboratory test and CRFC assessment 〔nine cardiometabolic risk factors, including central obesity, hypercholesterolemia, hypertriglyceridemia, elevated LDL-cholesterol, decreased HDL-cholesterol, hypertension, diabetes, hyperuricemia, and nonalcoholic fatty liver disease (NAFLD) 〕, were included in the multivariate Cox regression model to calculate the regression coefficient β of them after adjusting for confounders, then the coefficient of each factor was used as the weight to calculate the total risk score by adding them together were finished at baseline. The participants were followed up in 2017, 2019, and 2021 by face-to-face interview coupled with searching the national death surveillance system. Log-rank test was used to compare the survival curves for all-cause mortality plotted using the Kaplan-Meier method for tertile groups of the total cardiometabolic risk score (<P₅₀, P₅₀-P₇₅, and >P₇₅) . The Cox regression model was employed to assess the association of all-cause mortality risk with sociodemographics, cardiometabolic risk factors, the total cardiometabolic risk score, the level of the total cardiometabolic risk score, and age.

The participants had an average age of (66.4±6.6) years (range: 55-88) at baseline. One hundred and six death cases were identified with a ten-year accumulated mortality rate of 10.13%. The individuals in >P₇₅ group had much lower accumulated mortality rate than the other two groups, indicating that the median survival time decreased with the increase in the total cardiometabolic risk score. Multivariate Cox regression analysis showed that age, sex, living alone and education level may be associated with all-cause mortality risk (P<0.05) . After adjusting for sociodemographic variables, the multivariate Cox regression model revealed that the cardiometabolic risk factor cluster was associated with increased risk of all-cause mortality〔HR=3.04, 95%CI (1.55, 5.97) , P=0.001〕, and a dose-response effect was found that higher score was associated with an increased risk of death〔HR=2.02, 95%CI (1.16, 3.50) , P=0.013〕for > P₇₅ when compared with risk score lower than P₅₀) . When stratified by age group, the association only persisted among those aged 65 and over〔HR=2.79, 95%CI (1.36, 5.74) , P=0.005〕; >P₇₅ group had higher risk of death than P₅₀ group〔HR=1.83, 95%CI (1.02, 3.28) , P=0.042〕.

The CRFC was positively associated with all-cause mortality risk among community-dwelling aged 55 and over adults, and higher level of clustering was associated with higher all-cause mortality risk. The findings indicate that early assessment and intervention of CRFC may play a role in improving the healthcare and reducing the risk of death in this population .

Menopause will cause series of pathophysiologic changes and long-term complications (coronary heart disease, cerebrovascular disease, osteoporosis, etc.), among which coronary heart disease is a major health threat.

To investigate the effects of menopausal status and aging on common risk factors for coronary heart disease (CHD) in middle-aged women, such as increased carotid intima-media thickness (CIMT), hypertension, dyslipidemia, diabetes, and obesity.

A total of 556 healthy premenopausal women aged 45 to 54 years who received regular physical examinations at the physical examination center of Beijing Shijitan Hospital affiliated to Capital Medical University in 2018 were initially selected, with 89 excluded according to relevant criteria, and 467 women were finally included as study subjects. The included subjects were divided into the pre-menopausal group (n=176) and postmenopausal group (n=291) according to whether they were postmenopausal during a 3-year follow-up period. Changes in BMI, waist circumference, blood glucose, blood pressure, blood lipids and other indicators were monitored, inter- and intra-group comparisons were performed before and after the follow-up period. Multivariate Logistic regression analysis was used to explore the effects of menopausal status and age on the incidence of risk factors for coronary heart disease in middle-aged women.

The average age of 467 subjects was (47.6±2.3) years old. Compared with baseline, waist circumference, uric acid (UA), total cholesterol (TC), triglyceride (TG), and low density lipoprotein cholesterol (LDL-C) levels increased, fasting blood glucose (FBG) level decreased after 3 years (P<0.05). The results of inter-group comparison showed that there was no significant difference in waist circumference, BMI, TG, FBG and high density lipoprotein cholesterol (HDL-C) levels between the two groups after three years (P<0.05) ; the levels of UA, TC and LDL-C in the menopausal group were higher than those in the pre-menopausal group, and the difference was statistically significant (P<0.05). The results of intra-group comparison showed that the waist circumference in the two groups after 3 years was higher than baseline (P<0.05) ; the levels of UA, TC and TG in the pre-menopausal group after 3 years were higher than the baseline (P<0.05) ; the levels of UA, TC, TG and LDL-C in the postmenopausal group after 3 years were higher than the baseline (P<0.05). Multivariate Logistic regression analysis showed that age ≥50 years old was a high-risk factor for increased CIMT in middle-aged women (OR=2.475, 95%CI=1.049-5.838, P=0.038) .

The changes in waist circumference and TG in middle-aged women are mainly affected by age, the changes of LDL-C are mainly affected by menopausal status, and the changes of TC and UA are affected by both menopausal status and increased age. Age ≥50 years is a high risk factor for increased CIMT in middle-aged women, and the changes of metabolic indicators such as UA, TC and LDL-C precede changes in CIMT after menopause.

Hypertensive nephropathy, a common chronic kidney disease, is a significant contributor to end-stage renal disease. Analyzing and predicting its epidemiological trends is crucial for the prevention and control of chronic kidney disease.

This study aims to analyze the temporal trends in the incidence and mortality of hypertensive nephropathy in China from 1990 to 2021 and to provide a theoretical basis for developing prevention and control strategies.

Data on the incidence and mortality of hypertensive nephropathy in China were obtained from the Global Burden of Disease (GBD) 2021 database. Joinpoint regression models were used to analyze the average annual percentage change (AAPC) in incidence and mortality. Age-period-cohort models were applied to estimate the age, period, and cohort effects by gender. Bayesian age-period-cohort (BAPC) methods were employed to predict the standardized incidence and mortality rates for both genders from 2022 to 2032.

After age standardization, the age-standardized incidence rates (ASIR) for both males and females showed a slight decline from 1990 to 1995, followed by a gradual increase. The age-standardized mortality rate (ASMR) for males decreased from 5.44 per 100 000 in 1990 to 4.72 per 100 000 in 2021, while for females, it decreased from 3.86 per 100 000 to 2.75 per 100 000, with a more pronounced decline in females. Joinpoint regression analysis indicated an overall increasing trend in ASIR (AAPC for males: 0.43%, females: 0.64%, P<0.05). The fastest decline in male ASIR occurred from 1990 to 1992 (APC=-1.62%, P<0.05), while the fastest increase was from 2019 to 2021 (APC=1.30%, P<0.05). For females, the fastest decline in ASIR was from 1990 to 1995 (APC=-1.31%, P<0.05). Overall, the ASMR rate showed a decreasing trend (AAPC for males: -0.51%, females: -1.09%, P<0.05), with a more significant decline in females. The fastest decline in male ASMR was from 2004 to 2007 (APC=-3.26%, P<0.05), while the fastest increase was from 1998 to 2004 (APC=1.30%, P<0.05). For females, the fastest decline in ASMR was also from 2004 to 2007 (APC=-4.47%, P<0.05). Age-period-cohort analysis revealed that males generally had higher incidence and mortality rates than females across all age groups, with rates increasing with age. The incidence growth accelerated after age 60-65, and mortality growth accelerated after age 70. The period effect on incidence risk was slightly higher in females than in males, while the cohort effect showed an overall increasing trend in incidence and a decreasing trend in ASMR for both genders. Predictions from 2022 to 2032 indicate a continued rise in ASIR and a sustained decline in mortality for both genders.

From 1990 to 2021, the ASIR of hypertensive nephropathy in China showed an overall upward trend, while ASMR decreased. Both incidence and mortality increased with age, particularly in the elderly. Over the next decade, ASIR is expected to continue rising, while ASMR will decline slowly. These findings suggest a need to focus on male and elderly patients in developing targeted prevention and control measures.

The incidence and prevalence of chronic kidney disease (CKD) remain high. Hypertension and diabetes frequently coexist and jointly accelerate the progression of kidney disease. The lipid accumulation product index (LAPI) is a novel indicator for predicting cardiovascular disease and abnormalities in glucose metabolism, and its relationship with CKD warrants further investigation.

This study aimed to investigate the relationship between LAPI and the risk of developing CKD in patients with hypertension and abnormal glucose metabolism.

A retrospective cohort of 2 033 patients with hypertension and abnormal glucose metabolism admitted to the Hypertension Center of People's Hospital of Xinjiang Uygur Autonomous Region from January 2012 to May 2019 was enrolled. General patient information and laboratory test indicators were collected. The LAPI was calculated, and the population was divided into four groups based on LAPI quartiles: Q1 (LAPI≤44.03, n=509), Q2 (44.03<LAPI≤64.68, n=508), Q3 (64.68<LAPI≤98.90, n=508), and Q4 (LAPI>98.90, n=508). Patients were followed up, with the endpoint event being CKD. Kaplan-Meier curves were used to analyze the cumulative incidence of CKD at different LAPI levels, and the Log-rank test was used to compare differences. Multivariate Cox regression models were employed to analyze the relationship between LAPI and CKD. Restricted cubic splines were fitted to the multivariate Cox regression model to explore the dose-response relationship between LAPI and CKD. Subgroup analysis and sensitivity analysis were conducted to test the stability of the relationship between LAPI and CKD.

Significant differences were observed in age, gender, BMI, waist circumference, heart rate, diastolic blood pressure, smoking, alcohol consumption, uric acid, total cholesterol, triglycerides, high-density lipoprotein, low-density lipoprotein, glycated hemoglobin, fasting blood glucose, use of calcium channel blockers, and hypoglycemic treatment among the 4 groups (P<0.05). Log-rank test results indicated that the cumulative risk of CKD increased with elevating LAPI levels (χ²=14.48, P<0.001). Multivariate Cox regression analysis revealed that for each standard deviation increase in LAPI, the hazard ratio (HR) for CKD increased by 12.5% (HR=1.125, 95%CI=1.035-1.223, P=0.005) ; compared to the Q1 group, the Q4 group had a 54.9% higher risk of CKD (HR=1.549, 95%CI=1.129-2.125, P=0.007). Restricted cubic spline regression analysis showed that LAPI>65.59 was a risk factor for CKD (P=0.007). Interaction and subgroup analyses revealed that the association between LAPI and the risk of developing CKD remained stable.

In patients with hypertension and abnormal glucose metabolism, a higher LAPI in the early stages increases the risk of developing CKD.

In the social situation of "three child" policy opening and late marriage to become the norm, the topic of female reproduction and health has attracted increasing attention. As one of the important markers of ovarian reserve in women, the relationship between anti-Mullerian hormone (AMH) and cardiovascular disease and cardiovascular risk indicators has become a hot research issue.

To establish a reference range of AMH in healthy women of reproductive age in Urumqi region, and to investigate the association between AMH and risk factors associated with cardiovascular disease.

From May to July 2018, healthy women aged 19-50 years who met the criteria were selected from the natural population of a community-based epidemiological survey with four living residents area in Urumqi city by targeted sampling, and the serum AMH, fasting plasma glucose, total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), triacylglyceride (TG), serum uric acid, and thyroid stimulating hormone (TSH) levels of the survey subjects were tested. Height, body mass, abdominal circumference, hip circumference, blood pressure, and other indicators were measured to analyze the relationship between AMH and the above indicators related to cardiovascular risk factors.

The median AMH among 855 healthy women of reproductive age was 1.58 (0.01, 8.78) μg/L. The reference range of AMH in healthy women of reproductive age in our region was established, that was, 0.89 to 10.94μg/L for 19-24 years old, 0.66 to 11.77 μg/L for 25-29 years old, 0.27 to 8.25μg/L for 30-34 years old, 0.01 to 6.87μg/L for 35-39 years old, 0.01 to 3.98μg/L for 40-44 years old, <0.01-1.87μg/L for 45-50 years old. Spearman correlation analysis showed that AMH was negatively correlated with age, body fat index (BMI), abdominal circumference, hip circumference, systolic blood pressure, diastolic blood pressure, TSH, TC, LDL-C (P<0.05), but not with blood glucose, TG, HDL-C, uric acid (P>0.05) .

In this study, the reference range of serum AMH in healthy women of reproductive age in Urumqi was established, which may provide a basis for the functional assessment of ovarian reserve in women of different ages. Low AMH levels in women of reproductive age are associated with cardiovascular risk factors such as increased age, obesity, abdominal obesity, hypertension, and hyperlipidemia.

It has been a consensus that cardiac rehabilitation is an effective comprehensive intervention for patients with coronary heart disease (CHD), but the quality of relevant guidelines is still unclear, and recommendations from the guidelines need to be integrated.

To systematically review the guidelines on cardiac rehabilitation in patients with CHD, providing evidence to inform clinical practice.

In June 2022, guidelines on cardiac rehabilitation in patients with CHD were searched in electronic databases of the Cochrane Library, Web of Science, PubMed, CNKI, CQVIP and Wanfang Data, relevant guideline repositories and association websites from inception to 30 June 2022. Literature screening and data extraction were performed by two researchers separately according to the inclusion and exclusion criteria. The quality of included guidelines was assessed using the Appraisal of Guidelines for Research & EvaluationⅡ (AGREEⅡ), and recommendations from which were summarized.

Ten guidelines (eight of them are foreign guidelines) with publication time ranging from 2011 to 2020 were eventually included. The average score of every AGREEⅡ domain was 71% for scope and purpose, 65% for stakeholder involvement, 58% for rigor of development, 80% for clarity of presentation, 64% for applicability, and 45% for editorial independence. Four guidelines were rated as grade A and the remaining six as grade B. Six aspects are involved in recommendations, including basic requirements of cardiac rehabilitation, heath education, risk factors control, psychological support, exercise training, and improvement of cardiac rehabilitation participation.

The quality of included guidelines is at a moderate to high level. More efforts are needed to improve the domains in stakeholder involvement, rigor of development, applicability, and editorial independence. Recommendations of the 10 guidelines tend to be consistent, but there are still insufficient recommendations on improving cardiac rehabilitation participation. There is a gap in the quality between domestic and foreign guidelines, so it is necessary to develop a high-quality guideline on cardiac rehabilitation for patients with CHD in China.

As the main cause of death in the world, the morbidity and mortality of cardiovascular diseases are increasing year by year. Chronic inflammation of circulatory system is common in middle-aged and older people, which is closely related to the pathogenesis of various cardiovascular diseases. Dyslipidemia is also one of the age-specific cardiovascular risk factors. Exercise has attracted much attention as an important intervention method, among which resistance training can reduce the risk of cardiovascular diseases in middle-aged and older people, but the regulation effect of inflammation and dyslipidemia is still controversial.

To explore the effect of resistance training on cardiovascular risk factors in middle-aged and older people, and to provide a basis for formulating exercise prescriptions for middle-aged and elderly people.

PubMed, Cochrane, Embase, Web of Science, China National Knowledge Infrastructure, Wanfang Data Knowledge Service Platform, and VIP Chinese Science and Technology Journal Full-text Database were retrieve by computer for randomized controlled trials on the effects of resistance training on cardiovascular risk factors in middle-aged and older people published from the date of establishment to 2021-08-31. The retrieved literatures were screened and data extracted, including the first author, the year of publication, general characteristics of the study population, resistance training protocols and outcome indicators. The bias risk assessment tool of Cochrane system evaluation manual was used to evaluate the bias risk of literature. Meta-analysis was performed using RevMan 5.3 software, including the statistics of combined effect size, heterogeneity test, sensitivity analysis, and subgroup analysis. Publication bias of included studies was analyzed using Stata 16.0 software, using Egger's test.

Fifteen papers with 476 observations were included. Meta-analysis showed that, resistance training were superior to control group in decreasing C-reactive protein〔SMD (95%CI) =-0.67 (-0.89, -0.46) , P<0.01〕, total cholesterol〔SMD (95%CI) =-0.37 (-0.66, -0.08) , P=0.01〕, triglyceride〔SMD (95%CI) =-0.29 (-0.53, -0.05) , P=0.02〕, low-density lipoprotein cholesterol〔SMD (95%CI) =-0.37 (-0.67, -0.06) , P=0.02〕 and improving high-density lipoprotein cholesterol levels〔SMD (95%CI) =0.33 (0.09, 0.57) , P<0.01〕. Subgroup analysis showed that C-reactive protein and total cholesterol levels were lower in the resistance training group than in the control group at training duration ≤12 weeks, with statistically significant differences (P<0.05) . In both the training intensity of high intensity and the chronic disease population, C-reactive protein levels were lower in the resistance training group than in the control group and high-density lipoprotein cholesterol levels were higher, with statistically significant differences (P<0.05) .

Resistance training has been shown to be effective in reducing cardiovascular risk factors, reducing chronic inflammation and improving dyslipidaemia in the middle-aged and older population.

Acute myocardial infarction (AMI) can be found in some patients with normal serum lipids although abnormal lipid metabolism is a major risk of AMI. The association of AMI with two unconventional lipid parameters, namely residual lipoprotein-cholesterol (RLP-C) and atherogenic index of plasma (AIP), has been studied rarely, and the predictive value of RLP-C and AIP for first-time AMI in young adults still needs to be explored.

To assess the value of RLP-C and AIP in predicting first-time AMI in young adults.

A total of 1 201 inpatients aged 18-45 years old with an initial diagnosis of coronary heart disease (CHD) were selected from Northern Jiangsu People's Hospital from November 2014 to November 2021, including 627 with first-time AMI and 574 without. General demographics, triglyceride (TG), total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C) and other indicators were collected, and RPL-C and AIP were calculated according to the formula for statistical analysis. Logistic regression analysis was used to explore the influencing factors of first-time AMI. Receiver operating characteristic (ROC) analysis was used to evaluate the predictive value of RLP-C and AIP for first-time AMI.

CHD patients with and without first-time AMI had significant differences in male ratio, smoking history, hypertension history, and average levels of TG, TC, HDL-C, LDL-C, RLP-C and AIP (P<0.05). Multivariate Logistic regression analysis showed that smoking history〔OR=2.541, 95%CI (1.824, 3.538) 〕, TC≥5.17 mmol/L〔OR=2.787, 95%CI (1.405, 5.531) 〕, RLP-C≥0.6 mmol/L〔OR=3.786, 95%CI (2.648, 5.413) 〕 and AIP≥0.2〔OR=3.427, 95%CI (2.106, 5.576) 〕independently increased the risk for first-time AMI (P<0.05), while HDL-C≥1.19 mmol/L〔OR=0.049, 95%CI (0.025, 0.093) 〕independently decreased the risk of first-time AMI (P<0.05). In ROC analysis, the performance of RLP-C and AIP predicting first-time AMI was as follows: RLP-C had an AUC of 0.851〔95%CI (0.830, 0.873) 〕, with 0.535 mmol/L as the optimal cut-off value, 0.848 sensitivity and 0.699 specificity; AIP had an AUC of 0.813〔95%CI (0.789, 0.837) 〕, with 0.122 as the optimal cut-off value, 0.852 sensitivity and 0.660 specificity.

The risk of first-time AMI in young adults may be increased by smoking history, TC≥5.17 mmol/L, RLP-C≥0.6 mmol/L and AIP≥0.2, and decreased by HDL-C≥1.19 mmol/L. RLP-C and AIP may partially predict first-time AMI.

Tolvaptan is widely used in elderly patients with chronic heart failure (CHF) , but the effect of different doses of tolvaptan on the prognosis of elderly CHF patients is unclear.

To investigate the effect of two commonly used doses of tolvaptan, 7.5 mg/d and 15.0 mg/d, on the prognosis of elderly patients with CHF.

This is a retrospective cohort study. This study selected patients (age≥80 years) with CHF treated with tolvaptan in the health care ward of the 960th Hospital of PLA Joint Logistics Support Force of China from February 2016 to February 2022, and analyzed their clinical data. The patients were divided into 7.5 mg/d and 15.0 mg/d groups based on the dose of tolvaptan. The end point of follow-up was the occurrence of all-cause mortality or cardiovascular mortality or until the end of follow-up. This study used Kaplan-Meier method to perform survival curves analysis and used Cox proportional hazards regression models to analyze the effect of two doses of tolvaptan on all-cause mortality and cardiovascular mortality in elderly patients with CHF.

This study enrolled 212 elderly patients with CHF, and the follow-up was 374.5 (155.5, 940.5) days. 124 (58.5%) patients died from all-cause mortality and 54 (25.5%) patients died from cardiovascular mortality during the follow-up. Kaplan-Meier survival curve showed that 15.0 mg/d group had higher rates of all-cause mortality and cardiovascular mortality compared with 7.5 mg/d group (P=0.004 3, P=0.001 2) . Multivariate Cox proportional hazards regression model analysis showed that after adjusting for age, NYHA cardiac functional class, chronic kidney disease, diabetes, hypertension, coronary artery disease, diuretics, albumin (ALB) , serum N-terminal brain natriuretic peptide precursor (NT-proBNP) and estimated glomerular filtration rate (eGFR) , 15.0 mg/d group had a 1.03-fold increased risk of all-cause mortality〔HR=2.03, 95%CI (1.34, 2.99) 〕and 1.51-fold increased risk of cardiovascular mortality〔HR=2.51, 95%CI (1.40, 4.50) 〕compared with 7.5 mg/d group. This study stratified analysis by eGFR, age, ALB, and NT-proBNP, the results showed that tolvaptan 15.0 mg/d group had higher rates of all-cause mortality and cardiovascular mortality.

Tolvaptan 15.0 mg/d group had higher rates of all-cause mortality and cardiovascular mortality compared with tolvaptan 7.5 mg/d in elderly CHF patients (age≥80 years) . We may recommend using low-dose tolvaptan.

Chronic heart failure is a syndrome occurring at the end-stage of multiple cardiovascular diseases. In the condition, nutritional and metabolic problems such as loss of appetite, diarrhea, abdominal distension, and constipation are highly prevalent, which in turn affect the prognosis of heart failure. The relationship of nutritional assessment results with prognosis in chronic heart failure has been studied extensively, while nutritional assessment for older adults with chronic heart failure has been rarely studied, and there is no clinically recognized assessment method.

To perform a comparative analysis of four nutritional assessment methods in terms of clinical prognosis prediction in elderly patients with chronic heart failure.

Eligible older inpatients with chronic heart failure (n=199) were recruited from Department of Cardiology, ICU, and Department of Geriatrics, Linyi People's Hospital from June 2018 to June 2020. Data were collected via reviewing the medical records and telephone-based follow-ups, including sex, age, height, weight, serum albumin (ALB) level, BMI, Geriatric Nutritional Risk Index (GNRI) , and result of Nutrition Risk Screening 2002 (NRS2002) , as well as prognosis〔containing three classifications: in-hospital deaths (n=43) and in-hospital survivors (n=156) ; one-year deaths (n=51) and one-year survivors (n=148) ; readmission within half a year (n=69) and readmission after half a year (n=130) 〕. Multivariate Logistic regression analysis was used to explore the prognostic factors of chronic heart failure. The analysis of ROC curve with AUC value was carried out to comparatively estimate prognosis predictive values of the nutritional assessment methods.

There were significant differences in mean age, serum ALB, GNRI and NRS2002 score between in-hospital deaths and survivors (P<0.05) . The mean age, height, serum ALB, GNRI and NRS2002 score were also significantly different between one-year deaths and survivors (P<0.05) . Those with readmission within half a year had significantly different mean BMI, serum ALB, GNRI and NRS2002 score compared with those with readmission after half a year (P<0.05) . For predicting in-hospital death, the AUC of serum ALB was 0.76〔95%CI (0.68, 0.84) , P<0.001〕, and that of NRS2002 score was 0.80〔95%CI (0.73, 0.86) , P<0.001〕. In predicting one-year death, the AUC of serum ALB was 0.75〔95%CI (0.67, 0.82) , P<0.001〕, and that of NRS2002 score was 0.82〔95%CI (0.76, 0.88) , P<0.001〕. The AUC of NRS2002 score in predicting readmission within half a year was 0.73〔95%CI (0.65, 0.80) , P<0.001〕.

On the whole, NRS2002 score could be the first choice for prognostic assessment in elderly patients with chronic heart failure, for it was more effective in predicting the risks of in-hospital death, one-year death and readmission within half a year than serum ALB level, GNRI and BMI.

Cardiovascular disease (CVD) is one of the leading causes of death worldwide. In April 2022, the U.S. Preventive Services Task Force (USPSTF) updated and published recommendations on aspirin use to prevent CVD based on the latest evidence-based research results. The USPSTF recommends against initiating low-dose aspirin use for the primary prevention of CVD in adults aged 60 years and above. The decision to initiate low-dose aspirin use for the primary prevention of CVD in adults aged 40 to 59 years who have a 10% or greater 10-year CVD risk should be an individual one based on shared decision-making between clinicians and patients about the potential benefits and harms. This paper aims to interpret the latest recommendations in the context of China's actual situation, providing a reference on aspirin use to prevent CVD in China.

As one exercise program of cardiac rehabilitation, the role of high-intensity interval training (HIIT) in improving myocardial infarction is still controversial, and the mechanism is unclear.

To investigate the effect of HIIT on improving the cardiac structure and function in a rat model of myocardial infarction.

An experiment was conducted from September 2020 to October 2021. From a random sample of 78 3-month-old male SD rats, 56 were eventually included, and 14 of them were randomly selected as sham-surgery group (Sham group) , and the remaining 42 rats were equally randomized into MI-sedentary group (MI-SED group) , MI-HIIT group (MI-HIIT group) , and MI-medium-intensity continuous training (MI-MICT group) after being used for preparing a model of acute myocardial infarction (AMI) . Sham group and MI-SED group were not trained, MI-HIIT group received high-intensity and medium-intensity training alternately, MI-MICT group received medium-intensity continuous training. After 1 week of AMI modeling, MI-HIIT and MI-MICT groups received 8 weeks of training. At the end of 4 weeks of training, 7 rats in each of the 4 groups were randomly selected for detecting cardiac ultrasound, and weighing body weight, then were sacrificed, and their heart weight and serum tumor necrosis factor (TNF-α) were measured, cardiac mass index was calculated, and heart tissues were measured using H&E staining, Masson's Trichrome staining and immunohistochemical staining. At the end of 8 weeks of training, the same operation was performed on the remaining 7 rats in each of the groups.

After 4 weeks of training, the standardized cardiac mass index of MI-HIIT group was higher than that of each of the other three groups (P<0.05) . The sham group had higher ejection fraction (EF) , fractional shortening (FS) and left ventricular end-systolic posterior wall thickness (LVPWs) than MI-HIIT and MI-MICT groups (P<0.05) . MI-SED group had lower EF, FS, and LVPWs, and higher left ventricular end-systolic diameter (LVESD) than MI-HIIT and MI-MICT groups (P<0.05) . After 8 weeks of training, MI-HIIT group had lower body weight than sham and MI-SED groups, higher heart weight than sham, MI-SED and MI-MICT groups, and higher standardized cardiac mass index than sham and MI-MICT groups (P<0.05) . MI-HIIT group demonstrated higher EF, LVESD, left ventricular end-diastolic diameter (LVEDD) , left ventricular end-systolic anterior wall thickness (LVAWs) than sham and MI-SED groups (P<0.05) . Moreover, MI-HIIT group also showed higher FS and LVPWs than MI-SED group (P<0.05) . HE staining results showed that MI-HIIT group had significantly improved inflammatory changes of heart tissue and more closely arranged myocardial cells at the end of the 8th week of training compared with at the end of 4 weeks of training. Masson's Trichrome staining results showed that after 8 weeks of training, the proportion of myocardial fibrillar collagen in myocardial tissues of MI-SED group was higher than that of MI-HIIT and MI-MICT groups. Immunohistochemical results showed that MI-HIIT group had more newly formed blood vessels in cardiac tissues than sham and MI-SED groups after 4 and 8 weeks of training, so did the MI-MICT group. The number of newly formed blood vessels in cardiac tissues of MI-HIIT group was more than that in MI-MICT group after 8 weeks of training. MI-HIIT group had higher serum TNF-α than MI-SED group after 4 weeks of training. After 8 weeks of training, the serum TNF-α in MI-HIIT group was higher than that in MI-MICT group.

HIIT performed in the early stage of AMI could improve cardiac mass index, induce early inflammatory response in myocardial tissue, reduce myocardial fibrosis, promote angiogenesis and ventricular remodeling. HIIT had better overall effect than MICT.

Cardiovascular disease (CVD) is a global health problem, and it is not known whether socioeconomic status (SES) and healthy lifestyle (HL) have an impact on CVD onset.

To understand the relationship between SES, HL and CVD, and to provide a basis for the prevention and control of CVD in the population.

A multi-stage cluster random sampling method was employed to select 9 280 residents aged 18 and above from 12 counties and districts in Guizhou Province as the baseline sample in 2010. In 2016-2020 follow the cohort, face to face interview by unified training and qualified personnel, including basic situation, lifestyle (smoking, drinking, vegetables and vegetables, etc.), previous disease history, according to the survey was divided into CVD group (123) and non-CVD group (4 025) ; we used COX proportional hazard regression models were used to analyze the effect of SES and HL on CVD incidence. Additionally, an accelerated failure time model was utilized to assess the impact of different SES and HL at the time of CVD onset.

After excluding baseline CVD patients, lost-to-follow-up and missing information, the valid sample size included in the analysis was 4 148, CVD onset 123, and the incidence density was 4.13 / 1 000 person-years. The results of multivariate analysis showed that compared with low SES (≤7 points), the risk of CVD in high SES (>7 points) decreased by 40.60% (HR=0.594, 95%CI=0.402-0.878). Compared with 6 HL populations, the population with 8 and 9 HL decreased by 44.40% (HR=0.556, 95%CI=0.320-0.968) and 49.20% (HR=0.508, 95%CI=0.284-0.912). Compared with the population in the low SES group and with HL ≤ 6 conditions, there was no statistically significant risk of CVD incidence in the population in the low SES group with HL of 7, 8, or ≥ 9 conditions (P>0.05) ; those with high SES (>7 points) and HL of 8 or 9 decreased CVD risk by 61.80% (HR=0.382, 95%CI=0.163-0.894) and 70.20% (HR=0.298, 95%CI=0.119-0.748, respectively), showing a decreasing trend. The results of the accelerated failure time model showed that those with high SES (>7 points), those with 8 species and 9 HL were delayed by 1.148 years (95%CI=0.049-2.287) and 1.407 (95%CI=0.227-2.588) .

Different SES and HL are negatively associated with CVD onset; in high SES population, the duration of CVD onset increases with increasing HL species. Low SES population is the key population of CVD prevention and control in Guizhou Province, so measures should be taken to improve their health literacy, and the health education and health promotion of CVD should be carried out accordingly.

Lipoprotein (a) [Lp (a) ] is significantly related to atherosclerotic cardiovascular disease (ASCVD), but it is unclear whether clinical agents that lower Lp (a) can reduce the risk of ASCVD. Here, we systematically reviewed the structure, function, genetic characteristics and detection status of Lp (a), discussed the relationship of Lp (a) with ASCVD, aortic valve stenosis and other cardiovascular diseases, and summarized new advance of Lp (a) -lowering therapies. The structural composition of Lp (a) indicates that Lp (a) may promote atherosclerosis, inhibit fibrinolytic reaction and promote inflammation. Multiple evidence from genetic studies and epidemiological studies supports that Lp (a) is significantly associated with an increased risk of ASCVD and major adverse cardiovascular events. In addition, Lp (a) is also associated with other cardiovascular diseases such as aortic valve stenosis. At present, several emerging drugs that lower Lp (a) are in clinical trials and may further reduce residual cardiovascular risk. This paper hopes to offer new thought for the study of Lp (a), and provide a basis for the monitoring and management of blood lipids.

Dysphagia incidence after cardiac surgery is increasing due to increased complexity of the surgery and number of older patients, which has become one of the most severe complications of cardiac surgery, affecting patients' physical health and recovery.

To perform a review of available evidence on the incidence of dysphagia after cardiac surgery.

Databases of PubMed, Embase, Cochrane Library, CINAHL, Web of Science, CBM, CNKI, Wanfang Data, and VIP were searched from inception to May 2022 for published studies on the incidence of dysphagia after cardiac surgery. Two researchers independently conducted a literature enrollment, quality assessment, and data extraction. Meta-analysis was conducted using Stata 15.0.

Fifteen studies with 7 880 patients were included. The meta-analysis revealed that the overall incidence of dysphagia after cardiac surgery was 13.3%〔95%CI (10.1%, 16.5%) 〕. Further region-specific analysis indicated that, the incidence of dysphagia following cardiac surgery in Asia, North America, and Oceania was 16.6%〔95%CI (10.4%, 22.8%) 〕, 10.0%〔95%CI (6.1%, 13.8%) 〕, and 17.4%〔95%CI (12.3%, 23.5%) 〕, respectively. According to sex-specific analysis, the incidence of dysphagia following cardiac surgery was 16.9%〔95%CI (11.8%, 21.9%) 〕, and 16.4%〔95%CI (11.1%, 21.8%) 〕 in male and female patients, respectively. The analysis based on age group indicated that the dysphagia incidence following cardiac surgery in patients aged <70 years and ≥70 years was 10.9%〔95%CI (8.6%, 13.5%) 〕 and 28.4%〔95%CI (19.7%, 37.9%) 〕, respectively. And analysis based on NYHA class found that the dysphagia incidence was 11.8%〔95%CI (7.4%, 16.3%) 〕 in patients with NYHA classⅠ or Ⅱ, and was 21.0%〔95%CI (11.0%, 30.9%) 〕 in those with NYHA class Ⅲ or Ⅳ. In accordance with analysis based on the duration of perioperative endotracheal intubation, the incidence of dysphagia following cardiac surgery in patients with <12 hours, 12-24 hours, 25-48 hours and >48 hours was 1.0%〔95%CI (0.3%, 1.8%) 〕, 6.4%〔95%CI (4.4%, 8.3%) 〕, 16.8%〔95%CI (9.5%, 24.1%) 〕, and 55.0%〔95%CI (28.0%, 82.0%) 〕, respectively. In addition, chronic kidney disease, chronic lung disease, previous history of cerebrovascular accident, atrial fibrillation, heart failure, intraoperative transesophageal echocardiography, perioperative stroke and sepsis were associated with a higher incidence of dysphagia after cardiac surgery. The results of the meta-analysis were robust, as shown by sensitivity analysis. Both Begg's and Egger's tests yielded P-value<0.05, indicating that publication bias existed in the studies.

Current evidence indicates that the incidence of dysphagia after cardiac surgery is high (13.3%), therefore, prompt postsurgical screening and treatment of dysphagia should be administered.

Cognitive impairment (CI) is a common complication of chronic heart failure (CHF) , which may significantly increase the risk of poor prognosis, so early identification of associated factors of CI in CHF is of great significance. Although there have been many relevant studies recently, their conclusions are inconsistent.

To perform a systematic review of the influencing factors of CI in CHF.

In August 2021, studies relevant to influencing factors of CI among patients with CHF were searched in databases including PubMed, Embase, The Cochrane Library, Web of Science, CINAHL, PsychINFO, CNKI, Wanfang Data, CQVIP, and SinoMed from inception to August 2021. Two researchers independently screened studies based on the inclusion and exclusion criteria, extracted data, and performed risk of bias assessment using the Newcastle-Ottawa Scale and The Agency for Healthcare Research and Quality methodology checklist, then conducted a descriptive analysis of the factors associated with CI in CHF. RevMan 5.3 was adopted for meta-analysis.

Fourteen studies were included, involving 6 324 cases of CHF, and 1 753 of them also with CI. Descriptive analysis indicated that five factors decreased the risk of CI in CHF, and 22 factors increased the risk, but the influence of sex and systolic blood pressure on CI is still far from inclusive. Meta-analysis demonstrated that education level〔OR=0.45, 95%CI (0.30, 0.70) 〕, age〔OR=1.17, 95%CI (1.10, 1.24) 〕, diabetes〔OR=2.17, 95%CI (1.17, 4.01) 〕, anemia〔OR=3.03, 95%CI (1.80, 5.10) 〕and left ventricular ejection fraction〔OR=0.91, 95%CI (0.88, 0.94) 〕were associated with CI in CHF.

High education level lowered the risk of CI in CHF, while older age, diabetes, anemia and decreased left ventricular ejection fraction increased the risk. Due to limited number and quality of included studies, the above-mentioned conclusion still needs to be verified by more high-quality studies.

Cardiometabolic multimorbidity (CMM) was one of the most common comorbidity aggregation patterns in different regions and populations, with a high risk of mortality. However, studies on the clinical and medication characteristics of CMM were limited.

To study the clinical characteristics and medication patterns of patients with CMM in the real world, and provide reference basis for the prevention and management of CMM.

Outpatient patients who were diagnosed with CMM in the hospital information system (HIS) of the First Affiliated Hospital of Ningbo University from January 2023 to June 2023 were selected. Basic prescription information was collected and analyzed using frequency analysis and association rule analysis methods.

A total of 7 059 patients with CMM were included, of which 3 960 (56.1%) were male and 3 099 (43.9%) were female, with an age range of 18 to 97 years and a mean age of (58.1±13.7) years. The results showed that 3 910 patients with less than 5 types of medication, accounting for 55.4%; 2 740 patients with 5-9 types of medication, accounting for 38.8%; and 409 patients with more than 10 types of medication, accounting for 5.8%. Hypertension, dyslipidemia, and diabetes were the core diseases of CMM. Among the comorbidities of cardiovascular metabolic diseases, chronic gastritis, renal insufficiency, and hyperuricemia were more common. In the prescription of patients with CMM, statins, calcium channel blockers (CCB), angiotensin receptor blockers (ARB), metformin, and sodium-dependent glucose transporters 2 inhibitors (SGLT2i) were the core medications.

Our findings suggest chronic gastritis, renal insufficiency, and hyperuricemia are more common diseases in patients with CMM. Screening and prevention should be strengthened and treatment strategies should be adjusted. In the CMM drug prescription, lipid-lowering, antihypertensive, and hypoglycemic drugs are the core drugs used.