Objective: To investigate the effects of weekly walking activity on the asymptomatic hypertensive mediated organ damage (HMOD) remains unclear. Design and method: 2830 community-dwelling elderly subjects (over 65 years) in northern Shanghai were recruited from June 2014 to June 2018. Weekly walking activity was evaluated by standard questionnaire based on the International Physical Activity Questionnaires-short form (including walking duration per time and walking days per week). Within the framework of comprehensive cardiovascular examinations, HMOD, including left ventricular mass index (LVMI), peak transmitral pulsed Doppler velocity/early diastolic tissue Doppler velocity (E/Ea), carotid intima-media thickness (CIMT), arterial plaque, creatinine clearance rate (CCR), urinary albumin-creatinine ratio (UACR), carotid-femoral pulse wave velocity (cf-PWV) and ankle-brachial index (ABI), were all evaluated. Results: There were 1862 (65.8%) participants enrolled in weekly walking activity, with 56.8 ± 36.8 min/day and a median of 6.71 days/week walking. Young elderly, fewer smokers, lower CIMT, lower cf-PWV, fewer abnormal ABI, lower prevalence of hypertension and coronary heart disease were observed in walking activity group (P < 0.05). Similarly, Pearson's correlation analysis revealed that weekly walking activity was significantly correlated with elderly (age 70 years or more) and smoker (both P < 0.05). To further investigate the association of weekly walking activity with HMOD, logistic regression analysis was conducted. Interestingly, weekly walking activity was only significantly associated with peripheral artery diseases (P < 0.05), together with cardiovascular risk factors. Subsequently, subgroup analysis about weekly walking activity was performed and the results revealed that only walking duration more than 30 min per time was related to arterial plaque (OR: 1.048, 95% CI: 1.002–1.095, P = 0.038). Conclusions: Taken together, in the community-dwelling elderly Chinese, weekly walking activity played a protective role in HMOD, especially vascular HMOD, regardless of walking duration per time and walking days per week.
Objective: This study investigated the association of metabolic syndrome (MS) and its components with cardiac, macro-, and micro-circulatory abnormalities in an elderly Chinese population. Methods: This cross-sectional study was conducted using data for 1,958 participants from the Northern Shanghai Study aged over 65 years without a history of cardiovascular disease. MS was defined according to the National Cholesterol Education Program Adult Treatment Panel III in 2005 (NCEPIII 2005). Asymptomatic cardiovascular impairment parameters, including the left ventricle mass index (LVMI), peak transmitral pulsed Doppler velocity/early diastolic tissue Doppler velocity (E/Ea), carotid-femoral pulse wave velocity (cf-PWV), ankle-brachial index (ABI), carotid intima-media thickness (CIMT), arterial plaque, and urinary albumin–creatinine rate (UACR), were evaluated. Results: LVMI, E/Ea, cf-PWV, and the proportion of UACR > 30 mg/g exhibited increasing trends while ABI exhibited a decreasing trend according to the number of MS components (all p for trend < 0.01). Logistic regression analysis revealed that MS was significantly associated with LV hypertrophy (LVH), LV diastolic dysfunction, arteriosclerosis, and microalbuminuria (all p < 0.001). Central obesity and high blood pressure were associated with all cardiovascular abnormalities (all p < 0.05), whereas elevated plasma glucose was associated with arteriosclerosis and microalbuminuria (both p < 0.001). In addition, high triglyceride levels were associated with microalbuminuria ( p < 0.05). Conclusions: MS is significantly associated with cardiac, macro-, and micro-circulatory abnormalities in elderly Chinese. Moreover, the presence of individual MS components may have specific prognostic significance.
Purpose: There have been few recent studies regarding vascular aging and its relationship with left ventricular (LV) geometry. Moreover, the association of abnormal LV geometry with various kinds of vascular aging has not yet been systematically analyzed. Thus, this study aimed to further elucidate this relationship. Materials and Methods: In this study, 3363 older participants (43.6% male, aged 71.1± 5.9 years; 56.4% female, aged 71.1± 6.1 years) derived from the Northern Shanghai Study were enrolled. Vascular aging criteria included arteriosclerosis, defined as carotid-femoral pulse wave velocity > 10 m/s or brachial–ankle pulse wave velocity > 1800 cm/s, and peripheral atherosclerosis, defined as ankle–brachial index < 0.9, carotid artery intima-media thickness (cIMT) greater than 0.9 mm, or carotid plaque indicating carotid artery abnormality. Micro-albuminuria was defined as urinary albumin-to-creatinine ratio > 30 mg/g. Decreased estimated glomerular filtration rate (eGFR) was defined as eGFR < 60 mL/min/1.73 m 2 . Results: When vascular aging parameters were respectively adjusted for age and sex, arteriosclerosis, micro-albuminuria, and peripheral atherosclerosis were significantly associated with concentric remodeling, eccentric LV hypertrophy (LVH), and concentric LVH (P< 0.045) but not with decreased eGFR or abnormal cIMT and presence of plaque. Peripheral atherosclerosis was strongly associated with LV concentric geometry (LVCG) when considering other covariates (risk factors, diseases, and treatments) (P< 0.012). Conclusion: Vascular aging parameters such as arteriosclerosis, micro-albuminuria, and peripheral atherosclerosis are significantly and independently associated with LVCG in community-dwelling older Chinese population, suggesting the importance of vascular aging during early clinical assessment of abnormal LV geometry change and serious cardiovascular events. Keywords: arteriosclerosis, micro-albuminuria, peripheral atherosclerosis, community-dwelling elderly
Abstract Background Body fat mass (FM) is associated with multiple organ damage. However, data regarding the relationship between various organ damage and FM are rare in the elderly. Therefore, we aim to perform an analysis on the relationship between organ damage and FM in a geriatric cohort. Methods 3331 participants were included in this analysis. Based on age, body height, body weight, waist circumference, and race, we calculated FM with the established formula. Organ damage, including arterial stiffening, lower extremity atherosclerosis, left ventricular hypertrophy (LVH), micro-albuminuria, and chronic kidney disease (CKD), were measured and calculated with standard methods. Results All organ damage parameters were significantly related to FM (all p < 0.001). In univariate logistics regression, the highest quartile of FM was tied to the increased risk of arterial stiffening, lower extremity atherosclerosis, LVH, micro-albuminuria, and CKD (all p < 0.05). After adjustment, participants with higher quantiles of FM had a significantly increased odd ratio (OR) for arterial stiffening [OR = 1.51, 95% confidence interval (CI): 1.15–1.99, p = 0.002] and LVH (OR = 1.99, 95% CI: 1.48–2.67, p < 0.001). Moreover, FM was linearly associated with arterial stiffening and LVH in total population and gender subgroups. Independent of confounders, FM was significantly correlated with arterial stiffening, lower extremity atherosclerosis, LVH and CKD in female, while was only related to LVH in male. Conclusions Among various organ damage, elevated FM is significantly and independently associated with arterial stiffening and LVH in the elderly. Compared with men, women with increased FM are more likely to have multiple organ damage.
Objective: The Eighth Joint National Committee Panel recommended novel blood pressure (BP) goals for individuals with hypertension, which is still under debate. We therefore assessed patients’ target organ damages in controlled hypertensives defined by the Seventh or Eighth Joint National Committee thresholds (JNC7 and JNC8) in a community-based elderly Chinese population, in order to find the optimal BP goal for the elderly Chinese. Design and Method: 1599 community-based elderly participants (age > 65 years old) were recruited in the northern Shanghai. Prevalence of hypertension was defined as a systolic and diastolic BP > 140/90 or a previous history of hypertension. Participants were classified by chronic kidney disease (CKD) or diabetes mellitus (DM) to investigate the conditions of their BP control based on both the JNC7 and JNC8. Then participants were categorized into 3 groups, individuals at goal BP by JNC7 (Group1), individuals at goal BP by JNC8 but not by JNC7 (Group2), and individuals not at goal by both guidelines (Group3). Patients’ hypertensive target organ damages as left ventricular mass index (LVMI), pulse wave velocity (PWV), carotid intima-medium thickness (CIMT), left ankle-brachial index (LABI), urinary albumin-creatinine ratio (UACR) and creatinine clearance rate (Ccr) were evaluated. Results: According to the JNC7, 48.5% of the entire population were at BP goal, while 67.5% were at-goal by the JNC8, including 19.0% reclassified as at-goal. Compared to Group1, Group2 and Group3 had a significantly greater LVMI (93.10 vs 84.47, 96.54 vs 84.47, p < 0.05), PWV (9.70 vs 8.73, 10.31 vs 8.73, p < 0.05) and CIMT (0.62 vs 0.60, 0.63 vs 0.60, p < 0.05), but had a significantly lower LABI (1.02 vs 1.05, 1.02 vs 1.05, p < 0.05). Conclusions: In the community-based elderly Chinese, 32.5% of the entire population remained uncontrolled BP by JNC8, but 19% were reclassified as at-goal. The reclassified group had more target organ damages than the original at-goal group, so BP criteria by JNC7, but not by JNC8, would be more beneficial for the elderly Chinese.
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