Yan Li

This study analyzed Global Burden of Disease (GBD) 2019 data to assess cardiovascular disease (CVD) burden in women worldwide. Using annual incident cases, deaths, age-standardized incidence (ASIR), and mortality rates (ASMR) from 1990–2019, trends were evaluated via percentage changes and estimated annual percentage change (EAPC). Globally, incident CVD cases in women rose by 73.86% (15.90 to 27.64 million), while deaths increased by 47.45% (6.06 to 8.94 million). Despite this, ASIR (EAPC: −0.57%) and ASMR (EAPC: −1.63%) declined. Regional disparities emerged in ischemic heart disease (IHD): ASIR increased in low/middle socio-demographic index (SDI) regions (EAPC: +0.04% and + 0.08%) but decreased in high-middle/high SDI regions (EAPC: −1.09% and −2.24%). Findings highlight persistent IHD incidence growth in lower-resource settings despite global improvements in age-standardized rates.

Adherence to antihypertensive medications is essential for blood pressure (BP) control, influencing long‐term outcomes in hypertensive patients. This study examines the association between visit‐to‐visit variability in BP and heart rate (HR) and its effect on adherence to beta‐blocker therapy among outpatients. Conducted across 160 hospitals in China from January 1, 2011, to December 31, 2011, this study included 9225 hypertensive outpatients prescribed metoprolol succinate. BP and HR variability were assessed over three visits (baseline, 1‐month, and 2‐month follow‐up) using standard deviation (SD) and mean‐independent parameters. Nonadherence was defined as medication discontinuation or treatment regimen changes by the 2‐month follow‐up. Among the 9037 patients analyzed, the mean age was 58.85 years (±12.54), and 52.9% were male. Visit‐to‐visit variability in the rate–pressure product (RPP; SBP×HR) was a significant predictor of nonadherence, with an odds ratio (OR) of 1.26 (95% confidence interval [CI]: 1.04–1.53, p < 0.05) for the top‐decile SD of RPP, independent of mean RPP. Variability in diastolic blood pressure (DBP) and pulse pressure (PP) were also associated with nonadherence, with ORs of 1.65 (95% CI: 1.35–2.00, p < 0.001) for DBP and 1.66 (95% CI: 1.39–1.99, p < 0.001) for PP, independent of their mean values. Patients with fluctuations in PP or HR had a higher risk of nonadherence compared to those with consistent reductions in these measures. Visit‐to‐visit variability in RPP, DBP, and PP is a significant predictor of nonadherence to beta‐blockers, regardless of mean levels. Addressing this variability is critical for improving adherence to antihypertensive treatments and optimizing patient outcomes.

Aims: Cardiovascular disease (CVD) is the main cause of morbidity and mortality worldwide and is linked with a regional economic burden. We analysed and compared global trends as well as regional and sociodemographic differences in CVD incidence and mortality. Methods and results: We obtained data to annual incident cases, deaths, age-standardized incidence rates (ASIRs), and age-standardized mortality rates (ASMRs) of CVD during 1990–2019 from the 2019 Global Burden of Disease Study. To quantify the temporal trends, we calculated changes in the incident cases and deaths as well as the estimated annual percentage changes (EAPCs) of age-standardized rates. Globally, CVD incident cases increased by 77.12% from 31.31 million in 1990 to 55.45 million in 2019; deaths rose by 53.81% from 12.07 million in 1990 to 18.56 million in 2019. The overall ASIR [EAPC, −0.56; 95% confidence interval (CI), −0.59 to −0.53] and ASMR (EAPC, −1.46; 95%CI, −1.51 to −1.40) decreased in this period. Against the global trend of ASIR falling, an increasing trend was found in Uzbekistan (EAPC, 1.24; 95%CI, 0.97–1.50), Tajikistan (EAPC, 0.49; 95%CI, 0.47–0.52), and Zimbabwe (EAPC, 0.42; 95%CI, 0.33–0.50). The number of CVD incident cases increased remarkably in low (108.3%), low-middle (114.81%), and middle (117.85%) sociodemographic index regions in 1990–2019. Conclusion: Despite the increased number of CVD cases and deaths after adjusting for changes in population age, we observed a consistent decrease in age-standardized incidence and mortality in most countries. However, specific regions—especially low to middle SDI regions—present worrying increases in CVD cases and deaths.

Objectives Apolipoprotein Cs (apoCs), especially apoC-II and apoC-III, as the components of triglyceride-rich lipoproteins, play a key role in the pathophysiology of diabetes. However, prospective studies examining direct associations between apoCs and diabetes are not reproducible. The aim of this study was to evaluate the impact of apoCs on the risk of developing diabetes in a middle-aged population, and to explore possible mediators responsible for the relationship between apoCs and diabetes. Design Prospective cohort study. Setting Community-based study carried out in Beijing. Methods ApoCs were measured in 1085 participants aged 45–74 years and free of type 2 diabetes mellitus (T2DM) at baseline from the Chinese Multi-Provincial Cohort Study-Beijing Project. Multivariate logistic regression was performed to examine the association of apoCs with a 5-year risk of new-onset T2DM. The impacts of triglycerides, insulin and high-sensitivity C reactive protein (hs-CRP) on the association between apoC-III and the risk of T2DM were explored by a mediation test. Results During the 5 years of follow-up, 97 (8.9%) participants developed T2DM. ApoC-III was significantly associated with the risk of developing T2DM after multivariable adjustment (OR=1.40; 95% CI 1.07 to 1.82). This association was mainly mediated by triglyceride levels with a significant indirect effect (OR 1.61; 95% CI 1.19 to 2.18), followed by hs-CRP and insulin. Conclusions Our findings demonstrated that higher serum apoC-III was independently associated with increased 5-year risk of new-onset T2DM in the Chinese population, and triglyceride plays a crucial role in mediating this relationship. More attention should be paid to preventive strategies of T2DM targeting apoC-III.

The purpose of the study was to investigate whether premenopausal body mass index (BMI) and waist circumference (WC) influence age at menopause. A total of 2116 women aged 35–64 years from two communities of the CMCS Beijing cohort were recruited in 1992 and followed up to 2018. Of 1439 premenopausal women at baseline, 6 women data were missing. Finally, 1433 women were included for analysis. Overweight was defined as BMI 24–27.99 kg/m². Central obesity was defined as WC ≥80 cm. Age at menopause was categorized as 51 years. Multinomial logistic regression models were used to estimate relative odds ratios (RORs) and 95% confidence intervals (CIs). Compared to women with normal weight and normal WC, overweight women with normal WC had higher risk of menopause at >51 years (ROR 1.64, 95% CI 1.10–2.45; P = .01); and overweight women with central obesity had higher risk of menopause at not only >51 years (ROR 1.82, 95% CI 1.13–2.93; P = .01) but also P = .02) and 45–49 years (ROR 2.76, 95% CI 1.71–4.46; P < .001). When overweight women combine with central obesity, the risk of early menopause will increase in some of them.

Background. Identification of potential molecular targets of acute myocardial infarction is crucial to our comprehensive understanding of the disease mechanism. However, studies of gene coexpression analysis via jointing multiple microarray data of acute myocardial infarction still remain restricted. Methods. Microarray data of acute myocardial infarction (GSE48060, GSE66360, GSE97320, and GSE19339) were downloaded from Gene Expression Omnibus database. Three data sets without heterogeneity (GSE48060, GSE66360, and GSE97320) were subjected to differential expression analysis using MetaDE package. Differentially expressed genes having upper 25% variation across samples were imported in weighted gene coexpression network analysis. Functional and pathway enrichment analyses were conducted for genes in the most significant module using DAVID. The predicted microRNAs to regulate target genes in the most significant module were identified using TargetScan. Moreover, subpathway analyses using iSubpathwayMiner package and GenCLiP 2.0 were performed on hub genes with high connective weight in the most significant module. Results. A total of 1027 differentially expressed genes and 33 specific modules were screened out between acute myocardial infarction patients and control samples. Ficolin (collagen/fibrinogen domain containing) 1 (FCN1), CD14 molecule (CD14), S100 calcium binding protein A9 (S100A9), and mitochondrial aldehyde dehydrogenase 2 (ALDH2) were identified as critical target molecules; hsa-let-7d, hsa-let-7b, hsa-miR-124-3, and hsa-miR-9-1 were identified as potential regulators of the expression of the key genes in the two biggest modules. Conclusions. FCN1, CD14, S100A9, ALDH2, hsa-let-7d, hsa-let-7b, hsa-miR-124-3, and hsa-miR-9-1 were identified as potential candidate regulators in acute myocardial infarction. These findings might provide new comprehension into the underlying molecular mechanism of disease.

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