It is important to estimate the sodium intake of primary hypertension patients through 24-hour urine sodium excretion, but the collection and testing processes are complicated. It is not clear whether the existing equation for estimating 24-hour urinary sodium excretion from spot urine sample is valid in Chinese primary hypertension patients.

To evaluate the validity of the Kawasaki, INTERSALT, and Tanaka equations using spot urine samples to estimate 24-hour urinary sodium excretion among Chinese primary hypertension patients.

This study retrospectively selected hospitalized primary hypertension patients from Department of Cardiology Peking University International Hospital from March 2018 to March 2021. General data were collected. The 24-hour urinary sodium extraction in the 24-hour urine sample was measured. The 24-hour urinary sodium extraction from spot urine sample was estimated. Paired t-test was used to measure the significance of difference between the 24-hour urine sodium excretion from spot urine samples predicted using Kawasaki, INTERSALT or Tanaka equation and measured 24-hour urinary sodium excretion from 24-hour urine collections, and the correlation and agreement between them were analyzed using the Spearman correlation coefficient and Bland–Altman plots, respectively. Relative deviation was calculated. The accuracy of the three equations were also evaluated in patients with different levels of salt intake, diabetes or proteinuria.

One hundred and ninety-six patients were finally included for analysis. The average 24-hour urinary sodium excretion level was (165.04±78.53) mmol/d, which was equivalent to daily NaCl intake of (9.65±4.59) g/d. Female patients were older, had higher ratios of microalbuminuria and proteinuria, while lower BMI, diastolic blood pressure on admission, 24-hour average diastolic blood pressure compared with male patients (P<0.05) . Moreover, female patients were less likely to be smokers, and had lower spot urine sodium, as while as lower 24-hour urinary sodium excretion (P<0.05) . The 24-hour urinary sodium excretion estimated by Kawasaki equation was significantly higher than the measured value (t_paired=-8.008, P<0.001) , and the Bland-Altman plots showed that 94.90% spots were in 95%CI. The 24-hour urinary sodium excretion estimated by INTERSALT equation was significantly lower than the measured value (t_paired=4.167, P<0.001) . The Bland-Altman plots showed that 94.39% spots were in 95%CI. The 24-hour urinary sodium excretion estimated by Tanaka equation was higher than the measured value (t_paired=-0.547, P>0.05) without significant difference, and the Bland-Altman plots showed that 96.43% spots were in 95%CI. The relative deviation of Kawasaki, INTERSALT and Tanaka equations was -31.82%, 12.94 % and -1.90%, respectively. After dividing patients according to salt intake, the moderate correlation between predicted and actual values of each equation was no longer significant. There was no significant difference in the predictive accuracy of the equations between patients with and without diabetes or proteinuria.

The accuracy and consistency of the Kawasaki, INTERSALT and Tanaka equations in estimating 24-hour urinary sodium levels by spot urine in primary hypertension patients were poor. Tanaka's overall estimated value is the closest to the measured mean value. No comorbidity (such as diabetes, proteinuria) that might affect urinary sodium excretion was found to have a significant effect on the accuracy of the estimation equation.

Pregnant women with gestational diabetes mellitus (GDM) are often comorbid with hypertensive disorders of pregnancy (HDP), which can severely impact pregnancy health and delivery outcomes. The relationship between gut microbiota and pregnancy health has received increasing attention, but its association with concurrent HDP in GDM remains to be investigated.

To explore the association between gut microbiota characteristics and concurrent HDP in GDM patients.

The 204 patients with GDM who underwent prenatal examination at the Hangzhou Women's Hospital from August 2019 to January 2020 were selected as the study subjects. Pregnant women diagnosed with GDM only were categorized as the GDM group (n=181), while those concurrently diagnosed with GDM and HDP were categorized as the GDM with concurrent HDP group (n=23). Clinical data and inflammation detection markers of the enrolled pregnant women were collected, and fecal samples of the same period were retained for gut microbiota 16S rDNA amplicon sequencing analysis. LEfSe analysis was used to compare microbiota composition between the two groups at the phylum, family and genus levels, and to identify distinct bacterial enrichments. Logistic regression analysis was performed to identify gut microbiota characteristics associated with concurrent HDP in GDM. Spearman's rank correlation analysis was performed to explore the association between gut microbiota and inflammatory markers.

No significant differences were found in overall gut microbiota composition and relative abundances of major phyla between the two groups (P>0.05). LEfSe analysis on family level showed that the Veillonellaceae family was enriched in the GDM with concurrent HDP group (P<0.05), while Mollicutes RF39 unclassified family and Lachnospiraceae were depleted (P<0.05). At the genus level, Dialister, Intestinibacter, Eubacterium and Parasutterella were enriched in the GDM with concurrent HDP group (P<0.05), whereas [Eubacterium] xylanophilum group, Ruminiclostridium 6, Mollicutes RF39 unclassified genus and Lachnospiraceae unclassified genus were enriched in the GDM group (P<0.05). Logistic regression analysis results showed increased abundances of Veillonellaceae (OR=1.06, 95%CI=1.01-1.11), Dialister (OR=1.26, 95%CI=1.10-1.45) and Intestinibacter (OR=2.07, 95%CI=1.12-3.84) were independent risk factors for concurrent HDP in GDM (P<0.05), while increased Lachnospiraceae was a protective factor (P<0.05). Spearman's rank correlation analysis results showed Veillonellaceae was positively correlated with the proportion of monocytes (r_s=0.149, P<0.05) ; Dialister was positively correlated with leukocyte count, eosinophil leukocyte, and eosinophil count (r_s=0.151, 0.163, 0.171, P<0.05) .

Increased abundances of Veillonellaceae, Dialister and Intestinibacter are independent risk factors for concurrent HDP in GDM pregnant women, while increased abundance of Lachnospiraceae unclassified genus is a protective factor. Veillonellaceae and Dialister are positively correlated with multiple inflammatory markers. Gut microbiota may be an important risk factor for concurrent HDP in GDM.

The prevalence of hypertension in population is still increasing by year, and the significant increase in the prevalence of chronic diseases caused by aging of the population results in a serious medical burden. There are still about 450 million people in China who use solid fuels for cooking or heating, causing indoor air pollution as an important public health problem in China. At present, the relationship between solid fuels use and the risk of hypertension in Chinese older adults still remains unclear.

To analyze the association between solid fuels use and the risk of hypertension in older adults in urban and rural areas of China through a prospective cohort study, so as to provide a theoretical basis for the prevention and treatment of hypertension in the elderly.

This study is a prospective cohort study. Data were obtained from 2011 to 2018 China Longitudinal Healthy Longevity Survey (CLHLS) by using baseline questionnaire and physical examination. A total of 1 453 non-hypertensive older adults aged 65 years and above from 2011 to 2012 cohort were included in the study, and the occurrence of hypertension during follow-up was considered as the outcome indicator, follow-up as of 2018-12-31. The included subjects were divided into the clean fuel (electrical appliances such as induction cooker, pipeline natural gas, solar energy) group (n=654) and solid fuel (charcoal, kerosene, coal, firewood) group (n=799). Multivariate Cox proportional hazard regression model was used to analyze the association between cooking with solid fuels and the risk of hypertension.

A total of 1 453 non-hypertensive older adults at baseline with an average age of (77.6±8.8) years and a median follow-up of 7 years, and a total of 838 people developed hypertension at the outcome. The results of this study showed that the proportion of cooking with solid fuels in rural areas was significantly higher than that in urban areas (70.3% vs. 1.1%, P<0.05). Multivariate Cox proportional hazard regression model showed that cooking with solid fuels significantly increased the risk of hypertension〔HR=1.20, 95%CI (1.05, 1.38), P=0.01〕, and the adjustment for covariates still indicated that it increased the risk of hypertension〔HR=1.21, 95%CI (1.04, 1.41), P=0.01〕. In addition, cooking with solid fuels was positively associated with abnormal mean arterial pressure (MAP) 〔HR=1.26, 95%CI (1.02, 1.55), P=0.03〕; and the adjustment for covariates still showed positive association of it with abnormal MAP〔HR=1.28, 95%CI (1.02, 1.60), P=0.03〕.

Cooking with solid fuels in urban and rural areas of China significantly increases the risk of hypertension in the elderly, as well as affects MAP. Reducing the use of solid fuels for cooking and promoting the use of clean fuels is a simple and effective measure in the prevention and control of hypertension.

Hypertension and diabetes are two major chronic diseases affecting population health, and need to be controlled through chronic diseases follow-up. However, there is currently insufficient understanding of the impact of different chronic diseases follow-up forms and contents on disease control and healthy behaviors of patients.

To explore the impact of the chronic diseases follow-up on health behaviors and blood pressure/glucose control of patients with hypertension and diabetes in the context of treatment-prevention integration.

Yiyang County in Henan Province, Xianfeng County in Hubei Province and Yangqu County in Shanxi Province were selected as study sites to collect data from the basic public health information system from 2017-01-01 to 2022-06-30. Patient survey was conducted in July 2022 to collect information on basic public health follow-up receiving, health behaviors and disease control of patients. Finally, 102 769 patients with hypertension and 26 586 patients with diabetes were obtained from the basic public health information system, the data of 1 172 patients with hypertension and 456 patients with diabetes were obtained through patient surveys. Multivariate Logistic regression was used to analyze the effects of the standard-reaching frequency of follow-up, follow-up forms and contents on health behaviors and disease control of patients.

In 2021, the standard-reaching rates of follow-up frequency of patients with hypertension and diabetes were 90.83% (67 709/74 545) and 83.35% (13 390/16 065) , with frequency≥4 times/year as the standard. The follow-up forms included household follow-up〔25.74% (408/1 585) 〕, follow-up at institutional visits〔58.80% (932/1 585) 〕, telephone or network follow-up〔15.46% (245/1 585) 〕. The follow-up contents included blood pressure and blood glucose measurements〔91.15% (1 484/1 628) 〕, lifestyle guidance〔74.14% (1 207/1 628) 〕, disease inquiry〔70.02% (1 140/1 628) 〕, and drug use understanding〔69.29% (1 128/1 628) 〕. Multivariate Logistic regression analysis showed that patients with higher standard-reaching rates of follow-up frequency had higher rates of blood pressure control (OR=1.09, P<0.05) and glucose control (OR=1.31, P<0.05) , lower rates of smoking and drinking (OR=0.83, P<0.05) , and higher rates of regular exercise habits (OR=1.30, P<0.05) . The proportions of smoking and alcohol cessation (OR=2.38, P<0.05) and regular exercise habits (OR=1.62, P<0.05) were higher in the patients followed up at institutional visits than those followed up by telephone or network. The proportions of smoking and alcohol cessation (OR=2.33, P<0.05) and regular exercise habits (OR=2.54, P<0.05) of patients received household follow up were higher than those followed up by telephone or network. Patients who received lifestyle guidance, disease inquiry, and drug use understanding had higher rates of blood pressure control (OR=1.61, 1.34, and 1.62, respectively; P<0.05) , smoking and alcohol cessation (OR=3.59, 3.54, and 2.91, respectively; P<0.05) and regular exercise habits (OR=3.16, 2.15, 2.45, respectively; P<0.05) .

Receiving chronic diseases follow-up at least 4 times per year, with follow-up at institutional visits and household follow-up as the forms, provided with blood pressure and blood glucose measurements, lifestyle guidance, disease inquiry and drug use understanding as the contents in patients were positive correlated with blood pressure/glucose control, smoking and alcohol cessation, and regular exercise habits.

Previous studies have compared the first and another 3-day blood pressure levels in populations with no history of self-reported hypertension, but there have been few studies conducted in COVID-19 vaccine recipients.

To understand the blood pressure levels among 35-64-year-old COVID-19 vaccine recipients during regular COVID-19 containment, and to assess the differences between the first and another 3-day blood pressure levels and the factors affecting the fluctuation of blood pressure levels in the recipients with suspected hypertension, providing a reference and guidance for blood pressure measurement before COVID-19 vaccination.

In September 2021, 2 814 residents aged 35-64 with no history of self-reported hypertension were randomly selected for screening for hypertension before receiving COVID-19 vaccination at Qingling Community Health Service Center, Hongshan District, Wuhan City, Hubei Province. Blood pressure was measured and recorded as the first blood pressure measurement value, then based on this, those who were found with suspected hypertension〔systolic blood pressure≥140 mmHg and/or diastolic blood pressure≥90 mmHg (1 mmHg=0.133 kPa) 〕standardizedly measured their clinic blood pressure for another three times on different days without the use of any antihypertensive drugs. Based on the 3-day blood pressure measurement results, the proportions of those with blood pressure in the ideal range (systolic blood pressure<120 mmHg and diastolic blood pressure<80 mmHg), in the high normal range (systolic blood pressure: 120-139 mmHg and/or diastolic blood pressure: 80-89 mmHg), and in the hypertensive range (systolic blood pressure≥140 mmHg and/or diastolic blood pressure≥90 mmHg) were calculated, and the rate of hypertension diagnosis was compared between them by sex, age group, and the first blood pressure measurement level. The factors affecting the fluctuation of blood pressure levels (changes in blood pressure analyzed based on comparing the first blood pressure level and the 3-day blood pressure levels) in suspected hypertensive patients were analyzed using univariate and multivariate ordered Logistic regression.

Of the 2 814 cases, 36.67% (1 032/2 814) were suspected hypertensive patients. Analysis of the 3-day blood pressure levels indicated that the proportions of suspected hypertensive patients with a blood pressure level in the ideal range, high normal range and hypertensive range were 8.82% (91/1 032), 14.34% (148/1 032), and 76.84% (793/1 032), respectively. Among the cases with confirmed hypertension, the prevalence of stages 1, 2, and 3 hypertension was 63.68% (505/793), 26.48% (210/793) and 9.84% (78/793), respectively. The hypertension diagnosis rate was higher in females〔80.68% (380/471) 〕than that in males〔73.62% (413/561) 〕, with statistical significance (χ²=7.173, P=0.007). The hypertension diagnosis rate increased with the increase in the first blood pressure level in suspected hypertensive patients (χ² _trend =23.443, P<0.001). The factors affecting the fluctuation of blood pressure levels in suspected hypertensive patients were gender, age, time period for first blood pressure measurement, psychological factors and environmental noise≥40 dB during first blood pressure measurement (P<0.05) .

There are significant differences between the first blood pressure measurement results and 3-day blood pressure measurement results among suspected hypertensive patients. To improve the reliability of blood pressure measurement results to ensure the successful implementation of COVID-19 vaccination, it is suggested for community medical workers to ensure the vaccine recipients are in good mental state, and pre-vaccination blood pressure measurement for them is performed in a quiet environment, and to pay more attention to verify the reliability of pre-vaccination blood pressure level in males, the 55-64 age group, or individuals receiving blood pressure measurement at community health centers between 11: 01 in the morning and 14: 00 in the afternoon.

Hypertensive patients with moderate or high risk of ASCVD had low lipid goal attainment rate. And those with high risk of ASCVD and concomitant other high risk factors had unsatisfactory lipid control status. Attention should be paid to the management of blood lipid in hypertension patients to improve their blood lipid control rate and reduce their risk of ASCVD.

In 2018, the weighted prevalence rate of hypertension among adults aged ≥18 years was 27.5%. Rural areas demonstrated a faster increase in the prevalence rate of hypertension, but lower awareness rate, treatment rate and control rate of hypertension compared with urban areas. Hypertension is the primary risk factor for cardiovascular diseases, and also a major contributor to the disease burden in the population. Understanding the costs of hospitalizations due to hypertension and related comorbidities and complications in rural areas can provide data support for the development of hypertension management and containment strategies in counties.

To analyze the costs of hospitalizations due to hypertension and related comorbidities and complications in county-level healthcare institutions.

This study selected inpatients with a diagnosis of hypertension via checking the home page of medical records in two county-level hospitals (people's hospital and TCM hospital) of a poverty-stricken county in Henan Province from 2017 to 2019. Patients' clinical information was collected from the medical records, and their healthcare costs were collected from the municipal and county medical insurance information systems.

A total of 36 565 hospitalizations related information was obtained. During the period, these county-level healthcare institutions had 139 169 hospitalizations in total, 36 565 of them (26.27%) were due to hypertension and related comorbidities and complications. Age, occupational type, marital status, and payment method differed significantly across inpatients due to hypertension and related comorbidities and complications (P<0.05). The severity of disease varied significantly among patients hospitalized due to hypertension and related comorbidities and complications by gender, age, occupational type, marital status, year of admission, and payment method (P<0.05). The average cost of hospitalization due to hypertension and related comorbidities and complications was 7 364.88 yuan in 2017, 6 724.36 yuan in 2018, and 7 134.09 yuan in 2019. And total costs of hospitalizations due to hypertension and related comorbidities and complications in the three years were 62 653 116.87 yuan, 84 394 889.48 yuan and 109 633 058.60 yuan, respectively, showing an increase trend, and the percent of which reimbursed by health insurance was 24.86% in 2017, 31.41% in 2018, and 33.25% in 2019, demonstrating an increasing trend year by year. The average hospitalization expenses, treatment expenses, and drug expenses due to hypertension and related comorbidities and complications differed significantly by year (P<0.05), while the average examination expenses did not (P>0.05). Moreover, the average hospitalization cost, treatment cost, drug cost and examination cost due to hypertension and related comorbidities and complications differed significantly by the severity of disease during the period (P<0.05) .

In these county-level healthcare institutions during the period, the number of hospitalizations due to hypertension and comorbidities and complications accounted a large percent of the total hospitalizations, and the percentages of relevant hospitalization costs and reimbursed costs showed an increase trend gradually. In view of this, it is suggested to strengthen the standardized management of people with a definite diagnosis of hypertension, enhance the capacities of primary medical institutions in identifying, diagnosing and managing hypertension, and reduce healthcare costs by delaying the progression of hypertension. Moreover, priority should be given to special groups to improve their health status to reduce the disease burden of hypertension, and multiple measures should be taken to improve people's awareness rate of hypertension and self-health management abilities.

Obstructive sleep apnea-hypopnea syndrome (OSAHS) is highly prevalent but is underdiagnosed in hypertensive patients. There are few studies on the internal association of OSAHS with two predictors of cardiovascular events, namely heart rate variability (HRV) and blood pressure variability (BPV), in hypertensive patients.

To explore the influence of OSAHS on HRV and BPV in hypertension patients, and to develop and validate a nomogram for predicting the risk of OSAHS in these patients using HRV and BRV related indicators.

Two hundred and twenty-eight hypertensive patients〔including 114 without OSAHS (simple hypertension subgroup) and 114 with OSAHS (hypertension with OSAHS subgroup) assessed by the diagnostic criteria of OSAHS〕were selected as internal validation group from the Second Xiangya Hospital of Central South University from January 2018 to December 2020, and other 34 hypertensive patients with or without OSAHS who hospitalized in the same hospital during January to February 2021 were selected as an independent external verification group. General information (age, gender, BMI, etc.〕, average blood pressure level〔nighttime systolic blood pressure (nSBP), etc.〕, BPV related indices〔nighttime systolic blood pressure standard deviation (nSSD), nighttime diastolic blood pressure standard deviation (nDSD), 24-hour diastolic blood pressure standard deviations (24 hDSD), etc〕, blood pressure circadian rhythm, HRV related parameters〔standard deviation of the mean RR intervals (SDANN), low frequency (LF), etc.〕, polysomnography parameters〔oxygen desaturation index (ODI), apnea hypopnea index (AHI), minimum oxygen saturation (MinSpO₂), etc.〕. Multiple linear regression analysis were used to explore the influencing factors of HRV and BPV. Restricted cubic splines were used to test the correlation of the average blood pressure level, BPV and HRV related indicators with the risk of OSAHS. Multivariate Logistic regression model was used to analyze the influencing factors of OSAHS, and the screened factors were used to construct a nomogram for predicting OSAHS risk. The Bootstrap method was used to validate the performance of the internal and external groups in the nomogram model. And its predictive value for OSAHS risk in the two groups was assessed using the receiver operating characteristic (ROC) curve with the area under the curve (AUC) and other indicators calculated.

Multiple linear regression analysis showed that BMI, ODI and MinSpO₂ were independently associated with nSSD, nDSD or HRV related indices in hypertensive patients with OSAHS (P<0.05). Restricted cubic splines revealed that BPV related indices had a nonlinear relationship with OSAHS, and so did HRV related indices (P<0.05). Multivariate Logistic regression analysis showed that nSBP, nSSD, 24 hDSD, SDANN, LF, age and BMI were associated with OSAHS in hypertensive patients (P<0.05). The Bootstrap method showed that, the absolute error of the nomogram constructed using age, BMI, nSBP, nSSD, 24 hDSD, SDANN and LF was 0.013 in internal verification group, and was 0.021 in external verification group, indicating that the model had good calibration. The values of the AUC of the nomogram in predicting the risk of OSAHS in hypertension in internal and external validation groups were 0.861〔95%CI (0.818, 0.919), P<0.001〕 and 0.744〔95%CI (0.691, 0.839), P<0.001〕, respectively.

OSAHS can increase the nSSD and nDSD and decrease HRV in hypertensive patients. Both HRV and BPV are closely related to the severity of OSAHS. Nocturnal hypoxia may be more likely to cause changes in blood pressure and heart rate. Our nomogram could be used to facilitate individualized prediction of OSAHS risk in hypertensive patients. HRV and BPV parameters might be powerful tools to screen for OSAHS.

As the prevalence of hypertension in China's rural areas is very high, hypertension management in these areas is particularly important.

To summarize the characteristics and weaknesses of hypertension management in Shandong's rural areas using the Innovative Care for Chronic Conditions Framework (ICCC) proposed by the WHO, and to put forward targeted recommendations.

According to the socio-economic level and geographical distribution of hypertension prevalence, three county-level centers for disease control and prevention, 9 town health centers and 36 village clinics were selected from A county of Heze, B district of Jinan and C city of Weihai in Shandong Province, from which 84 cases (including individuals responsible for hypertension management programs, medical workers and hypertensive patients) were selected from June to July 2021 using a purposive sampling method to attend a face-to-face semi-structured interview for understanding the status of hypertension management in Shandong's rural areas. NVivo 12 and Qualitative Data Analysis Model proposed by MILES and HUBERMAN, were used to encode and analyse the interview results using the macro-, meso- and micro-level components of the ICCC.

A total of 13 themes and 51 subthemes were derived from the analysis at three levels. At the macro level, the implementation of hypertension management in Shandong's rural areas was generally in a positive policy environment, such as implementing national policies regarding chronic disease management and publicizing chronic disease management, but the policy framework was not complete, the integration within the departments in the health system was poor, and shortages of professional hypertension managers and sufficient financial support were serious. At the meso level, various medical institutions strived to promote the continuity of medical services, but the organization and deployment of family doctor teams and the promotion and use of information systems still needed to be further strengthened. At the micro level, the cooperation between patients and their families and the family doctor team needed to be improved, and the involvement of patients and their families in hypertension management should be enhanced as well.

The implementation of hypertension management in Shandong's rural areas is good generally, but the following efforts should be made for improvements: vigorously strengthening the leadership and supervision role of the government, formulating and integrating relevant policies, and promoting the integration of relevant departments; increasing financial support, and addressing the relatively shortage of health human resources and improving the weakness of informatization construction in rural areas to promote the delivery of high-quality medical services; attaching importance to the interaction between patients and families, health service team and community partners to promote patients' self-management.

Klotho is closely related to the occurrence and development of kidney disease. Salt-sensitive hypertension (SSH) is often accompanied by kidney disease. At present, there are few reports on the role and molecules mechanism of klotho in renal injury in SSH.

To investigate the role and molecules mechanism of klotho in renal injury in SSH.

The rat glomerular mesangial cell line HBZY1 was selected as the experimental cells from June 2021 to January 2022, and the experimental cells were divided into the control group and the model group. The model of HBZY1 cell injury induced by NaCl 137 mmol/L and angiotensin Ⅱ (Ang Ⅱ) 10^-6 mmol/L was used to simulate the renal injury in SSH, and the cells were collected. The differences in the expression of klotho mRNA and protein were detected by real-time fluorescent quantitative PCR (qRT-PCR) and Western Blot. The interference vector and overexpression vector of klotho and the overexpression vector of angiotensin Ⅱ type 1 receptor (AT1R) were constructed. The klotho interference experiments were divided into five groups, including the control group, empty group, klotho-siRNA1 group, klotho-siRNA2 group and klotho-siRNA3 group; the klotho overexpression experiments were divided into three groups, including the control group, empty group and klotho overexpression group; the AT1R overexpression experiments were divided into three groups, including the control group, empty group and AT1R overexpression group. The constructed vectors were transfected into cells with verified transfection efficiency. After successful transfection, the experiment was divided into two parts. The first part of the experiment was to verify the renal protective effect of klotho, the experiment subjects were divided into four groups, including the control group, model group, klotho overexpression group and klotho interference group. The second part of the experiment was to explore whether the renal protective effect of klotho was related to AT1R, the experiment subjects were divided into three groups, including the model group, klotho overexpression group and klotho+AT1R overexpression group. After successful transfection, the tests including cell viability detected by cell counting kit-8 (CCK-8) method, reactive oxygen species (ROS) content detected by flow cytometry, malondialdehyde (MDA) and superoxide dismutase (SOD) content in cell supernatant detected by enzyme-linked immunosorbent assay (ELISA) , interaction effect between kltho and AT1R detected by co-immunoprecipitation (Co-IP) .

Compared with the control group, mRNA level and protein expression of klotho in the model group decreased in model group (t=7.102, 7.506; P=0.002, 0.002) , klotho-siRNA2 interference effect was more significant (P<0.001) , the expression of klotho protein in the klotho overexpression group increased significantly (P<0.001) , the expression of AT1R protein in the overexpression group increased significantly (P<0.001) . Effects of klotho on cell viability and oxidative stress injury: compared with the control group, cell viability in the model group decreased (P<0.001) , intracellular ROS and MDA content increased (P<0.001, P=0.004) , and SOD content decreased (P=0.041) ; compared with the model group, cell viability in the klotho overexpression group increased (P<0.001) , intracellular ROS and MDA content decreased and SOD content increased (P<0.001, P=0.003, P=0.018) ; compared with the model group, cell viability in the klotho interference group decreased (P<0.001) , while intracellular ROS and MDA content increased and SOD content decreased (P<0.001, P=0.002, P=0.001) . Effects of klotho on cell viability and oxidative stress injury through AT1R: compared with the model group, cell viability increased (P<0.001) , intracellular ROS and MDA content decreased and SOD content increased (P<0.001, P=0.024, P=0.007) in the klotho overexpression group; compared with the klotho overexpression group, cell viability decreased (P<0.001) , ROS and MDA content increased and SOD content decreased (P<0.001, P=0.001, P=0.002) in the klotho+AT1R overexpression group. Co-IP determined that there was an interaction between klotho and AT1R.

Klotho plays a protective role in renal injury in SSH by inhibiting oxidative stress injury through interaction with AT1R.

Low shearing force can induce vascular inflammatory response, which leads to the occurrence and development of hypertension. Estrogen can regulate the immune system and inflammatory response through estrogen receptor mediated pathway, with a protective effect on hypertension. Cardiovascular diseases have become the leading cause of death in China.

To investigate the current prevalence and influencing factors of hypertension in women, explore the correlation of shearing force and estradiol with hypertension as well as the effect of estradiol on hypertension under various shearing force, so as to further explore the effect of the interaction between estradiol and shearing force on hypertension.

Female patients admitted to the Department of Cardiology of Hunan People's Hospital from January to August 2021 were selected as the study subjects, 288 of whom with essential hypertension were included as the case group, and 296 female non-hypertensive medical examiners in the physical examination department of Hunan People's Hospital were randomly selected as the control group. The self-designed questionnaire was used to investigate the general information of the study subjects, and the fasting venous blood samples of the subjects were taken in the early morning for the examination of laboratory indicators. The color doppler ultrasound was used for ultrasonography on vessels to calculate the shearing force. Multivariate Logistic regression was used to construct the hypertension prediction model and draw the nomogram. Receiver operating characteristic curve (ROC curve) was plotted to evaluate the hypertension prediction model. Stratification analysis was conducted on estradiol in four groups to explore the effect of each estradiol group on the occurrence of hypertension under different shearing force dichotomous groups. The multiplicative interaction model was used to evaluate the interaction between estradiol and shearing force.

There were significant differences in age, education level, body mass index (BMI), menopause, family history of hypertension, triglyceride (TG), total cholesterol (TC), low density lipoprotein cholesterol (LDL-C), high density lipoprotein cholesterol (HDL-C), estradiol, uric acid (UA), creatinine (Scr), urea nitrogen (BUN), shear force, and blood viscosity between the case group and control group (P<0.05). Multivariate Logistic regression results showed age>60 years old〔OR=2.172, 95%CI (1.361, 3.468) 〕, menopause〔OR=14.940, 95%CI (1.938, 115.176) 〕, family history of hypertension〔OR=1.614, 95%CI (1.014, 2.570) 〕, BMI of 24-28 kg/m²〔OR=3.454, 95%CI (2.072, 5.758) 〕, BMI>28 kg/m²〔OR=6.750, 95%CI (2.380, 19.146) 〕, TG of 1.30-1.83 mmol/L〔OR=1.980, 95%CI (1.114, 3.520) 〕, TG>1.83 mmol/L〔OR=2.311, 95%CI (1.308, 4.082) 〕, TC of 4.29-5.12 mmol/L〔OR=2.222, 95%CI (1.250, 3.950) 〕, TC>5.12 mmol/L〔OR=1.884, 95%CI (1.062, 3.341) 〕, LDL-C>2.81 mmol/L〔OR=1.546, 95%CI (1.150, 2.078) 〕, HDL-C>1.17 mmol/L〔OR=0.140, 95%CI (0.065, 0.301) 〕, BUN>5.47 mmol/L〔OR=3.249, 95%CI (2.380, 4.434) 〕, Scr>69 μmol/L〔OR=1.166, 95%CI (1.126, 1.207) 〕, UA>324 μmol/L〔OR=1.040, 95%CI (1.029, 1.050) 〕, WBV<3.39 mPa·s or >4.41 mPa·s〔OR=3.456, 95%CI (2.557, 4.671) 〕, estradiol of 10.60-<15.39 ng/L〔OR=0.053, 95%CI (0.015, 0.183) 〕, estradiol of 15.39-<23.99 ng/L〔OR=0.022, 95%CI (0.006, 0.077) 〕, estradiol >23.99 ng/L〔OR=0.005, 95%CI (0.001, 0.020) 〕, shearing force >8.21 dyne/cm²〔OR=0.033, 95%CI (0.017, 0.062) 〕were influncing factors for hypertension (P<0.05). ROC curve of clinical prediction model of hypertension was plotted, the results showed that the area under ROC curve of the prediction model was 0.907〔95%CI (0.882, 0.923), P<0.01〕, with sensitivity of 79.60% and specificity of 87.90%. The risk of hypertension tended to decrease in the shearing force≤8.21 dyne/cm² group (P_trend =0.001). In the shearing force ≤8.21 dyne/cm² group, estradiol≥15.39 ng/L was more significantly associated with reduced risk of hypertension〔OR=0.037, 95%CI (0.017, 0.079), P<0.05〕. In the shearing force >8.21 dyne/cm² group, estradiol≥15.39 ng/L was significantly associated with reduced risk of hypertension〔OR=0.012, 95%CI (0.005, 0.019), P<0.05〕.

Estradiol≥10.60 ng/L as a protective factor for hypertension, with higher protective effect of estrogen on hypertension at low shearing force, and there is a multiplicative interaction between shearing force and estradiol on hypertension.

Primary care physicians play a vital role in the health management of hypertensive patients. Health assessment is an important tool for screening, diagnosis, and risk prediction of hypertension. Risk assessment allows early detection of target organ damage in hypertensive patients and provides a basis for treatment planning. Currently, the national public health service specification has clear requirements for health assessment for hypertensive patients, and such assessments have been carried out in primary health care institutions, but there are few reports on the competence of primary care physicians in health assessment for hypertensive patients.

To understand the levels of knowledge, attitude and practice (KAP) about health assessment for hypertensive patients among primary care physicians, and to analyze their influencing factors.

From May to June 2022, an online questionnaire survey was conducted among a multistage stratified sample of 420 primary care physicians in northern, central and southern Shanxi Province for collecting information of their baseline demographics, levels of KAP for health assessment for hypertensive patients, and hypertension assessment devices equipped in their medical institutions. Multiple linear regression was used to identify factors associated with primary care physicians' level of health assessment for hypertensive patients.

A total of 402 cases (95.7%) who returned responsive questionnaires were finally included. The total average score of KAP of the primary care physicians on the health assessment for hypertensive patients was (127.16±18.65) , with an average score of (53.68±8.95) on the knowledge dimension, (28.62±4.09) on the attitude dimension and (44.86±7.53) on the practice dimension. The results of multiple linear regression analysis showed that work unit, the level of highest educational attainment, specialty, participation in standardized training, learning the latest National Guidelines for the Management of Primary Hypertension in Primary Care, receiving health management-related training, frequency of learning chronic disease knowledge and skills organized by their medical institutions, and weekly hours of independent learning were associated with the knowledge dimension of hypertension health assessment among primary care physicians (P<0.05) . The participation in standardized training, mode of employment, learning the latest National Guidelines for the Management of Primary Hypertension in Primary Care, frequency of learning chronic disease-related knowledge and management skills organized by their medical institutions, and weekly hours of independent learning were factors influencing primary care physicians' scores on the attitude dimension of hypertension health assessment (P<0.05) . Acquisition of physician qualifications, the participation in standardized training, learning the latest National Guidelines for the Management of Primary Hypertension in Primary Care, receiving health management-related training, frequency of learning chronic disease-related knowledge and management skills organized by their medical institutions, and weekly hours of independent learning were factors influencing primary care physicians' scores on the behavioral dimension of hypertension health assessment (P<0.05) . In terms of the hypertension assessment equipment equipped in the medical institutions of primary care physicians, except for sphygmomanometer, height and weight measuring instruments and soft rulers for measuring waist circumference with a configuration rate of more than 96.8%, the configuration rates of routine hematology analyzers, routine urine chemistry analyzers, blood biochemistry analyzers, electrocardiogram machines, and chest X-ray (radiography) equipment (35.6%, 35.8%, 26.9%, 42.8%, and 23.1%, respectively) were all less than 45.0%, and the configuration rates of ambulatory blood pressure monitor, cardiac ultrasound machines, vascular color Doppler ultrasound equipment and funduscopic examination equipment were even lower (less than 15.0%) .

Primary care physicians have a relatively positive attitude toward health assessment for hypertensive patients, and there is still room for improvement in their levels of related knowledge and practical skills. In the future, we can improve primary healthcare services and standards by strengthening the standardized training of professional knowledge and skills of primary care physicians, improving the incentive and assessment system of primary healthcare institutions, and stimulating the awareness of independent learning of primary care physicians.

Hypertension and mild cognitive impairment (MCI) are ordinary health problems in the elderly. The research on the status and risk factors of hypertension complicated with MCI in elderly population in the community is insufficient.

To inquire into the prevalence of hypertension combined with MCI in urban communities and analyze the possible influencing factors of its comorbidities.

Five communities with a relatively high proportion of elderly population were selected in Yinchuan City and Wuzhong City of Ningxia Hui Autonomous Region by typical sampling from September to November 2011. A health survey was conducted among all community residents aged≥55 years in the communities. 509 patients with hypertension were included, and multivariate Logistic regression was used to analyze the influencing factors of hypertension patients with MCI. The regression coefficient of each influencing factor was used as the weight to calculate individual predictive risk value, and receiver operating characteristic curve (ROC curve) was drawn to evaluate the predictive value of individual predictive risk value for hypertensive patients with MCI.

The patients were divided into hypertension with MCI group (n=97) and hypertension without MCI group (n=412) according to whether they were combined with MCI. There were statistically significant differences in age distribution, gender, smoking, hypertension grade, depression score, uric acid and albumin between the two groups (P<0.05) . Age≥75 years old〔OR=2.63, 95%CI (1.31, 5.27) 〕, gender〔OR=0.46, 95%CI (0.22, 0.94) 〕, albumin〔OR=0.96, 95%CI (0.91, 0.99) 〕, depression score〔OR=1.06, 95%CI (1.01, 1.10) 〕, hypertension grade 2〔OR=2.12, 95%CI (1.16, 3.89) 〕, hypertension grade 3〔OR=2.38, 95%CI (1.22, 4.66) 〕were the influential factors for hypertensive patients with MCI (P<0.05) . ROC curve analysis results showed that the area under ROC curve of individual predictive risk value predicting hypertensive patients with MCI was 0.72〔95%CI (0.65, 0.78) , P<0.001〕. The optimal cut-off value was 0.18, the sensitivity was 0.69, and the specificity was 0.63.

Community hypertension patients aged 75 years or older, with grade 2 or higher hypertension, with depressive symptoms, and female patients had an increased risk of MCI, screening programs and treatment of hypertension and depression symptoms can be helpful on maintaining cognitive function.

Global population epidemiology research shows that by 2019, there were 1.28 billion hypertensive patients, and about 59.7 million patients with atrial fibrillation (AF) worldwide. Hypertension greatly increases the risk of AF. And in older hypertensive patients, the incidence of AF will be higher than 60%. Moreover, AF increases the risk of ischemic stroke, heart failure, myocardial infarction, chronic kidney disease and dementia. However, there are few studies on whether AF increases the risk of new-onset myocardial infarction, and whether the risk interacts with age is still unclear in large hypertensive populations.

To examine whether AF increases the risk of new-onset myocardial infarction in hypertensive patients.

Individuals with hypertension were selected as subjects from the employees of Kailuan Group who underwent the medical check-up in Tangshan Gongren Hospital and Kailuan General Hospital from June 2006 to October 2007. General data and laboratory test results of subjects were collected. And all of them were regularly followed up until 2020-12-31. The endpoint event was new-onset myocardial infarction. The finally enrolled cases (n=42 833) included 270 with AF diagnosed by baseline ECG (AF group) and 42 563 without (non-AF group) . The cumulative incidence of myocardial infarction was calculated by the life table method. The survival curve for the cumulative incidence of new-onset myocardial infarction was plotted by Kaplan-Meier method. The difference of the cumulative incidence of myocardial infarction between AF and non-AF groups was compared by Log-rank test. Multivariate Cox proportional hazards regression model was used to investigate the effect of AF on new-onset myocardial infarction in hypertension.

AF group had greater mean age, and lower mean levels of diastolic blood pressure, total cholesterol, triglyceride, low-density lipoprotein cholesterol than non-AF group (P<0.05) . There were also statistically differences in the incidence of myocardial infarction and cumulative incidence of new-onset myocardial infarction between the two groups (P<0.05) . After age-stratification, it was found that the differences in the incidence of new-onset myocardial infarction and cumulative incidence of myocardial infarction were statistically significant between those aged ≤60 years with AF and without AF (P<0.05) , but were insignificant between those aged > 60 years with and without AF (P>0.05) . Adjusted multivariate Cox proportional hazards regression analysis showed that AF was a risk factor for new-onset myocardial infarction in hypertensive population〔HR=2.89, 95%CI (1.74, 4.82) , P<0.01〕, and also in hypertensive population aged ≤60 years old〔HR=4.72, 95%CI (2.11, 10.56) , P<0.01〕.

AF is a risk factor for new-onset myocardial infarction in hypertensive population, especially in those ≤60 years old. Active control of blood pressure and treatment of AF are important prevention and treatment measures for new-onset myocardial infarction.

In recent years, due to the increase of life stress, there is an increasing number of the men and women of childbearing age suffering from hypertension in China. Therefore, the standardized management of hypertension during the preparation for pregnancy has become a current focus. The standardized management of blood pressure of males and females of childbearing age during pregnancy preparation was discussed in this paper in terms of both monitoring and evaluating of hypertension during the preparation for pregnancy and application of antihypertensive drugs, emphasizing that the management of hypertension during pregnancy preparation in women should consider both maternal and fetal safety, choose relatively safe antihypertensive drugs such as methyldopa, labetalol, nifedipine, etc; the management of hypertension during pregnancy preparation in men should consider the efficacy of antihypertensive drugs and the effects on sexual function and sperm, Nebivolol, ACEI/ARB and CCB drugs are recommended, in order to provide guidance for the management of hypertension during the preparation for pregnancy reference direction for future research.

Long-term high level of mental tension induced by nursing work may be associated with increased blood pressure in nurses. The factors influencing hypertension may differ by sex, since there are sex-specific differences in the regulation of blood pressure in molecules, cells and tissues. So exploring influencing factors for hypertension in male and female nurses is significant for formulating targeted prevention and control strategies.

To examine the prevalence and influencing factors of hypertension among male and female nurses in Hebei Province, providing a basis for developing sex-based hypertension prevention and control measures for nurses.

A census survey method was used. The prevalence and influencing factors of hypertension were investigated among 128 009 nurses in all hospitals in 11 cities of Hebei Province from November 2016 to July 2018. The recognized factors influencing hypertension were matched between male and female nurses by propensity score matching. Based on the matched data, multivariate Logistic regression was used to explore the factors influencing hypertension among male and female nurses.

The prevalence of hypertension was higher in male nurses than in female nurses〔20.36% (1 115/5 476) vs 6.26% (669/122 533) , P<0.001〕. After propensity score matching, age〔>25-35 years old (OR=2.182) , >35-45 years old (OR=3.560) , >45-55 years old (OR=7.406) , >55-65 years old (OR=13.339) 〕, BMI〔24.0-<28.0 kg/m² (OR=1.591) , ≥28.0 kg/m² (OR=2.739) 〕, location of hospital〔Cangzhou (OR=1.431) , Hengshui (OR=1.834) , Tangshan (OR=1.408) 〕, years of hyperlipidemia〔>0-5 years (OR=3.399) , >5-10 years (OR=4.451) 〕, family history of hypertension (OR=1.225) were influencing factors of hypertension for male nurses (P<0.05) . Age〔>25-35 years old (OR=1.382) , >35-45 years old (OR=4.125) , >45-55 years old (OR=6.510) , >55-65 years old (OR=5.616) 〕, BMI〔24.0-<28.0 kg/m² (OR=1.749) , ≥28.0 kg/m² (OR=3.111) 〕, department〔paediatrics (OR=1.570) , medical technology department (OR=1.779) 〕, years of hyperlipidemia〔>0-5 years (OR=2.863) , >5-10 years (OR=3.713) 〕, years of diabetes〔>0-5 years (OR=3.126) , >5-10 years (OR=2.947) , >10 years (OR=9.743) 〕, family history of hypertension (OR=1.243) , menstrual condition〔irregular (OR=1.358) , menopause (OR=1.689) 〕, pregnancy hypertension〔no (OR=0.486) , no history of pregnancy (OR=0.507) 〕were influencing factors of hypertension for female nurses (P<0.05) .

The prevalence of hypertension was higher in male nurses than in female nurses. Age, BMI, years of hyperlipidemia, and a family history of hypertension are influencing factors of hypertension for both male and female nurses. Working at the pediatric or medical technology department, irregular menstruation, menopause, or gestational hypertension only affected the risk of hypertension in female nurses. These factors associated with hypertension can inform targeted prevention and control measures. In addition, the location of hospital was influencing factors of hypertension only for male nurses.

Epidemiological studies have demonstrated that the prevalence of hypertension is higher in postmenopausal women than in elderly men. Increasing attention has been paid to postmenopausal hypertension recently, involving its clinical manifestations, pathological features, pathogenesisand treatment. However, due to disparities in study design, sample size and population characteristics, as well as insufficient resources, the research results of risk factors for postmenopausal hypertension are inconsistent and incomprehensive.

To perform a systematic review of risk factors for postmenopausal hypertension, so as to provide evidence-based basis for better prevention and management of the disease.

From January to May 2022, the databases of CNKI, WanfangData, SinoMed, PubMed, EmBase, the Cochrane Library, and Web of Science were searched for cohort and case-control studies related to risk factors for postmenopausal hypertension from the establishment of the databases to May 20, 2022. Studies were identified using the inclusion and exclusion criteria, then assessed in terms of quality using the Newcastle-Ottawa Scale (NOS) , and those with NOS score≥6 (high quality) were included. RevMan 5.3 was used for meta-analysis.

Ten high-quality studies were included, 5 of which were cohort studies, and the other 5 were case-control studies. Overall, 16 potential risk factors for postmenopausal hypertension were identified in a total sample size of 34 864. Meta-analysis showed that the risk factors for postmenopausal hypertension included elevated hs-CRP〔RR (95%CI) =1.38 (1.04, 1.83) 〕, older age〔OR (95%CI) =1.39 (1.11, 1.74) 〕, elevated BMI〔OR (95%CI) =1.61 (1.19, 2.18) 〕, elevated total cholesterol〔OR (95%CI) =1.35 (1.14, 1.59) 〕, elevated triglyceride〔OR (95%CI) =2.17 (1.03, 4.59) 〕, history of diabetes〔OR (95%CI) =1.70 (1.27, 2.27) 〕. The risk-reducing factors included high adiponectin〔RR (95%CI) =0.83 (0.70, 0.99) 〕and advanced menopausal age〔OR (95%CI) =0.90 (0.82, 0.98) 〕.

Older age, high levels of hs-CRP, BMI, total cholesterol, and triglyceride, and diabetes are independent risk factors for postmenopausal hypertension. Thus, controlling some of the above controllable factors may effectively decrease the risk of postmenopausal hypertension.

Sleep duration is strongly associated with hypertension, but its effect on H-type hypertension in female population is not well characterized.

The examine the effect of sleep duration on the prevalence of H-type hypertension in female population.

A cross-sectional study design was used. One thousand seven hundred and nine female hypertensive inpatients were selected from Department of General Medicine and Geriatric Department of Hunan Provincial People's Hospital from July 2018 to December 2020, among whom those who with serum Hcy≥10 μmol/L and the others were assigned into H-type hypertension and non-H-type hypertension groups, respectively. Binary Logistic regression was used to assess the correlation of between sleep duration and H-type hypertension across three groups with different self-reported mean daily sleep durations in the past month (<7 h, 7-8 h, and >8 h) , and to further assess the correlation between the two across by age (≤60 and >60) .

The distribution of age, education level and marital status differed across three groups with different daily sleep durations (P<0.05) . 901 (52.72%) with daily sleep duration of <7 h, 697 (40.78%) with daily sleep duration of 7-8 h, and 111 (6.50%) with daily sleep duration of >8 h. The distribution of age, education level, living area (urban or rural) , marital status, BMI, exercise status, and daily sleep duration, as well as prevalence of drinking between H-type hypertension group〔973 (56.93%) 〕 and non-H-type hypertension group〔736 (43.07%) 〕 (P<0.05) . The risk of H-type hypertension in those with <7 h of daily sleep duration was 1.291 times higher than that in those with 7-8 h of daily sleep duration〔95%CI (1.032, 1.615) , P<0.05〕after adjusting for confounding factors such as age, education level, living area, marital status, BMI and exercise status. Further analysis revealed that <7 h of daily sleep duration was associated with increased risk of H-type hypertension only in those aged greater than 60 years〔OR (95%CI) =1.421 (1.021, 1.978) , P<0.05〕.

Less than 7 h of daily sleep duration was a risk factor for H-type hypertension in female over 60 years old. In view of this, it is suggested to put more attention to sleep health to improve blood pressure in this group.

Clinical treatment of target organ damage in hypertension is mainly based on systemic hypotension supplemented by topical medication, but the treatment is unsatisfactory due to different or even mutually exclusive responses of tissues to the drugs. The relationship between calcium-sensing receptors (CaSR) and hypertension has been investigated, however, studies on their role and mechanisms in hypertensive retinal disease are still lacking.

To investigate the expression level of CaSR in hypertensive retina and its relationship with myocardial remodeling and retinal vascular changes in hypertension.

Ten 8-week-old healthy wistar-kyoto rats (WKY) were selected as the WKY group, and 20 homologous spontaneous hypertensive rats (SHR) of the same age were randomly divided into SHR group and inhibitor (SHR+NPS2143) group from May to December 2021. During a 16-week intervention, the SHR+NPS2143 group received intraperitoneal injection of CaSR inhibitor NPS2143, while WKY and SHR groups were intraperitoneally injected with the equal volume of normal saline. At baseline and the end of intervention, blood pressure was measured by non-invasive blood pressure monitor in all rats, and from each group, five rats were selected and executed, and myocardial and retinal tissues were taken out for testing. Masson's Trichrome staining was used to measure the collagen deposition in the myocardium. H & E staining was used to detect the pathological changes in retinal tissues. The distribution and expression of CaSR and vascular endothelial growth factor A (VEGFA) in retinal tissues were detected using immunohistochemical staining and qRT-PCR.

SHR group had significantly higher levels of systolic blood pressure (SBP) , diastolic blood pressure (DBP) and mean arterial pressure (MAP) than WKY group either at baseline or the end of intervention (P<0.05) . SHR group had much lower levels of SBP, DBP and MAP levels than SHR+NPS2143 group at the end of intervention (P<0.05) . At the end of the intervention, a significant growth was found in SBP, DBP and MAP levels in both SHR and SHR+NPS2143 groups (P<0.05) . Compared with SHR group, heart weight/body weight ratio (HW/BW%) , left ventricle weight/body weight ratio (LVW/BW%) , and myocardial collagen volume fraction (CVF) were significantly decreased in WKY group but increased significantly in SHR+NPS2143 group (P<0.05) . A significant growth was found in HW/BW%, LVW/BW% and CVF in both SHR and SHR+NPS2143 groups (P<0.05) . The total retinal thickness and inner plexiform layer thickness were higher in SHR group than in WKY group at baseline and 16 weeks of intervention (P<0.05) . The total retinal thickness and inner plexiform layer thickness were lower in the SHR group than in the SHR+NPS2143 group at 16 weeks of intervention (P<0.05) . Compared with SHR group, the inner plexiform layer thickness at 16 weeks of intervention was decreased in WKY group and increased in SHR+NPS2143 group (P<0.05) . CaSR in the retina of SHR group was lower than that of WKY group but higher than that of SHR+NPS2143 group (P<0.05) at 16 weeks of intervention. VEGFA in the retina of SHR group was higher than that of WKY group but lower than that of SHR+NPS2143 group (P<0.05) at 16 weeks of intervention.

The use of CaSR inhibitor could reduce the activation of CaSR, increase the expression of VEGFA in the retina, exacerbate hypertension-induced myocardial remodeling and the development of retinal vasculopathy.

Older people are a group susceptible to hypertension, and among whom hypertension prevalence is increasing as population aging aggravates. Early prevention, diagnosis and treatment of hypertension in the elderly are very important, which can be enhanced by an important way, namely developing high-quality clinical practice guidelines.

To perform an analysis of the guidelines regarding the diagnosis and management of hypertension in the elderly, and to assess their methodological quality.

In December 2021, we searched for clinical guidelines for hypertension in the elderly in databases of CNKI, CQVIP, WanFang Data, SinoMed, PubMed, EmBase and Medlive, as well as in the official websites of the National Guideline Clearing house, the Guidelines International Network and the National Institute for Health and Care Excellence from inception to December 2021. Two reviewers independently conducted literature screening and data extraction. Four reviewers independently evaluated the methodological quality of included guidelines using the AGREEⅡ. Recommendations from each guideline were retrieved.

A total of 11 guidelines were included: seven are Chinese guidelines, two are US guidelines and the other two are European guidelines. The mean standardized domains scores of the AGREEⅡinstrument in assessing the overall guideline quality were as follows: 50.13% for scope and purpose, 24.24% for stakeholder involvement, 18.51% for rigour of development, 54.03% for clarity of presentation, 11.36% for applicability and 30.30% for editorial independence. The recommendation level was B for five guidelines, and was C for the remaining six guidelines. The main recommendations involve three aspects: pharmacological intervention, non-pharmacological intervention, and continuing health management.

The overall methodological quality of included guidelines is unsatisfactory. To improve the quality of such guidelines developed in the future to better guide clinical practice, it is suggested to give more attention and priority to domains of stakeholder involvement, rigour of development, and applicability.

Hypertension is closely related to serum uric acid (SUA) level, and often accompanied by thyroid function changes. However, there are few reports on the relationship between thyroid hormone level and hyperuricemia (HUA) in euthyroid hypertensive patients.

To explore the correlation between serum thyroid hormone level and HUA in euthyroid individuals with essential hypertension (EH) .

Two hundred and sixty-seven euthyroid patients with EH were retrospectively selected from Department of Cardiology, Xianyang Hospital of Yan'an University from January 2019 to December 2020, including 101 with HUA (combined HUA group) and 166 without HUA (non-HUA group) . The general demographic data and laboratory examination indices of the two groups were compared, including gender, age, body mass index (BMI) , systolic blood pressure (SBP) , diastolic blood pressure (DBP) , smoking history, drinking history, total cholesterol (TC) , triacylglycerol (TG) , high-density lipoprotein cholesterol (HDL-C) , low-density lipoprotein cholesterol (LDL-C) , serum creatinine (Scr) , SUA, thyroid-stimulating hormone (TSH) , free triiodothyronine (FT₃) , and free thyroxine (FT₄) . Multivariate Logistic regression analysis was used to explore factors associated with HUA. Pearson correlation was used to examine the correlation between thyroid hormone level and SUA level.

There were significant intergroup differences in gender ratio, mean age, BMI, and DBP, as well as prevalence of smoking history and drinking history (P<0.05) . Moreover, the mean levels of TC, TG, LDL-C, Scr and SUA were also significantly different in the two groups (P<0.05) . In particular, the mean level of FT₃ in combined HUA group was significantly higher (t=-5.066, P<0.05) . Multivariate Logistic regression analysis demonstrated that male〔OR=2.843, 95%CI (1.121, 7.215) , P=0.028〕, higher BMI〔OR=1.126, 95%CI (1.020, 1.234) , P=0.018〕, TG〔OR=1.824, 95%CI (1.300, 2.560) , P=0.001〕, LDL-C〔OR=2.804, 95%CI (1.157, 6.795) , P=0.022〕, Scr〔OR=1.071, 95%CI (1.041, 1.102) , P<0.001〕and FT₃〔OR=2.297, 95%CI (1.326, 3.977) , P=0.003〕were associated with increased risk of HUA. Advanced age〔OR=0.959, 95%CI (0.931, 0.989) , P=0.007〕was decreased risk of HUA. Pearson correlation analysis revealed that the level of FT₃ was positively correlated with SUA (r=0.327, P<0.001) .

Being male, high BMI, elevated TG, LDL-C, Scr and FT₃ levels may be risk factors for HUA in euthyroid patients with EH. Advanced age may be protective factor for HUA in euthyroid patients with EH. As FT₃ level is positively correlated with SUA in these patients, those with elevated serum FT₃ level are prone to HUA, which should be paid attention by clinicians.

The prevalence of sarcopenia is rising along with global population aging, and it is estimated that there will be about 200 million sarcopenia patients worldwide by the mid-21st century. Both essential hypertension and sarcopenia are common in the elderly, but the correlation between them has been rarely studied in China.

To examine the prevalence and risk factors of sarcopenia in middle-aged and elderly patients with essential hypertension, providing a reference for secondary prevention and early delivery of intervention of sarcopenia in this group.

A total of 107 patients with essential hypertension aged ≥50 years who were hospitalized in Geriatric Department, the First People's Hospital of Yunnan Province from December 2020 to December 2021 were enrolled. Sarcopenia was diagnosed by the recommendation from Asian Working Group for Sarcopenia in 2019. Nutrition status was assessed using the Mini-Nutritional Assessment Scale-Short Form (MNA-SF) . The general demographics, sarcopenia diagnostic indicators, laboratory indicators and MNA-SF assessment results were collected. Binary Logistic regression analysis was used to explore the influencing factors of sarcopenia in essential hypertension. The receiver operating characteristic (ROC) analysis was performed to explore the predictive value of body mass index (BMI) for sarcopenia in essential hypertension.

Among the 107 patients, 53 (49.5%) were diagnosed with sarcopenia, and other 54 (50.5%) cases had no sarcopenia. The prevalence of sarcopenia in slightly underweight, normal weight, overweight or obesity patients was 83.3% (5/6) , 64.2% (34/53) , 30.0% (12/40) , 25.0% (2/8) , respectively. The prevalence rate of sarcopenia decreased with the increase of BMI (χ²_trend=15.027, P=0.001) . Logistic regression analysis showed that female〔OR=0.175, 95%CI (0.059, 0.518) 〕, overweight〔OR=0.039, 95%CI (0.003, 0.513) 〕, obesity〔OR=0.019, 95%CI (0.001, 0.459) 〕, higher 25- (OH) D〔OR=0.914, 95%CI (0.843, 0.991) 〕, and higher MNA-SF score〔OR=0.832, 95%CI (0.697, 0.992) 〕 were associated with decreased risk of sarcopenia (P<0.05) , while older age〔OR=1.139, 95%CI (1.073, 1.209) 〕, increased systolic blood pressure〔OR=1.038, 95%CI (1.001, 1.076) 〕 and increased diastolic blood pressure〔OR=1.095, 95%CI (1.035, 1.159) 〕 were associated with increased risk of sarcopenia (P<0.05) . The area under the ROC curve of BMI in predicting sarcopenia was 0.749〔95%CI (0.656, 0.843) 〕, with 52.8% sensitivity and 88.9% specificity when 22.0 kg/m² was determined as the optimal cut-off value.

The prevalence of sarcopenia was high in middle-aged and elderly patients with essential hypertension, the risk of which was increased with advanced age, higher systolic blood pressure and diastolic blood pressure, and declined with being female, overweight, obesity, higher vitamin D and good nutrition. BMI may be a good predictor of sarcopenia in essential hypertension.

The new electrocardiogram (ECG) criteria have higher accuracy in the diagnosis of left ventricular hypertrophy (LVH) in general population with hypertension than traditional ECG voltage criteria. However, the diagnostic efficacy of new ECG criteria for LVH in overweight and obese patients with hypertension has been rarely reported.

To explore the diagnostic value of new ECG indicators for LVH in overweight and obese patients with hypertension.

A retrospective design was used. A total of 368 overweight and obese patients with hypertension were recruited from the First Affiliated Hospital of Wannan Medical College from December 2017 to December 2020, and divided into LVH (+) group (including males with LVH>115 g/m² and females with LVH >95 g/m²) and LVH (-) group (including males with LVH≤115 g/m² and females with LVH≤95 g/m²) . General data were collected and compared between two groups. Intergroup comparison was also performed in terms of ultrasonic cardiography (UCG) indicators〔diastolic interventricular septal thickness (IVST) , left ventricular posterior wall thickness (LVPWT) , left ventricular mass (LVM) , left ventricular mass index (LVMI) , left ventricular ejection fraction (LVEF) 〕and ECG indicators〔QRS duration (QRSd) , corrected QT interval (QTc) , Sokolow-Lyon voltage criteria, Cornell voltage criteria, Peguero Lo-Presti voltage criteria, Cornell product〕with the accuracy of UCG indicators as the gold standard. Binary Logistic regression model was used to analyze the influencing factors of LVH in hypertension with overweight or obesity. ROC analysis was used to evaluate the diagnostic efficacy of new ECG indicators (Sokolow-Lyon voltage criteria, Cornell voltage criteria, Peguero Lo-Presti voltage criteria, Cornell product) for LVH in hypertension with overweight or obesity.

There were statistically significant differences in sex ratio, mean age, body surface area (BSA) , SBP, DBP, β-blocker utilization rate and blood pressure control between LVH (+) and LVH (-) groups (P<0.05) . The mean values of IVST, LVPWT, LVM, LVMI, QRSd, QTc, Sokolow-Lyon voltage criteria, Cornell voltage criteria, Peguero Lo-Presti voltage criteria and Cornell product in LVH (+) group were higher than those in LVH (-) group (P<0.05) . The mean LVEF value in LVH (+) group was lower than that in LVH (-) group (P<0.05) . Age 〔OR=1.046, 95%CI (1.024, 1.069) 〕 and Sokolow-Lyon voltage criteria〔OR=1.793, 95%CI (1.305, 2.463) 〕 were influential factors for LVH risk in hypertension with overweight or obesity (P<0.05) . The AUC of Sokolow-Lyon voltage criteria, Cornell voltage criteria Peguero Lo-Presti voltage criteria and Cornell product for LVH diagnosis in hypertension with overweight or obesity was 0.674, 0.695, 0.662 and 0.722, respectively. The AUC of the combined diagnostic model with age, BSA, SBP, DBP, time of the duration of hypertension, QRSd, QTc, Sokolow-Lyon voltage criteria, Cornell voltage criteria, Peguero Lo-Presti voltage criteria, and Cornell product incorporated was 0.846.

In overweight and obese people with hypertension, the Sokolow-Lyon voltage criteria was associated with LVH. Moreover, the new ECG indicator Peguero Lo-Presti voltage criteria was less effective than Cornell product and other traditional ECG indicators in diagnosing LVH. The combined diagnostic model has proven to be with better diagnostic performance for LVH, which is recommended to be used and promoted in primary care settings with relatively unsatisfactory examination conditions.

High blood pressure can cause damages of target organs such as the heart, brain, kidneys and retina, while diabetes can cause a series of metabolic disorders, resulting in a variety of complications. Both are major risk factors for cardiovascular and cerebrovascular diseases. Eating a healthy diet may significantly contribute to the prevention and control of hypertension and diabetes.

To investigate the effects of a Chinese-style DASH diet in improving the nutritional status of community-living patients with type 2 diabetes and hypertension.

Sixty-one hypertensive patients with type 2 diabetes with medical records created in Chongqing Sihai Community Health Center were selected to undergo an eight-week Chinese-style DASH diet intervention, including dietary guidance (at 1 and 2 weeks) , eating the Chinese-style DASH diet provided using a group-based approach (at 3 and 4 weeks) , and home-based medical care (at 5 to 8 weeks) . Food frequency survey and 24-hour dietary recall were used to investigate the dietary structure and nutritional intake at baseline and after intervention. Anthropometric indicators (BMI and waist-to-hip ratio) , blood lipids (triacylglycerol, total cholesterol, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol) , glycemic control and hypertension control status at baseline and after intervention were compared.

A total of 59 cases were included in the study. Regarding dietary structure after intervention, the average daily intake of soy, nuts, pickled products, fried foods and salt significantly decreased in subjects, while that of fresh fruit, milk and dairy products increased significantly (P<0.05) . Regarding nutritional status, the daily average intake of fat and sodium was significantly reduced, while that of dietary fiber, calcium, potassium and magnesium was significantly increased (P<0.05) . The number of participants eating a diet with a recommended ratio of fat increased significantly (P<0.05) . Health monitoring showed that total cholesterol, low-density lipoprotein cholesterol, systolic blood pressure, diastolic blood pressure and 2-hour postprandial glucose were partially improved after intervention (P<0.05) . From the 4th week of the intervention, the control rate of 2-hour postprandial glucose at follow-up was significantly higher than the baseline level (P<0.05) , and it reached 69.5% at the end of the intervention. Except for the 2nd week of the intervention, the blood pressure control rate at follow-up was notably higher than the baseline level (P<0.05) , and it reached 67.8% at the end of the intervention.

Eating the Chinese-style DASH diet helps to promote the health in community-living hypertension patients with type 2 diabetes via effectively adjusting the inappropriate diet structure and improving the nutritional status.

Mild cognitive impairment (MCI) is highly prevalent in hypertensive patients, but the current studies on MCI in hypertension mostly focus on the elderly group, while scarcely involve young and middle-aged patients.

To investigate the prevalence and associated factors of MCI in young and middle-aged hospitalized patients with hypertension.

A convenience sample of 213 young and middle-aged hypertensive inpatients were recruited from a tertiary grade A hospital in Harbin from May to December 2021. The General Demographic Questionnaire, Montreal Cognitive Assessment (MoCA) , and the Type-D Scale-14 (DS14) were used for understanding patients' demographics, cognitive impairment status, and D-type personality prevalence, respectively. Multiple Logistic regression was used to analyze associated factors of MCI.

The prevalence of MCI was 37.56% (80/213) . Multiple Logistic regression analysis showed that age〔OR=1.073, 95%CI (1.033, 1.115) 〕, education level〔junior college education level: OR=0.278, 95%CI (0.084, 0.920) , smoking history〔OR=2.494, 95%CI (1.146, 5.426) 〕, stage of hypertension〔stage 2: OR=3.442, 95%CI (1.252, 9.468) ; stage 3: OR=3.934, 95%CI (1.518, 10.193) 〕, D-type personality〔OR=2.160, 95%CI (1.015, 4.598) , TG〔OR=1.596, 95%CI (1.125, 2.265) 〕, and HDL-C〔OR=0.185, 95%CI (0.049, 0.707) 〕were influential factors of MCI in hypertension (P<0.05) .

Young and middle-aged hospitalized patients with hypertension had a high prevalence of MCI. Older age, lower level of education, D-type personality, higher level of TG and lower level of HDL-C were related to increased risk of MCI in hypertension. In view of this, medical workers should screen MCI in these patients to identify those at high risk of MCI as early as possible, and deliver interventions to them timely.

Population aging has become a prominent problem in recent years. At present, there are many studies on hypertension and mild cognitive impairment (MCI) , but few studies on the relationship between masked hypertension (MH) and MCI in elderly patients.

To investigate the relationship of carotid intima-media thickness (CIMT) and epicardial fat thickness (EAT) with cognitive dysfunction in elderly patients with MH, to provide a theoretical basis for early detection of mild changes in cognitive function in this group.

A total of 255 cases were selected from Municipal Hospital of Traditional Chinese Medicine of Jiayuguan from January 2019 to February 2022, including 173 elderly inpatients and outpatients diagnosed with MH (MH group) , and 82 elderly healthy people with normal blood pressure (control group) . Ambulatory blood pressure monitoring, CIMT and EAT measurement were performed in both groups, and relevant indicators were recorded. The Montreal Cognitive Assessment (MoCA) scale was used to assess the cognitive function. Binary Logistic regression analysis was used to explore the factors associated with MCI in MH.

Compared with control group, MH group had greater average age, and higher levels of average clinic systolic blood pressure (SBP) , clinic diastolic blood pressure (DBP) , 24 h ambulatory SBP, 24 h ambulatory DBP, 24 h SBP coefficient of variation, 24 h DBP coefficient of variation, CIMT and EAT, as well as less average years of education (P<0.05) . The average scores of executive function/visuospatial ability, animal naming, attention, language, abstraction, delayed recall and average total MoCA score in MH group were significantly lower than those in control group (P<0.05) . Correlation analysis showed that the total score of MoCA was negatively correlated with age, 24 h DBP coefficient of variation, CIMT, and EAT (P<0.001) . Binary Logistic regression analysis indicated that CIMT〔OR=48.282, 95%CI (10.734, 217.168) 〕, EAT〔OR=2.124, 95%CI (1.057, 4.269) 〕 were associated with MCI in MH (P<0.05) .

Increased age, lower education level, increased 24 h SBP coefficient of variation, and increased CIMT and EAT values are risk factors for cognitive dysfunction in elderly patients with MH.

Inter-arm systolic blood pressure difference (IASBPD) is associated with an increased risk of cardiovascular events, which may be involved with arterial stiffness.

To investigate the association of IASBPD with arterial stiffness in essential hypertension.

This retrospective study consecutively included 6 834 patients with essential hypertension who were admitted to Beijing Anzhen Hospital, Capital Medical University from December 2019 to September 2021. The patients were divided into three groups according to IASBPD. Arterial stiffness was assessed by the value of brachial-ankle pulse wave velocity (baPWV). Multiple linear regression and multivariate Logistic regression models were used to analyze the association of arterial stiffness with IASBPD, then based on this, multivariate Logistic regression was further used for subgroup analysis to explore the impact of each influencing factor and their interaction on arterial stiffness.

The IASBPD tertile groups were: IASBPD<5 mm Hg (n=4 248), 5 mm Hg≤IASBPD<10 mm Hg (n=1 806) and IASBPD≥10 mm Hg (n=780) .The median baPWV was 1 572 (1 392, 1 702) cm/s. The prevalence of arterial stiffness (defined as baPWV>1 800 cm/s) was 15.26% (1 043/6 834). Multiple linear regression analysis showed that IASBPD was associated with baPWV, and an increase in IASBPD by 1 mm Hg corresponded to an increase of 4.31 cm/s in baPWV〔B=4.31, 95%CI (3.29, 5.31), P<0.05〕. Multivariate Logistic regression analysis demonstrated that IASBPD≥10 mm Hg was associated with increased risk of arterial stiffness〔OR=2.28, 95%CI (1.76, 2.94), P<0.05〕, and the risk was much higher in those with LDL-C≥3.4 mmol/L (P=0.021) indicated by further subgroup analysis.

IASBPD≥10 mm Hg was a risk factor of arterial stiffness among essential hypertensive patients, especially in those with LDL-C≥3.4 mmol/L. IASBPD might be used as a simple and effective predictor of arterial stiffness.

The spreading epidemic of novel coronavirus (corona virus disease 2019, COVID-19) pneumonia poses a serious challenge to global life health and disease control, with significantly higher mortality rates among individuals infected with COVID-19 comorbid underlying disease. Inhibitors of the rennin-angiotensin-aldosterone system (RAASi) , an important class of anti-hypertensive drugs, have been found to increase the morbidity and mortality of COVID-19. This study aimed to clarify the efficacy and safety of RAASi treatment in COVID-19 patients with hypertension.

To systematically evaluate the efficacy and safety of RAASi therapy in COVID-19 patients with hypertension.

PubMed, Embase, Cochrane Library and China National Knowledge Infrastructure (CNKI) were searched from inception to January 2022. A publicly available case-control studies of COVID-19 patients with hypertension treated with RAASi versus non RAASi therapy were included, and outcome measures were overall mortality, incidence of critical illness, incidence of acute respiratory distress syndrome (ARDS) , incidence of myocardial injury, and incidence of renal injury, with meta-analysis performed using Revman 5.3.

Seventeen studies with a total of 5 689 patients were included, of whom 2 168 received RAASi therapy and 3 521 did not. Meta analysis showed that overall mortality was lower in COVID-19 comorbid hypertensive patients treated with RAASi compared with non RAASi treated patients 〔OR=0.54, 95%CI (0.41, 0.72) , P<0.000 1〕; Between RAASi treated and non RAASi treated COVID-19 patients associated with hypertension, the incidence of critical illness 〔OR=0. 92, 95%CI (0.79, 1.08) , P=0.30〕, the incidence of ARDS 〔OR=0.81, 95%CI (0.57, 1.13, P=0.22〕, the incidence of myocardial injury 〔OR=1.03, 95%CI (0.83, 1.27) , P=0.82〕, and the incidence of kidney injury 〔OR=1.13, 95%CI (0.78, 1.66) , P=0.52〕, differences were not statistically significant.

Treatment with RAASi in COVID-19 patients with hypertension reduced the overall mortality rate, and did not increase the incidence of critical illness, ARDS, myocardial injury, and renal injury in COVID-19 patients with hypertension. RAASi therapy is effective and safe in treating patients with COVID-19 combined with hypertension.

Launched in 2009, the National Essential Public Health Service Program has been conducted for 13 years. Among which the antihypertensive care ranks first among all types of antihypertensive care in terms of population coverage in China. To promote the sustainable development of the National Essential Public Health Services (NEPHSs) , it is important to understand the feedback of hypertensive population on the antihypertensive care.

To explore hypertension patients' self-rated improvement gained from and satisfaction with the NEPHSs and associated factors, providing a scientific basis for promoting the quality development of the services.

By use of multi-stage stratified sampling, 2 419 hypertensive patients (≥35 years old) were selected from 20 community (township) health centers in 10 districts (counties) of 5 cities in eastern, central and western China from November to December 2019. A questionnaire survey was conducted with them for understanding their general demographic information and management of hypertension.

The prevalence of having self-rated health improvement associated with the NEPHSs in the survey respondents was 86.26% (2 072/2 402) . The prevalence of self-reported satisfaction with healthcare workers' attitudes toward patients, and their care quality, physical examination, health education, TCM treatment, follow-up service, screening for hypertension complications, blood pressure control effect and overall services was 97.15% (2 349/2 418) , 94.09% (2 275/2 418) , 88.16% (2 129/2 415) , 87.81% (2 118/2 412) , 61.36% (1 469/2 394) , 95.04% (2 297/2 417) , 83.67% (2 013/2 406) , 82.34% (1 981/2 406) , and 95.53% (2 310/2 418) , respectively. The prevalence of self-rated improvement gained from the NEPHSs varied significantly by education level, self-rated health, prevalence of blood pressure abnormalities first detected in primary care, and the number of different follow-up services received within the past year (P<0.05) . The prevalence of self-reported satisfaction with overall services differed significantly by education level, prevalence of blood pressure abnormalities first detected in primary care, and the number of different follow-up services received within the past year (P<0.05) .

The prevalence of self-rated improvement gained from and self-reported satisfaction with the NEPHSs in hypertension patients were high on the whole. To promote the sound and sustainable development of these services, priority should be given to the standardization of the provision of NEPHSs and the homogeneity of NEPHSs provided to both urban and rural areas.

Drinking sugary drinks are common in China, but inadequate intake of which can induce a variety of diseases. Many studies have reported the relationship between intake of sugary drinks and the risk of hypertension, however, there are still disputes over the specific dose-response relationship between them.

To assess the dose-response relationship between the intake of sugary drinks and the risk of hypertension.

We searched for cross-sectional and prospective studies about the intake of sugary drinks and risk of hypertension in databases of CNKI, CQVIP, SinoMed, Wanfang Data, PubMed, EMBase, Cochrane Library, and Web of Science from inception to November 2021. Two reviewers independently extracted data, and evaluated the quality of included studies. Stata 16.0 was used for meta-analysis.

Sixteen studies with 316 205 subjects were included. Meta-analysis results showed that the intake of sugary drinks increased the risk of hypertension〔OR=1.12, 95%CI (1.10, 1.15) , P<0.05 〕. Subgroup analyses revealed that by the intake of sugary drinks, the risk of hypertension increased by 34% in Asian population〔OR=1.34, 95%CI (1.20, 1.51) , P<0.05〕, and increased by 11% in North American population〔OR=1.11, 95%CI (1.09, 1.14) , P<0.05〕, and rose by 82% in Oceanian population〔OR=1.82, 95%CI (1.04, 3.21) , P<0.05〕, and grew by 18% in European population〔OR=1.18, 95%CI (1.02, 1.36) , P<0.05〕. Furthermore, the intake of sugary drinks was associated with a 43% higher risk of hypertension in minors〔OR=1.43, 95%CI (1.21, 1.69) , P<0.05〕, and a 12% higher risk of hypertension in adults〔OR=1.12, 95%CI (1.09, 1.15) , P<0.05〕 . In addition, the intake of sugary drinks was associated with a 12% higher risk of hypertension in people with normal BMI〔OR=1.12, 95%CI (1.09, 1.15) , P<0.05〕, a 17% higher risk of hypertension in overweight people〔OR=1.17, 95%CI (1.00, 1.38) , P<0.05〕, and a 19% higher risk of hypertension in obese people〔OR=1.19, 95%CI (1.06, 1.34) , P<0.05〕. Dose-response analysis results showed that for every additional sugary drink (i.e. 12 ounces, about 340 g or 355 ml) per day, the risk of hypertension increases by 16%〔OR=1.16, 95%CI (1.13, 1.18) , P<0.05〕. The basically symmetrical funnel plot and the Begg's test (Z=0.23, P>0.05) and Egger's test (t=1.46, P>0.05) showed no published bias.

The intake of sugary drinks may be associated with increased risk of hypertension, and for every increased intake of a sugary drink (i.e. 12 ounces, about 340 g or 355 ml) per day, the risk of hypertension increased by 16%. So controlling the intake of sugar is important for preventing hypertension.

There were many hypertensive patients at non-high risk of developing COVID-19 that needed to be medical observation at home, but the changes in their blood pressure and measurement frequency as well as heart rate during the period are still unclear.

To perform an analysis of the changes in blood pressure and measurement frequency as well as heart rate in hypertensive patients that needed to be medical observation at home.

Through the iHealth cloud platform, data〔including age, sex, systolic blood pressure (SBP) and diastolic blood pressure (DBP) measured by the iHealth Clear (BPM1) at home, and heart rate〕were collected from December 1st, 2019 to March 27th, 2020, involving all hypertensive patients in Wuhan who had an ID number for consecutively uploading blood pressure readings, and were desensitized for removing the confidential information. The features of blood pressure during the period were analyzed. ARIMAX model was used to assess the association of age, sex, number of confirmed COVID-19 cases per day, cumulative confirmed COVID-19 deaths, time granularity and the traffic control with participants' blood pressure and hear rates.

In total, blood pressure readings of 36 472 measurements by the participants using 1 232 iHealth Clear (BPM1) were collected during the 118-day period. Men demonstrated higher mean SBP, DBP and heart rate than women (P<0.05) . After January 23, 2020, the mean SBP of the participants decreased from (141±19) mm Hg to (138±18) mm Hg (P<0.05) . The analysis using the ARIMAX model revealed that after adjusting for month, week, age and number of confirmed COVID-19 cases per day, male participants showed a decrease in blood pressure (β_SBP=-1.08×10^-3, P=0.028, β_DBP=-6.35×10^-4, P=0.002) , and an increase in heart rate (β_HR=2.02, P=0.003) and measurement frequency (β_times=0.035, P=0.002) . But no significant changes were seen in females (P<0.05) .

In general, among hypertensive patients that needed to be medical observation at home, males were found with higher mean SBP, DBP, heart rate and blood pressure measurement frequency. And these hypertensive patients were found with decreased SBP and DBP after the implementation of traffic control. Using the Internet to store blood pressure data measured by the home blood pressure monitor for data assessment and treatment, is contribute to out-of-hospital management of blood pressure in hypertensive patients, which demonstrates the significance of Internet in combination with healthcare.

The prevalence of hypertension and cognitive dysfunction in the elderly in China is not optimistic, and hypertension has been associated with an increased risk of developing cognitive dysfunction. It is of great significance to explore and promote the methods for prevention and control of cognitive dysfunction in elderly patients with hypertension in community.

To explore the effect of leisure physical activities on cognitive function in elderly patients with hypertension in community.

From August 2020 to December 2020, a total of 770 patients with hypertension aged ≥65 years who underwent chronic disease management were selected from community health service centers in Wuhan using the stratified random sampling method. A questionnaire was administered to obtain the general information of the subjects, leisure physical activity (including 6 cognitive activities and 11 physical activities) and cognitive function (using the Mini-Mental State Examination Scale). Multivariate Logistic regression was used to analyze the influencing factors of cognitive dysfunction in elderly patients with hypertension. Multiple linear regression was used to analyze the influence of leisure physical activity on cognitive function in elderly patients with hypertension. Multiple Logistic regression was used to analyze the influence of the weekly participation frequency of 17 leisure physical activity on cognitive dysfunction in elderly patients with hypertension.

The incidence of cognitive dysfunction in elderly hypertensive patients in community was 39.4% (303/770). There were significant differences in gender, age, education, duration of hypertension, leisure physical activity scores between patients with and without cognitive impairment (P<0.05). Multivariate Logistic regression analysis showed that duration of hypertension〔OR (95%CI) =1.02 (1.01, 1.03) 〕 and leisure physical activity score〔OR (95%CI) =0.98 (0.96, 0.99) 〕 were influencing factors for the development of cognitive impairment in older patients with hypertension. Further analysis found that the leisure physical activity score was an influential factor in the MMSE for scores on the attention and calculation power dimension〔b (95%CI) =0.02 (0.01, 0.03) 〕, the language ability dimension score〔b (95%CI) =0.02 (0.01, 0.03) 〕. After refining the categories to leisure physical activity style, the results of multivariate Logistic regression analysis showed that older adults with hypertension who participated in writing〔OR (95%CI) =0.34 (0.12, 0.95) 〕, board games〔OR (95%CI) =0.21 (0.06, 0.72) 〕 daily were less likely to be cognitively impaired than those who occasionally/never participated in this activity.

Leisure physical activity is a protective factor of cognitive function in elderly patients with hypertension, which mainly affects two dimensions of cognitive function: attention and calculating ability, and language ability. Daily participation in writing and checkerboard games play a positive role in cognitive function in elderly patients with hypertension.

IgA nephropathy (IgAN) is the most common primary glomerular disease, and one major cause of malignant hypertension (MHT) secondary to renal parenchymal disease. The clinical conditions and severity of renal lesion have been reported to be more serious when IgAN is accompanied by MHT, but risk factors of MHT in IgAN analyzed from Traditional Chinese Medicine (TCM) perspective are still unclear.

To explore the TCM-related factors and pathogenesis associated with MHT in IgAN patients.

From 518 cases of primary IgAN who were diagnosed by renal biopsy in First Medical Center of Chinese PLA General Hospital during December 2013 to September 2021, a sample of 12 cases accompanied by MHT (IgAN-MHT group) computed by PASS 15.0 were selected for correlation power analysis, and they were matched at a ratio of 1∶5 with other randomly selected 85 cases without MHT (IgAN group) . Clinical, pathological and TCM syndromes between the two groups were compared. Lasso regression was used to screen 93 TCM syndromes, among which those with significant associations with IgAN-MHT were identified by multivariate Logistic regression.

Compared with IgAN group, IgAN-MHT group had higher prevalence of headache and dizziness or nausea and vomiting as the first clinical manifestations, and clinically diagnosed nephrotic syndrome, higher levels of baseline mean arterial pressure, highest systolic and diastolic blood pressure, blood urea nitrogen, serum creatinine, serum inorganic phosphorus, serum magnesium, and quantitatively estimated 24-hour urinary protein excretion, higher prevalence of CKD stages 3-5, blood stasis syndrome, subtypes of qi-deficiency syndromes (including mental fatigue and lack of strength, limb fatigue, tibia and leg weakness, dizziness, headache with nausea, and vomiting) , subtypes of yin-deficiency syndromes (including blurred vision and eye floaters) , subtypes of blood stasis syndromes (including nail cyanosis, and dark purple tongue) , and intrarenal arteriosclerosis (P<0.05) . Moreover, IgAN-MHT group had lower prevalence of abnormal urine test results as the first clinical manifestations, previous hypertension and clinical diagnosed chronic nephritic syndrome, as well as lower levels of mean serum IgM and IgG levels, and eGFR (P<0.05) . Both groups had no significant difference in the prevalence of interstitial fibrosis/tubular atrophy (T) lesions among the two groups (P<0.05) . The common TCM syndrome in IgAN-MHT group was qi-yin deficiency syndrome combined with blood stasis syndrome. Correlation analysis showed that IgAN-MHT was positively associated with blood stasis syndrome (P<0.05) ; in IgAN-MHT group, male and quantitatively estimated 24-hour urinary protein excretion was positively associated with qi-deficiency syndrome (P<0.05) ; serum inorganic phosphorus and potassium was negatively associated with yin-deficiency syndrome (P<0.05) , and renal tubular atrophy/interstitial fibrosis was positively associated with blood stasis syndrome (P=0.040) . Multivariate Logistic regression analysis showed that headache〔OR=7.895, 95%CI (1.643, 37.935) , P=0.010〕, blurred vision〔OR=5.499, 95%CI (1.207, 25.053) , P=0.028〕, dry mouth with desire for drink 〔OR=10.079, 95%CI (2.289, 44.373) , P=0.002〕, and nail cyanosis〔OR=18.312, 95%CI (2.179, 153.884) , P=0.007〕 were associated with MHT in IgAN.

IgAN-MHT patients had worse renal function and more serious renal pathological damage. The common TCM syndrome in IgAN-MHT was qi-yin deficiency syndrome with blood stasis syndrome. The clinical and pathological indices of IgAN-MHT patients had a certain level of correlation with qi-deficiency syndrome, yin-deficiency syndrome and blood stasis syndrome. The subtypes of TCM syndromes, such as headache, blurred vision, dry mouth with desire for drink, and nail cyanosis were the influencing factors of MHT in IgAN. Early detection, diagnosis and treatment, concern for and improvement of symptoms related to syndromes of qi-deficiency, yin-deficiency, and blood stasis, may contribute to decreased risk of MHT in IgAN.