Table_1_Association of the metabolic score for insulin resistance with cardiovascular diseases, cardiovascular and all-cause mortality in Chinese hypertensive population.pdf

ImportanceLittle is known about the relationship between the metabolic score for insulin resistance (METS-IR) and the prognosis of hypertensive patients in China.ObjectiveTo investigate the association between the novel non–insulin‐based METS-IR index and the cardiovascular composite endpoints and all-cause mortality in Chinese hypertensive participants.Design, setting, and participantsThis cohort study used data from the China H-Type Hypertension Project, a long-term prospective cohort consisting of 14234 hypertensive patients in southern China, with a baseline from March to August 2018. The median follow-up period for participants was 3.94 years, as of 2022. The data analysis period is from July 2023 to September 2023.ExposuresMETS-IR index of participants in the Chinese H-type hypertension project. The calculation formula for METS-IR is (Ln (2 × FPG) +TG) × BMI/Ln (HDL-C).Main outcomes and measuresCardiovascular events and cardiovascular, all-cause mortality were identified by linking the cohort database with the health care system through October, 2023.ResultsA total of 14220 participants were included in this study. The prevalence rates of cardiovascular disease (CVD), cardiovascular death, and all-cause death were 2.59% (369/14220), 2.79% (397/14220), and 5.66% (805/14220), respectively. After adjusting for confounding factors in the multivariate logistic regression analysis models, the METS-IR index was significantly positively correlated with CVD, and cardiovascular, all-cause mortality, whether as a categorical or continuous variable. Layered analysis showed that the METS-IR index of hypertensive participants in different subgroups was positively correlated with the endpoint event.Conclusions and relevanceThis large, prospective cohort study demonstrated that the METS-IR index, a new IR evaluation index, were independently associated with a higher risk of the cardiovascular composite endpoint and all-cause mortality among Chinese hypertensive population. Importantly, our finding provides an independent indicator for evaluating the prognosis of hypertensive patients.</p

DataSheet_1_Association of the metabolic score for insulin resistance with cardiovascular diseases, cardiovascular and all-cause mortality in Chinese hypertensive population.pdf

ImportanceLittle is known about the relationship between the metabolic score for insulin resistance (METS-IR) and the prognosis of hypertensive patients in China.ObjectiveTo investigate the association between the novel non–insulin‐based METS-IR index and the cardiovascular composite endpoints and all-cause mortality in Chinese hypertensive participants.Design, setting, and participantsThis cohort study used data from the China H-Type Hypertension Project, a long-term prospective cohort consisting of 14234 hypertensive patients in southern China, with a baseline from March to August 2018. The median follow-up period for participants was 3.94 years, as of 2022. The data analysis period is from July 2023 to September 2023.ExposuresMETS-IR index of participants in the Chinese H-type hypertension project. The calculation formula for METS-IR is (Ln (2 × FPG) +TG) × BMI/Ln (HDL-C).Main outcomes and measuresCardiovascular events and cardiovascular, all-cause mortality were identified by linking the cohort database with the health care system through October, 2023.ResultsA total of 14220 participants were included in this study. The prevalence rates of cardiovascular disease (CVD), cardiovascular death, and all-cause death were 2.59% (369/14220), 2.79% (397/14220), and 5.66% (805/14220), respectively. After adjusting for confounding factors in the multivariate logistic regression analysis models, the METS-IR index was significantly positively correlated with CVD, and cardiovascular, all-cause mortality, whether as a categorical or continuous variable. Layered analysis showed that the METS-IR index of hypertensive participants in different subgroups was positively correlated with the endpoint event.Conclusions and relevanceThis large, prospective cohort study demonstrated that the METS-IR index, a new IR evaluation index, were independently associated with a higher risk of the cardiovascular composite endpoint and all-cause mortality among Chinese hypertensive population. Importantly, our finding provides an independent indicator for evaluating the prognosis of hypertensive patients.</p

Image_1_Triglyceride–glucose index change and chronic kidney disease progression in a Chinese hypertensive population.pdf

BackgroundThe impact of triglyceride–glucose (TyG) index variations on chronic kidney disease (CKD) progression remains unexplored. To investigate the effects of the TyG index and its dynamic changes on CKD progression.MethodThis prospective cohort study included data from 8,418 hypertensive participants. The exposure variable in this study was defined as the difference between the TyG index at the last visit from that at baseline. The study’s outcome variable was the progression of CKD, defined as follows: for subjects with an estimated glomerular filtration rate (eGFR) ≥60 mL/min, a ≥30% decrease in eGFR with a final follow-up value ResultsDuring a median follow-up period of 48 months, 1077 patients were diagnosed with CKD progression. In the fully adjusted Model 3, patients with a change in the TyG index ConclusionsOur findings suggest that TyG variability may serve as a useful tool for identifying individuals at risk of CKD progression, particularly hypertensive patients with normal DBP levels.</p

A Pulse BP device and the illustration for SBP determination.

<p>The numbers represent the pressure values (mmHg) in the large cuff. When the pressure decreases in the large cuff, the amplitudes of the first several pulse waves recorded from the small cuff gradually increases in a linear manner. Pss 0, Pss 1 and Pss 2 represent the first 3 pulse waves, respectively. H represents the vertical height of the pulse wave. The pressure in the large cuff at Pss0 is determined as SBP. Pss0 =  (H2 X Pssl -Hl X Pss2)/(H2— HI).</p

Comparison of ΔD/D0 and ΔDBPl-r between groups with hypertension or normotension.

<p>* P<0.001 compared with hypertension group. ΔD/D0: percentage increase in right brachial artery diameter. ΔDBPl-r: DBPl-r change following ischemia. (DBPl-r: DBP difference between left and right arms).</p

The correlation of ΔD/D0 with DBPb-p and ΔDBPl-r.

<p>△D: increase in artery diameter (ΔD =  post-D - D0). ΔD/D0: percentage increase in right brachial artery diameter. DBPb-p: DBP change following right-arm ischemia. ΔDBPl-r: DBPl-r change following ischemia. (BPl-r: DBP difference between left and right arms).</p

Datasheet1_Estimated pulse wave velocity as a predictor of all-cause and cardiovascular mortality in patients with hypertension in China: a prospective cohort study.docx

BackgroundWhether the estimated pulse wave velocity (ePWV) in Chinese patients with hypertension can serve as an independent predictor of cardiovascular and all-cause mortality remains unknown. Therefore, this study investigated the associations between ePWV and cardiovascular and all-cause mortalities and explored potential effect modifiers influencing these relationships. Finally, we compared the ePWV with the brachial-ankle pulse wave velocity (baPWV) to determine which parameter better predicts mortality.MethodsThe population of this longitudinal cohort study was selected from the China H-type Hypertension Registry Study. The exposure and outcome variables were ePWV and all-cause and cardiovascular mortalities, respectively. The Cox proportional hazard regression model was applied to assess the associations between ePWV and all-cause and cardiovascular mortalities. The performances of ePWV and baPWV in predicting death were compared using the receiver operating characteristic (ROC) curve area, net reclassification improvement index (NRI), and integrated discrimination improvement index (IDI).ResultsThis prospective study enrolled 14,232 patients with hypertension. Following an average follow-up of 48 months, 806 individuals succumbed to all-cause mortality, with 397 cases specifically attributed to cardiovascular diseases. The Cox proportional regression analysis revealed a significant association between a 1 m/s increase in ePWV and a 37% higher risk of all-cause mortality (hazard ratio [HR]: 1.37, 95% confidence interval [CI]: 1.31–1.43) as well as a 52% higher risk of cardiovascular mortality (HR: 1.52, 95% CI: 1.43–1.62) in the fully adjusted model. The findings for ePWV according to quartile demonstrated hazard ratios for all-cause mortality for Q2 (10.25 ConclusionsThe performance of ePWV in predicting all-cause and cardiovascular mortalities was superior to that of baPWV alone. Patients who were overweight or obese with higher ePWV values exhibited a significantly increased risk of all-cause death. The correlation between elevated ePWV and the risk of cardiovascular death was more pronounced in patients who had not received hypoglycemic drugs.</p

The correlation of age with ΔDBPl-r and ΔD/D0.

<p>ΔD/D0: percentage increase in right brachial artery diameter. ΔDBPl-r: DBPl-r change following ischemia. (DBPl-r: The DBP difference between left and right arms).</p

The comparison between intra-radial and intra-brachial artery BPs.

<p>BPr-b: the difference between intra-radial and intra-brachial artery BP.</p><p>*: compared with intra-radial, P<0.05.</p><p>(n = 48, mmHg).</p

The Bland-Altman plots for the inter-measurement differences between intro-radial artery BP and Pulse BP or Microlife BP.

<p>Difference  =  intra-radial BP- non-invasive BP.</p