Mingjing Tang

Background: Cardiometabolic disorders, including hypertension, dyslipidemia, and diabetes, are increasingly prevalent globally, yet evidence in economically underdeveloped high-altitude areas remains limited. This study sought to assess the prevalence and control of these diseases in the southwestern plateau areas of China and to evaluate their associations with altitude and sociodemographic factors. Methods: We conducted two cross-sectional surveys among adults aged ≥35 years in the southwestern plateau areas of China. Disease definitions were based on measured biomarkers, self-reported diagnoses, and medication use. Logistic regression and restricted cubic spline models were applied to examine associations between sociodemographic factors, altitude, and prevalence and control rates of cardiometabolic disorders. Results: 7,668 adults with an average age of 54.88 ± 12.64 years were investigated. The prevalence, awareness, treatment, and control rates were 46.20%, 58.65%, 43.80%, and 15.75% for hypertension; 37.06%, 15.90%, 5.77%, and 2.11% for dyslipidemia; 11.79%, 27.54%, 21.68%, and 6.86% for diabetes. Higher disease prevalence was associated with male, older age, higher income, overweight/obesity, and alcohol use. Reduced control and treatment rates were observed at altitudes ≥2,242 m, among younger adults, smokers, and drinkers. Altitude significantly modified the association between sociodemographic factors and cardiometabolic disorders. Furthermore, there was a non-linear relationship between these rates and both age and altitude of residence. Conclusions: This study reveals a high burden of cardiometabolic disorders with suboptimal management in the southwestern plateau areas of China. Altitude and sociodemographic factors significantly interact with disease prevalence and control. Targeted public health efforts should prioritize high-risk populations and regions to improve prevention and management.

(1) Aim: The incidence of high-altitude pulmonary hypertension (HAPH) has risen in recent years and is expected to continue increasing; however, its diagnosis remains challenging. In this study, we employed proteomics and metabolomics to identify the proteins and metabolic biomarkers that contribute to the development of HAPH. (2) Methods: We applied integrated proteomics and metabolomics to match blood samples from 40 HAPH patients and 40 healthy controls in Yunnan’s high-altitude regions to characterize molecular profiles, identify biomarkers, and develop a predictive model. (3) Results: Proteomic analysis identified four proteins (A2IPH7, K1C14, PSME2, SERPINE2) commonly dysregulated in HAPH patients from two high-altitude regions. SERPINE2 was notably downregulated and showed a negative correlation with clinical severity, which was further validated in HAPH rat lung tissues and supported by UK Biobank data for idiopathic PAH. Concurrent metabolomics uncovered 11 shared metabolites, largely acyl fatty acids, enriched in pathways such as unsaturated fatty acid synthesis. Integration of these multi-omics data enabled the development of a robust predictive model. (4) Conclusion: Our study identified key protein and metabolic biomarkers involved in HAPH development, which were validated in animal models. Based on these findings, a predictive model was developed, highlighting SERPINE2 and 11 metabolites as promising targets for the prediction and prevention of HAPH.

The triglyceride-glucose (TyG) index is a straightforward and widely used surrogate marker for identifying insulin resistance (IR). The association between

Background The burden of valvular heart disease (VHD) is rising rapidly globally, accompanied by substantial geographical disparities. Although altitude may influence cardiovascular system, no community-based studies have yet explored altitudinal differences in VHD epidemiology. Objective This study aims to investigate the prevalence, spectrum and aetiology of VHD in different altitude areas. Methods We conducted two sequential community-based echocardiography screening programmes in Yunnan Province of China and included 5059 eligible participants aged 35 years and older. The multivariable Poisson regression models with robust variance were performed to assess the association of different altitude groups with VHD and its subtypes. Results The prevalence of overall VHD, clinically significant VHD and clinically significant regurgitant VHD was 36.7%, 2.5% and 2.4%, respectively. After stratification by altitude, the prevalence of any VHD among participants in the Conclusions Adults living at high altitudes have a higher prevalence risk of VHD; significant altitudinal differences exist in the characteristics and aetiology of VHD. The findings could provide insights into primary prevention and early screening for VHD in low- and middle-income countries where a majority of the population lives at high altitudes.

Background: The relationship between different grades of compliance to antihypertensive medication and blood pressure (BP) control rate remains unclear. This study highlighted the Chinese Basic Public Health Service (BPHS) program upgraded antihypertension medication compliance to improve the blood pressure control rate contributing to the UN sustainable development goal of lowering chronic illness fatalities by one‐third by 2030. Methods: In 2015, 1254 hypertensive patients aged ≥ 35 years were selected in the baseline survey in Yunnan Province by a multistage stratified random sampling method and followed up from 2018 to 2022. Then, they were divided into three groups by tertiles as antihypertensive medicine compliance “poor,” “intermittent,” and “sustained” groups. Then, the robust variance Poisson regression models were performed to estimate the association between three groups and the number of referrals. Kaplan–Meier curves calculated the cumulative risk of onset and survival probability of cardiovascular events from three medication compliance groups. Results: A total of 1254 hypertension patients were included in the study; 992, 1218, 1121, 1066, and 999 hypertension patients were followed up annually. From the baseline to last follow‐up, systolic BP declined with the largest decrease in the sustained group (2015: 152.88 ± 21.64 mmHg vs. 2022: 134.61 ± 10.49 mmHg, p < 0.05) and the least decrease in the poor group (2015: 157.07 ± 15.37 mmHg vs. 2022: 140.33 ± 12.04 mmHg, p < 0.05). Under the management of BPHS, the BP control rate of all three groups increased significantly. Compared with the baseline, the control rate in the sustained group reached 70% in 2022 ( p < 0.01). The number of referrals from the poor group was 11.5%, higher compared with the sustained group (IRR = 1.115 and 95% CI: 1.043–1.193). The poor group also had the highest probability of cardiovascular disease (CVD). The survival probability in the sustained group was the highest and kept at 0.950 at the end of 5 years. Conclusions: High‐grade compliance to antihypertensive drugs significantly improves BP control rate and reduces the risk of CVD events and mortality. The decline of medication compliance grades is closely related to decreasing BP control rate and increased risk of CVD and mortality.

Global Heart is the official and primary publication of the World Heart Federation, offering a platform for the dissemination of knowledge on research, developments, trends, solutions and public health programmes in the area of cardiovascular disease. Global Heart welcomes research results, points of view and educational material on the prevention, treatment and control of cardiovascular disease with a special focus on low and middle-income countries which are facing the brunt of epidemiological transition.Global Heart strongly encourages authors to adhere to CONSORT, STROBE, STARD, and PRISMA guidelines for reporting of clinical trials, observational studies, diagnostic test accuracy papers, and systematic reviews or meta-analyses. Authors are required for submission to download and complete the appropriate Equator Network checklist: http://www.equator-network.org/.

Background The relationship between different grades of compliance to antihypertensive medication and blood pressure(BP) control rate remains unclear. The study underscores the relationship that long-term compliance with regular antihypertensive medication to improve rates of BP control.Methods Using 5-year follow-up data, hypertensive patients were categorized into "poor", "intermittent", and " sustained" groups according to tertiles of antihypertensive medication compliance, and the BP control rates of the three groups were compared.Then, the robust variance Poisson regression model estimated the association between three groups and the number of referrals. Kaplan-Meier calculated the cumulative risk of onset and survival probability of cardiovascular events from three medication compliance groups.Results A total of 1254 patients were enrolled and annual follow-up studies of 992, 1218, 1121, 1066 and 999 hypertensive patients were conducted from 2018 to 2022. From baseline to last follow-up, systolic BP declined from 154.69 ± 20.90 mmHg to 137.48 ± 12.44 mmHg and diastolic BP from 84.08 ± 12.80 mmHg to 79.50 ± 7.88 mmHg (p < 0.01). All three groups showed a significant improvement in BP control rates after management, especially the persistence group which reached 70% in 2022(p < 0.01). The number of referrals from the poor group was 11.5% higher than the sustained group (IRR = 1.115,95% CI:1.043 to1.193). The survival probability in the sustained group was the highest and kept at 0.950 at the end of 5 years.Conclusions Long-term high-grade compliance with antihypertensive medications significantly improves BP control rates and reduces the risk of cardiovascular disease (CVD) events and death.

Background The relationship between different grades of compliance to antihypertensive medication and blood pressure(BP) control rate remains unclear. The study underscores the relationship that long-term compliance with regular antihypertensive medication to improve rates of BP control.Methods Using 5-year follow-up data, hypertensive patients were categorized into "poor", "intermittent", and " sustained" groups according to tertiles of antihypertensive medication compliance, and the BP control rates of the three groups were compared.Then, the robust variance Poisson regression model estimated the association between three groups and the number of referrals. Kaplan-Meier calculated the cumulative risk of onset and survival probability of cardiovascular events from three medication compliance groups.Results A total of 1254 patients were enrolled and annual follow-up studies of 992, 1218, 1121, 1066 and 999 hypertensive patients were conducted from 2018 to 2022. From baseline to last follow-up, systolic BP declined from 154.69 ± 20.90 mmHg to 137.48 ± 12.44 mmHg and diastolic BP from 84.08 ± 12.80 mmHg to 79.50 ± 7.88 mmHg (p < 0.01). All three groups showed a significant improvement in BP control rates after management, especially the persistence group which reached 70% in 2022(p < 0.01). The number of referrals from the poor group was 11.5% higher than the sustained group (IRR = 1.115,95% CI:1.043 to1.193). The survival probability in the sustained group was the highest and kept at 0.950 at the end of 5 years.Conclusions Long-term high-grade compliance with antihypertensive medications significantly improves BP control rates and reduces the risk of cardiovascular disease (CVD) events and death.

Congenital heart disease (CHD) is the leading cause of mortality in childhood worldwide. However, a large number of children with CHD are not diagnosed promptly in low- and middle-income regions, due to limited healthcare resources and lack the ability of prenatal and postnatal ultrasound examinations. The research on asymptomatic CHD in the community is still blank, resulting in a large number of children with asymptomatic CHD can not be found and treated in time. Through the China-Cambodia collaborative health care initiative, the project team conducted research, screened children’s CHD through a sampling survey in China and Cambodia, collected relevant data, and retrospectively analyzed the data of all eligible patients. The project aimed to evaluate the prevalence of asymptomatic CHD in a sample population of 3-18years old and effects on their growth status and treatment outcomes. We examined the prevalence of ‘asymptomatic CHD’ among 3-18years old children and adolescents at the township/county levels in the two participating. A total of eight provinces in China and five provinces in Cambodia were analyzed from 2017 to 2020. During 1 year follow-up after treatment, the differences in heights and weights of the treated and control groups were evaluated. Among the 3,068,075 participants screened from 2017 to 2020, 3967 patients with asymptomatic CHD requiring treatment were identified [0.130%, 95% confidence interval (CI) 0.126 -0.134%]. The prevalence rate of CHD ranged from 0.02 to 0.88%, and was negatively related to local per capita GDP (p = 0.028). The average height of 3310 treated CHD patients were 2.23% (95% CI: -2.51%~-1.9%) lower than that of the standard group and the average weight was − 6.41% (95% CI: -7.17%~-5.65%) lower, the developmental gap widening with advancing age. One year after treatment, the relative height difference remained comparable while that, in weight was reduced by 5.68% (95% CI: 4.27% ~7.09%). Asymptomatic CHD now is often overlooked and is an emerging public health challenge. Early detection and treatment are essential to lower the potential burden of heart diseases in children and adolescents.