In China, there are approximately 250 million adults who have hypertension with low rates of awareness, treatment and control. Changes in lifestyles at a population level have the potential to enhance or deteriorate the prevention and control of hypertension. We used data from a regional hypertension survey to examine the impact of 2/1 mm Hg decreases or increases in population blood pressure on hypertension prevalence, and rates of unawareness of the hypertension diagnosis, treatment, and control. The primary analysis was based on the average blood pressure of respondents from three visits and a diagnostic threshold of 140/90 mm Hg for hypertension. Secondary analyses examined average blood pressure from the first survey visit and also a diagnostic threshold of 130/80 mm Hg for hypertension. The baseline hypertension prevalence was 33.4%, and rates of unawareness of the hypertension diagnosis, treatment, and control were 74.2%, 25.8%, and 9.7%, respectively. Decreases or increases in blood pressure by 10/5 mm Hg resulted in changes in hypertension prevalence (22.1% vs 53.4%) and rates of unawareness of the diagnosis (60.9% vs 83.8%), treatment (39.1% vs 16.2%), and control (21.2% vs 3.6%), respectively. Similar trends were seen in the secondary analyses. Population changes in lifestyle could have a very large impact on the prevalence and control of hypertension in China. The results support implementation of programs to improve population lifestyles while implementing health services policies to enhance the clinical management of hypertension.

To investigate the responses of nasal airway and autonomic nervous system (ANS) under controlled nasal breathings. Ten healthy volunteers, aged between 21 and 37 years, were enrolled. The participants breathed either through bilateral nostrils (BNB) or unilaterally through the left nostril (UNB) at 0.25 Hz for 5 min. The electrocardiography was simultaneously recorded and the ANS activities were evaluated using heart rate variability analysis. Nasal airway resistance and related factors were measured by rhinomanometry. The results showed that the mean heartbeat interval during UNB was significantly greater than during BNB. The sympathetic modulation decreased significantly during UNB. The correlations between nasal airway resistance and mean heartbeat interval were significant for both UNB and BNB. The increase of heartbeat intervals during UNB was associated with the decrease of cardiac sympathetic activities. The changes of ANS activities and nasal airway resistance during UNB are similar to the changes caused by a prolonged lying.

Objective The aim of this study was to test whether ambulatory blood pressure monitoring (ABPM) in patients with atrial fibrillation is reliable as in patients with sinus rhythm. Method This study included 92 persistent atrial fibrillation patients (50% females; mean age 70.49 ± 11.56 years) and 92 matched sinus rhythm patients (46% females; mean age 69.23 ± 12.63 years). The participants were examined simultaneously with 24-hour ABPM and 24-hour Holter electrocardiography. The mean 24-hour (24-hour-), daytime (day-) and nighttime (night-) BP, types of BP curve, morning systolic BP (SBP) surge (MBPS), the SD of BP readings and the coefficient of variability (the SD/mean BP × 100%) were compared between atrial fibrillation and sinus rhythm patients. Results No differences of 24-hour-, day- and night-SBP levels were observed between two groups. Meanwhile, the 24-hour-SD, day-SD and night-SD, as well as the coefficient of variability for SBP were also similar between two groups. There was no significant difference in the number of MBPS between the two groups. On diastolic BP (DBP), the similar 24 hour and day levels, the 24-hour-SD, day-SD and night-SD as well as the coefficient of variability were also similar between two groups. But the nighttime DBP levels and the night-SD were higher in atrial fibrillation than in sinus rhythm. Conclusion ABPM provides data with similar SBP variability in patients with atrial fibrillation as in subject with normal cardiac rhythm. The ABPM on oscillometric method may be suitable for the atrial fibrillation patients, especially for the SBP evaluation.

Introduction: Drug-induced QT interval prolongation has been reported to be related tolife-threatening polymorphic ventricular tachycardia (torsade de pointes). Proton pump inhibitors (PPIs) are prescribed widelyfor hospitalized patients, the QT interval prolongation and torsade de pointes caused by PPIs were reported. We tried to explore whether PPIs can increase the risk of QT interval prolongation among intensive care unit (ICU) patients.Methods: This study included patients with electrocardiography (ECG) reports from the Medical Information Mart for Intensive Care III database (MIMIC-III). Patients younger than 18 years and those with missing laboratory results were excluded. The end point was QT interval prolongation according to ECG reports.Results:This study included 84,653 ECG reports of 25,426 ICU patients, 14,520 (57.1%) patients had been prescribed PPIs and 2,271 (8.93%) showed a prolonged QT interval. Patients treated with PPIs had a higher incidence of QT interval prolongation (11.17% vs. 5.95%; odd ratio [OR] 1.99, 95% CI: 1.81-2.19; P < 0.001) than those absent PPIs prescription. PPI treatment was associated with an increased risk of QT interval prolongation (OR 1.45, 95% CI: 1.30-1.62; P < 0.001) in adjusted logistic regression for serum potassium, serum magnesium, serum total calcium, estimated glomerular ltration rate (eGFR), comorbidities and known QT-prolonging drugs. In the matched population, patients treated with PPIs also had a higher risk of QT prolongation (8.74% vs. 6.29, OR 1.43, 95% CI: 1.23-1.66). Pantoprazole was associated with higher risk of QT interval prolongation compared with omeprazole and lansoprazole. Conclusion:There was an association between PPI prescription and QT interval prolongation in ICU patients, independent on known QT-prolonging factors. Pantoprazole had thehighest risk among three PPIs.

Atrial fibrillation (AF) patients are more susceptible to dementia, but the results about the effect of oral anticoagulants (OACs) on the risk of dementia are not consistent. We hypothesize that OAC is associated with a reduced risk of dementia with AF and that nonvitamin K antagonist oral anticoagulants (NOAC) are superior to vitamin K antagonists (VKA). Four databases were systematically searched until July 1, 2022. Two reviewers independently selected literature, evaluated quality, and extracted data. Data were examined using pooled hazard ratios (HRs) and 95% confidence intervals (CIs). Fourteen research studies involving 910 patients were enrolled. The findings indicated that OACs were associated with a decreased risk of dementia (pooled HR: 0.68, 95% CI: 0.55–0.82, I2 = 87.7%), and NOACs had a stronger effect than VKAs (pooled HR: 0.87, 95% CI: 0.79–0.95, I2 = 72%), especially in participants with a CHA2DS2VASc score ≥ 2 (pooled HR: 0.85, 95% CI: 0.72–0.99). Subgroup analysis demonstrated no statistical significance among patients aged <65 years old (pooled HR: 0.83, 95% CI: 0.64–1.07), patients in “based on treatment” studies (pooled HR: 0.89, 95% CI: 0.75–1.06), or people with no stroke background (pooled HR: 0.90, 95% CI: 0.71–1.15). This analysis revealed that OACs were related to the reduction of dementia incidence in AF individuals, and NOACs were better than VKAs, remarkably in people with a CHA2DS2VASc score ≥ 2. The results should be confirmed by further prospective studies, particularly in patients in “based on treatment” studies aged <65 years old with a CHA2DS2VASc score < 2 or without a stroke background.