Yudong Miao

There is a lack of broader, systematic research examining differences in health-related quality of life (HRQoL) among elderly hypertensive populations acro

To examine and compare the associations between lifestyle behaviors and health-related quality of life (HRQoL) among older and non-older adults. A cross-sectional survey was conducted from Feb. 1 to 18, 2023 in East, Central, West, and Northeast regions of China. HRQoL was assessed by five-level EuroQol-5D scale and visual analogue scale (VAS). Demographic information and lifestyle behaviors were compared between non-older adults (aged < 60 years) and older adults (aged ≥ 60 years). Tobit regressions and generalized linear model were employed to evaluate the associations of lifestyle behaviors with utility index (-0.391,1.000) and VAS score (0,100). A total of 5,780 adults were included in the analysis (21.33% older adults, median age: 66.00 years; 78.67% non-older adults, median age: 40.00 years). The mean utility index and VAS score were 0.953 and 76.22 among older adults, and 0.980 and 82.08 among non-older adults, respectively (all P < 0.05). The median lifestyle score was 33.00 for older adults and 34.00 for non-older adults (P < 0.05). Higher lifestyle scores were associated with higher HRQoL in both age groups. Engaging in physical activity, practicing psychological decompression, maintaining work and study routines, and undergoing regular physical examinations were significantly associated with the utility index and VAS score in both groups (all P < 0.05). Smoking status showed a stronger association with HRQoL among older adults, whereas maintaining a reasonable weight, limiting unhealthy diets, obtaining sufficient sleep, and maintaining social relationships were significantly associated with HRQoL among non-older adults (all P < 0.05). Older adults reported lower HRQoL and lifestyle scores than non-older adults. Although higher lifestyle scores were associated with better HRQoL in both groups, the patterns of associations differed by age, with smoking-related factors more prominent among older adults and diet, sleep, weight, and social relationships more relevant among non-older adults. These findings highlight age-specific patterns in lifestyle-HRQoL associations. The online version contains supplementary material available at 10.1186/s13690-026-01862-x.

Objectives: Among patients undergoing heart transplantation, BTT-tMCS therapy demonstrates superior clinical efficacy compared to nonbridged HTx; however, its cost-effectiveness among Chinese patients remain uncertain. To evaluate the cost-effectiveness of BTT-tMCS therapy compared with nonbridged HTx among transplant-eligible Chinese patients from the healthcare payer’s perspective. Methods: The cost-effectiveness analysis for this economic evaluation was conducted at a qualified heart transplantation center in Central China. Participants included patients admitted since 2018 who underwent either BTT-tMCS or nonbridged HTx, identified retrospectively from local electronic medical records and supplemented by corresponding questionnaires. Propensity score matching (PSM) was employed to obtain a homogeneous group of HTx patients to generate model input parameters. A Markov model simulates lifetime disease progression and associated costs for HTx patients, with monetary values standardized to 2023. Sensitivity analyses were performed to test the internal validity of the model’s conclusions. The model evaluated two competing treatment strategies: BTT-tMCS and standard care. Lifetime health care cost and quality-adjusted life-years (QALYs) of the simulated cohort. Results: PSM identified 40 matched subjects who met the predefined criteria, creating a homogeneous cohort for analysis. Compared to nonbridged HTx, BTT-tMCS yielded higher lifetime incremental costs (510,361 RMB) and effects (5.88 QALYs), resulting in an ICER of 28966.88 RMB/QALY. Sensitivity analyses demonstrated the robustness of these findings, with a 90% probability of cost-effectiveness achieved at a willingness-to-pay threshold exceeding 80422.20 RMB/QALY. Conclusion: In this economic evaluation study, BTT-tMCS therapy was more likely to be cost-effective compared with non-bridged HTx.

Life’s Crucial 9 (LC9), an extension for Life’s Essential 8 with the addition of psychological health, provides a new tool for assessing cardiovascular health. However, the association between LC9 and cardiovascular diseases (CVD) in elderly hypertensive patients remains unclear. A cross-sectional survey was carried out among elderly hypertensive patients from the National Basic Public Health Service Programs in Jia County, Henan Province, from July 1 to August 31, 2023. The primary outcome was defined as a composite CVD (coronary heart disease and stroke). The LC9 consisted of 9 metrics (diet, physical activity, nicotine exposure, sleep, psychological health, body mass index, blood pressure, fasting blood glucose, and non-high-density lipoprotein cholesterol). The logistic regression model was established to estimate the odds ratio (OR) and 95% CI of CVD across different LC9 groups. A total of 13,032 elderly hypertensive patients (mean age: 73.45) were analyzed. 5,664 (43.46%) patients were diagnosed with CVD (including 4,455 coronary heart disease and 2,062 stroke). The median (interquartile range) of the LC9 score in all patients, those without CVD, and those with CVD were 65.56 (58.33-72.22), 66.67 (59.44-73.33), and 64.44 (56.67-71.11), respectively. As the number of ideal LC9 metrics increased, the prevalence of CVD decreased (Ptrend 0.05). Higher LC9 scores and more ideal health metrics, including psychological health, are associated with lower CVD risk in elderly hypertensive patients, highlighting the need for policy efforts to strengthen primary healthcare, expand access to preventive services, and promote comprehensive CVH management in this high-risk population.

This study aimed to accessed the current status of the physical activity and the prevalence of comorbidity among the elderly (≥ 65 years old) in rural areas and to investigate the effect of physical activity intensity on hypertension-diabetes comorbidity in the elderly. A cross-sectional survey was conducted in Jia County, Pingdingshan, Henan Province from July 1 to August 31, 2023. A questionnaire was used to collect information on socio-demographic factors and chronic diseases, and the IPAQ (short form) to collect information about physical activity. Multivariate logistic regression models were performed to identify factors influencing the prevalence of comorbidity in rural areas. Propensity score matching (PSM) was performed to explore the effects of high-intensity versus low-intensity physical activity on the prevalence of comorbidity among the elderly in rural areas. In total of 16,795 participants were recruited. The prevalence of comorbidity was lower in participants with high-intensity physical activity than in those with low-intensity physical activity (45.4% vs. 58.3%). After adjusting for the effects of potential confounders, we found that the prevalence of comorbidity was higher in females (OR 1.194, 95% CI [1.122–1.271]) than in males. Participants’ education level, occupation, and income all influenced the occurrence of comorbidity. PSM analysis revealed a 13.2% difference in comorbidity prevalence between high-and low-intensity physical activity participant. The prevalence of comorbidity is lower in participants with high-intensity physical activity than in those with low-intensity physical activity in rural areas. Physical activity interventions may be strengthened to encourage the elderly to actively increase their physical activity levels. Furthermore, we advocate that more attention should be paid to the physical activity of the elderly, improving the construction of sports facilities in rural areas, and village clinics should strengthen guidance to encourage the elderly to participate in high-intensity physical activities.

Background: Socioeconomic status (SES) plays a crucial role in blood pressure (BP) control. SES may influence BP control through obesity indices, such as body mass index (BMI) and waist circumference (WC). This study aimed to understand the relationships between SES and BP control in the elderly hypertensive population, and to determine whether BMI and WC mediate the relationship between SES and BP control. Methods: The study was conducted in Jia County, Henan Province, China, from 1 July to 31 August 2023. The 18,963 hypertensive people over 65 years old who were included in the National Basic Public Health Service Program were investigated. The study utilized questionnaire surveys to collect data on participants’ demographic characteristics, disease history, lifestyle behaviors, antihypertensive medication, and measured height, weight, and blood pressure. SES was indexed by participants’ self-reported educational level, family income, and occupation, and categorized into low, medium, and high groups by using latent category analysis (LCA). Logistic regression models were used to analyze the associations between SES and BP control. Obesity indicators, represented by BMI and WC, were included in mediation models to examine the indirect effects of BMI/WC on the association between SES and BP control. Results: The mean age of 17,234 participants was 73.4 years and 9888 (57.4%) of the participants were female. The LCA results indicated the number of participants in low SES, middle SES, and high SES groups were 7760, 8347, and 1127, respectively. Compared with the low SES group, the odds ratios (ORs) and 95% confidence intervals (CIs) for the association of BP control with middle SES and high SES were 1.101 (1.031, 1.175), and 1.492 (1.312, 1.696). This association was similarly found in the subsequent subgroup analyses (p < 0.05). Compared with low SES, our findings further suggested that BMI (indirect effects: 95% CIs: −0.004–−0.001; p < 0.001) and WC (indirect effects: 95% CIs: −0.003–−0.001; p = 0.020) play a suppressing role in the association between high SES and BP control. Conclusions: Our study indicated that the elderly hypertensive population with high SES may have a better result for BP control. However, we found that BMI/WC plays a suppressing role in this association. This indicated that despite the better BP control observed in elderly hypertensive populations with high SES, BMI and WC might undermine this beneficial relationship. Therefore, implementing strategies for obesity prevention is an efficient way to maintain this beneficial association between high SES and BP control.

The public health service capability of primary healthcare personnel directly affects the utilization and delivery of health services, and is influenced by various factors. This study aimed to examine the status, factors, and urban-rural differences of public health service capability among primary healthcare personnel, and provided suggestions for improvement. We used cluster sampling to survey 11,925 primary healthcare personnel in 18 regions of Henan Province from 20th to March 31, 2023. Data encompassing demographics and public health service capabilities, including health lifestyle guidance, chronic disease management, health management of special populations, and vaccination services. Multivariable regression analysis was employed to investigate influencing factors. Propensity Score Matching (PSM) quantified urban-rural differences. The total score of public health service capability was 80.17 points. Chronic disease management capability scored the lowest, only 19.60. Gender, education level, average monthly salary, professional title, health status, employment form, work unit type, category of practicing (assistant) physician significantly influenced the public health service capability (all P < 0.05). PSM analysis revealed rural primary healthcare personnel had higher public health service capability scores than urban ones. The public health service capability of primary healthcare personnel in Henan Province was relatively high, but chronic disease management required improvement. Additionally, implementing effective training methods for different subgroups, and improving the service capability of primary medical and health institutions were positive measures.

Background: Healthy lifestyle behaviors (LBs) have been widely recommended for the prevention and management of cardiovascular disease (CVD). Despite a large number of studies exploring the association between combined LBs and CVD, a notable gap exists in integration of relevant literatures. We conducted a systematic review and meta-analysis of prospective cohort studies to analyze the correlation between combined LBs and the occurrence of CVD, as well as to estimate the risk of various health complications in individuals already diagnosed with CVD.Methods: Articles published up to February 10, 2023 were sourced through PubMed, EMBASE and Web of Science. Eligible prospective cohort studies that reported the relations of combined LBs with pre-determined outcomes were included. Summary relative risks (RRs) and 95% confidence intervals (CIs) were estimated using either a fixed or random-effects model. Subgroup analysis, meta-regression, publication bias, and sensitivity analysis were as well performed.Results: In the general population, individuals with the healthiest combination of LBs exhibited a significant risk reduction of 58% for CVD and 55% for CVD mortality. For individuals diagnosed with CVD, adherence to the healthiest combination of LBs corresponded to a significant risk reduction of 62% for CVD recurrence and 67% for all-cause mortality, when compared to those with the least-healthy combination of LBs. In the analysis of dose-response relationship, for each increment of 1 healthy LB, there was a corresponding decrease in risk of 17% for CVD and 19% for CVD mortality within the general population. Similarly, among individuals diagnosed with CVD, each additional healthy LB was associated with a risk reduction of 27% for CVD recurrence and 27% for all-cause mortality.Conclusions: Adopting healthy LBs is associated with substantial risk reduction in CVD, CVD mortality, and adverse outcomes among individuals diagnosed with CVD. Rather than focusing solely on individual healthy LB, it is advisable to advocate for the adoption of multiple LBs for the prevention and management of CVD.Trial registration: PROSPERO: CRD42023431731.