Background Left ventricular hypertrophy （LVH） and geometric abnormality are associated with morbidity and mortality of cardiovascular disease and stroke. Hypertension is the major cause of LVH. Yet the prevalence and other risk factors of LVH and geometric abnormality in Chinese hypertensive population are unknown. The objective of this study was to investigate the prevalence and risk factors of LVH and geometric abnormality in community-based Chinese hypertensive population. Methods The study was a community-based cross-sectional study, and comprised 4270 hypertension patients with integrated clinical and echocardiographic data. Left ventricular mass was measured by transthoracic echocardiography. LVH was diagnosed by using the criteria of over 49.2 g/m^2.7 for men and 46.7 g/m^2.7 for women. LV geometric patterns （normal, concentric remodeling, concentric or eccentric hypertrophy） were calculated according to LVH and relative wall thickness. Logistic regression model was used to determine the odds ratio （OR） and 95% confidence intervals （CI） of the risk factors of LVH. Results The prevalence of LVH was 42.7% in 4270 hypertensive patients, with 37.4% in males and 45.4% in females, respectively. The prevalence of concentric remodeling, concentric or eccentric hypertrophy was 24.7%, 20.2%, and 22.6%, respectively. In Logistic regression model, female （OR 1.3, 95%C/ 1.1-1.5, P 〈0.01）, age （OR 1.02, 95%C/ 1.01-1.03, P 〈0.01）, body mass index （OR 1.2, 95%C/1.15-1.20, P 〈0.01）, systolic blood pressure （OR 1.02, 95%C/ 1.01-1.03, P 〈0.01 ）, and serum triglyceride （OR 1.10, 95% CI 1.00-1.20, P 〈0.01 ） were risk factors of LVH. Female, age, body mass index, systolic blood pressure and serum triglyceride were also risk factors of left ventricular geometric abnormality. Conclusions The echocardiographic LVH is the major complication of patients with hypertension in rural area of China, especially for women. To effectively treat hypertension, weight loss and control of serum trig
WANG Shu-xiaXUE HaoZOU Yu-baoSUN KaiFU Chun-yanWANG HuHUI Ru-tai
Background Growing epidemiologic evidence has indicated that genetics can predispose individuals to the occurrence of lone atrial fibrillation （AF）. The angiotensin-converting enzyme 2 （ACE2） gene has been established to be associated with hypertension and left ventricular hypertrophy. The objective of our study was to investigate the association of ACE2 gene polymorphisms with lone AF. Methods A total of 265 consecutive lone AF patients and 289 healthy controls were successfully investigated. The polymorphisms rs2106809 and rs2285666 were genotyped by polymerase chain reaction （PCR） and direct sequencing. A Logistic regression model was used to determine the odds ratio （OR） and 95% confidence intervals （CO of variations of ACE2 for lone AF. Results The T allele of rs2106809 conferred an increased risk for lone AF （OR 1.24, 95% CI 1.01-1.52, P=0.03） in males after adjustment for conventional risk factors. SNP at rs2285666 in males was not significantly different between AF patients and controls. No association was found between the two polymorphisms in the female population with lone AF. After （36.3±4.5） months of follow-up, the end point data were obtained： death （cardiac and noncardiac）, ischemic stroke, and heart failure. In the male subgroup, the associations between rs2106809 T male carriers and combined end points including ischemic stroke, heart failure, and death in our study were of significance （OR 3.6, 95% CI 1.0-13.1, P=-0.04）. Conclusions The results indicate that polymorphism at ACE2 gene is associated with male lone AF in a Chinese Han population. Lone AF males who c.arrv the. rs2106809T alle.le, are. associate.d with adverse cardiac, e.ve.nts
WANG Shu-xia TAO Tao FU Zhi-qing XIE Xiang-zhu WANG Hao WANG Yu-tang
Background Many studies have indicated that medical therapy and percutaneous coronary intervention have similar effects in terms of the long-term prognosis of patients with stable coronary artery disease. This study investigated the effects of optimal medical therapy （OMT） and revascularization-plus-OMT in elderly patients with high-risk angina. Methods In this prospective non-randomized study, 241 consecutive high-risk elderly male patients （65-92 years of age） with angiographically confirmed multivessel disease were enrolled in the registry from January 2004 to April 2005. Of these, 98 patients underwent OMT and 143 underwent revascularization therapy plus OMT. Results After 6.5 years of follow-up, we found that the rate of long-term cardiac mortality was significantly higher in patients who under- went OMT than in those who underwent revascularization （6.5-year unadjusted mortality rate, 14.3% for OMT vs. 7.0% for revascularization patients; log-rank P = 0.04）. However, the overall risks of major adverse cardiac cerebrovascular events （MACCE） were similar among all patients （6.5-year unadjusted mortality rate, 29.6% for OMT vs. 27.3% for revascularization patients; log-rank P = 0.67）. Conclusions OMT was associated with an increase in cardiac death but a similar 6.5-year risk of MACCE compared with revascularization in high-risk elderly male patients with coronary multivessel disease.
Tao TAOHao WANGShu-Xia WANGYu-Tao GUOPing ZHUYu-Tang WANG
