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ObjectiveThis study was performed to evaluate the association between urinary sodium excretion and coronary heart disease (CHD) in hospitalized elderly patients in China.MethodsThe 24-h urinary excretion specimens of 541 patients were collected, and the serum creatinine concentration and urinary sodium/potassium ratio were measured. Associations were explored by multivariate logistic regression analysis.ResultsThe mean 24-h urinary sodium excretion was 200.4 mmol, corresponding to 11.7 g of salt intake. Both of these values were higher in men than in women. The salt intake of 80- to 89-year-old patients was significantly lower than that of 70- to 79-year-old patients. The 24-h urinary sodium excretion and spot urine Na/K ratios were significantly higher in overweight/obese and hypertensive patients. The 24-h urinary sodium excretion of men who smoked was significantly higher than that of women. The spot urine Na/K ratio was significantly higher in patients with cerebral thrombosis. The urinary Na/K ratio, smoking status, and hypertension were independent risk factors for CHD.ConclusionsThis cross-sectional survey suggests that the Na/K ratio may better represent salt loading than Na excretion alone in studying the association between sodium intake and CHD. There was no association between sodium and CHD prevalence.

Objective To determine the multiple functions of policosanol in elderly dyslipidemia patients. Methodology: There were 294 elderly dyslipidemia patients enrolled into this clinical study. They were randomly divided into four groups, as follows: 20 mg policosanol (group A, n = 64); 10 mg policosanol (group B, n = 72); 20 mg atorvastatin (group C, n = 91); and 10 mg policosanol + 20 mg atorvastatin (group D, n = 62). Plasma platelet count, platelet aggregation rate, circulating endothelial cell (CEC) count, high sensitivity C-reactive protein (hs-CRP), and carotid intima–media thickness (IMT) were measured before the study (week 0) and at weeks 12, 24, and 52. Results In group A, the platelet aggregation rate caused by adenosine diphosphate (ADP) after treatment was significantly decreased compared with before treatment (48.79% ± 20.29% vs. 40.37% ± 23.56%), but the arachidonic acid (AA)-induced platelet aggregation rates were similar. The platelet aggregation rates induced by AA and ADP in groups B, C, and D did not change significantly. CEC counts and hs-CRP and homocysteine levels in all groups after treatment were significantly lower compared with before treatment, but carotid IMTs were similar. Conclusion Policosanol regulates blood lipid levels and improves endothelial cell function, and it could delay the progress of atherosclerosis. Trial registration number: ChiCTR-RRC-17013396 (retrospectively registered).

ObjectiveWe aimed to explore the effects of lipid smoothness on the progression and vulnerability of atherosclerotic plaques.Approach24 rabbits were divided into three groups randomly. Group 1 was given standard chow diet; group 2 was fed with cholesterol-rich diet; for group 3, subjects were planned to take cholesterol-rich diet at the first phase for 12 weeks and during the second phase, low-fat and cholesterol-rich diet was then applied alternately every three weeks till the end of the experiment. Lipid profiles, inflammatory factors, endothelium functions, pathological and histological changes were examined. Expressions of matrix metalloproteinase-9 and lectin-like oxidized LDL receptor-1 were measured by immunohistochemical staining.ResultsAccording to data collected during the whole experiment, lipid smoothness index of group 3 was the lowest. Compared with group 2, statistics of the group 3 indicated that: the development of plaques progressed faster; the plaque area and plaque thickness (53.53[22.6]% vs 33.90[24.91]% , 800.38[98.25]µm vs 675.00[109.67]µm) were higher while the fibrous cap thickness (103.50[45.66]µm vs 295.83[97.90]µm) was lower; hs-CRP (0.53[0.07]mg/dL vs 0.45[0.06]mg/dL), interleukin-18 (186.01[8.41]ng/L vs 158.08[2.37]ng/L), OX-LDL (177.15[5.93]µg/L vs 139.57[2.35] µg/L) and endothelin-1 (164.66[9.54]ng/L vs 131.52[4.39]ng/L) were higher while nitric-oxide (22.41[1.69]µmol/L vs 27.23[1.36]µmol/L) was lower; expressions of matrix metalloproteinase-9 (IOD: 37375.87[5634.52] vs 20956.57[4616.93]) and lectin-like oxidized LDL receptor-1 (IOD: 45213.04[16653.81] vs 21921.68[6142.32]) were higher.ConclusionsLipids fluctuation could accelerate the progression and vulnerability of atherosclerotic plaques through worsening arterial endothelium dysfunction and inflammatory reactions.

Objective This study aimed to evaluate the effects of moderate chronic kidney disease (CKD) and left atrial enlargement on the risks of thromboembolic events, and all-cause and cardiovascular mortalities in elderly patients with atrial fibrillation (AF). Methods We retrospectively studied 751 patients (82.16% men, mean age: 79.0±9.1 years) with AF who were followed up for an average of 34.5 months at a single center. Adjusted hazard ratios (HRs) of risk factors for adverse clinical events were calculated using the Cox proportional hazards model. Results The risks of thromboembolic events, and all-cause and cardiovascular deaths were higher in patients with moderate CKD compared with patients with normal renal function after adjusting for other traditional risk factors (HR: 1.63, 95% confidence interval (CI): 1.03–2.58; HR: 1.55, 95% CI: 1.08–2.23; HR: 3.49, 95% CI: 1.57–7.74; respectively). Left atrial volume index >28.0 mL/m2 was an independent risk factor associated with thromboembolic events and all-cause and cardiovascular deaths (HR: 1.62, 95% CI: 1.21–2.33; HR: 1.56, 95% CI: 1.16–2.10; HR: 1.87, 95% CI: 1.07–3.28; respectively). Conclusions Moderate CKD and left atrial enlargement may predict thromboembolic events, and all-cause and cardiovascular mortalities in elderly patients with AF without anticoagulation therapy.