Objective To systematically review the intervention effects and safety of cardiovascular polypill for the relevant risk factors of coronary heart disease. Methods The randomized clinical trials (RCTs) on polypill in intervening coronary heart disease were searched in PubMed, CENTRAL, ICTRP, CBM, CNKI, WanFang and VIP from their inception to September 2012. Two reviewers independently screened the literature according to the inclusion and exclusion criteria, extracted the data, and assessed the methodological quality. Then the analysis was conducted. Results A total of 5 RCTs from overseas were included. The descriptive analysis showed that: a) as for blood pressure, polypill was obviously superior to placebo in reducing SBP and DBP with a significant difference, but it didn’t reveal difference compared to the hypotensive drugs used alone; b) as for serum lipid, polypill was obviously superior to placebo in reducing TC, TG and LDL-C with a significant difference, but there was no difference between polypill and standard drug treatment; c) as for glucose, polypill was obviously superior to placebo in reducing glucose with a significant difference; d) as for adverse reaction, such adverse events as cough, bleeding tendency or gastritis, liver and kidney dysfunction were reported in the included studies; e) as for drug compliance, polypill showed no differences compared with either standard treatment or placebo. Conclusion Polypill has intervention effects on the relevant factors of coronary heart disease, such as hypertension and serum lipid, etc. Due to quantity limitation of the included trials, the above conclusion still needs to be further proved by performing more large scale and high quality studies. For lack of adequate evidence, this review does not recommend polypill as a primary care for cardiovascular disease.
Objective To investigate pre-hypertension in aspects of its incidence, accompanied cardiovascular risk factors, and difference between urban and rural areas in Chengdu. Methods By cluster random sampling method, a total of 2 011 patients aged 35-70 years from urban and rural communities in Chengdu were selected as respondents. The investigation was conducted through questionnaire, physical examination and laboratory tests, so as to find out the main cardiovascular risk factors of pre-hypertension. All data were dual input into computer by a specially-assigned person. SPSS 13.0 software was used for analysis, Chi-square test was adopted for categorical data, and Plt;0.05 was taken as an index for significant difference. Results a) The incidence rate of pre-hypertensive in Chengdu was 33.6%, and it was 45.67% and 46.31% in urban and rural areas, respectively. In rural area, more male (51.04%) were affected than female (42.83%). b) The smoking population with pre-hypertension were mainly the male, and the ratio of rural male was 60% (132/220), far higher than that of urban male which was 32.6% (59/181). c) The pre-hypertensive population accompanied with diabetes was higher in urban (27.97%) than rural (14.01%). d) The pre-hypertensive population accompanied with hypercholesterolemia or low HDL was 33.04% (150/454) in urban, as twice as that in rural which was 16.41% (76/471). e) The pre-hypertensive population accompanied with abdominal obesity was far higher in urban (28.41%) than rural (12.74%). Conclusion Smoking is the risk factor which needs to be primarily intervened for male hypertensive patients in rural area. Impaired glucose tolerance is the common risk factor for both urban and rural residents, and hyperlipidemia is the most primarily risk factor for urban pre-hypertensive patients, followed by diabetes, and abdominal obesity.
Objective To explore the status of women’s quality of life and analyze risk factors related diminished ovarian reserve (DOR). Methods We applied the method of convenient sampling to investigate 61 patients with DOR (DOR group) and 60 women with normal ovarian reserve function (control group) who visited a reproductive centre of a Triple-A hospital from February to May 2013, using a questionnaire which included basic information table, Menopausal Quality of Life Scale (MENQOL) and SF-36 Health Survey for quality of life, and Kupperman Index Scale (KI) for the degree of clinical symptoms. Then, statistical analysis was performed using SPSS 17.0 software. Results Compared with the control group (43.60±16.82), the level of women’s quality of life in the DOR group (73.42±24.15) was significantly lower (Plt;0.01), while the degree of clinical symptoms was significantly higher (Plt;0.01). There were positive associations between quality of life and degree of clinical symptoms. The risk factors related to DOR were various such as age, weight, quality of sleep, menstrual disorders, number of abortion, age of the first pregnancy, gynecologic surgery, economic income, education, family relationship, unsatisfactory sexual life, and psychological factors. Conclusion In order to improve women’s quality of life, effective treatment should be conducted to relieve clinical symptoms of women with DOR. Good life style, harmonious family relationship, healthy mind and avoiding the risk factors, which could effectively help the prevention and treatment of the disease.
Objective To explore the key influencing factors of HIV risk behavior among male who have sex with male (MSM). Methods 36 MSM subjects in a community were recruited for HIV risk behavior characteristics, social environment and the attitude of exposure of high risk sexual intercourse, using behavior scales and qualitative research methods. The collected data were orderly input and analyzed using Nvivo 8.0 software. Then, after three-level transcription, the data were further summarized and extracted based on the method of the grouding theory. Results The HIV Risk Assessment Questionnaire score of 36 subjects was 8.08±2.46, of whom, 72% scored at a medium level (5 to 10 scores) and 19% scored at a high level (more than 10 scores). The social support rating scale (SSRS) score was 32.38±5.99 in MSM population, lower than in undergraduates and floating population. The results of qualitative analysis showed that, after open coding, 11 key message and 4 categories contributed to HIV risk in MSM populaiton, including: a) low levels of fear for AIDS; b) male role and uncertain sexual orientation; c) low degree social support; and d) poor availability of condom in the setting of sexual intercourse. Conclusion The interventions against AIDS/HIV for MSM need to be further studied. Besides, we should strengthen the community intervention mode based on fear for AIDS, social support, and condom distribution methods
Objective To investigate the prevalence of hyperuricemia and the current status as well as differences of cardiovascular risk factors in hyperuricemia patients between urban and rural areas in Chengdu. Methods We randomly sampled 2 032 patients aged from 35 to 70 years age in urban and rural communities, using a questionnaire, physical examination and laboratory tests. Results a) The prevalence of hyperuricemia was 17.77%, which was higher in urban residents (21.38%) than that in rural residents (14.16%). b) The prevalence of hyperuricemia associated with hypercholesterolemia was higher in urban residents (34.10%) than that in rural residents (13.98%); urban women (39.06%) were higher than rural women (16.13%) and urban men (26.97%) were higher than rural men (12.20%). c) The prevalence of hyperuricemia associated with hypertension which was higher in urban residents (58.06%) than that in rural residents (32.64%); urban women (59.38%) were higher than rural women (35.48%) and urban men (56.18%) were higher than rural men (30.49%). d) The prevalence of hyperuricemia associated with impaired glucose tolerance (IGT) in urban women (28.91%) were lower than that in rural women (45.16%). Conclusion Hypercholesterolemia and hypertension are the most commonly seen cardiovascular risk factors accompanied in patients with hyperuricemia in urban areas, which has obviously higher prevalence than in rural areas. IGT is the most commonly seen cardiovascular risk factors accompanied in patients with hyperuricemia among rural women. But in aspects of hyperuricemia associated with impaired fasting glucose (IFG), hypertriglyceridemia, low high-density fetoprotein cholesterol, abdominal obesity and obesity, there is no difference between urban and rural areas.
Objective To explore the difference of cardiovascular risk factors and coronary artery lesion between Hui nationality and Han nationality patients with premature coronary heart disease. Methods A total of 316 patients with premature coronary heart disease were divided into two groups, including the Hui group (78 cases) and the Han group (238 cases). Eight risk factors for premature coronary heart disease (including age, gender, body mass index, familial heredity, diabetes, hypertension, dyslipidemia and smoking history) and coronary artery lesion characteristics were compared between the two groups. Results Compared with the Han group, the Hui group had a higher prevalence of smoking history and myocardial infarction, but a lower prevalence of angina (Plt;0.05). Type A disease was the major type in both Hui and Han groups. Compared with the Han group, the rate of type C were higher. Single-vessel lesion was the major lesion in both Hui and Han groups. The incidence of three-vessel lesion in the Han group was significantly lower than that in the Hui group. Gensini score in the Hui group was higher than that in the Han group, with a significant difference (Plt;0.05). Conclusion Hui patients with premature coronary artery disease are more than Han patients with premature coronary artery disease in proportions of smoking, diabetes, and the lesions of the left anterior descending artery, the right coronary artery disease, three-vessel disease rate, and C-type lesions. The coronary artery disease of the Hui group is more serious.
Objective To analyze and explore the risk factors of secondary tricuspid regurgitation (TR) after left-sided valve surgery (left cardiac valve replacement or valvuloplasty) using meta-analysis, so as to provide evidence for clinical diagnosis and treatment of secondary TR. Methods We electronically searched databases including PubMed, MEDLINE, CBM, CNKI, VIP, for literature on the risk factors of secondary TR after left-sided valve surgery from 1995 to 2012. According to the inclusion and exclusion criteria, we screened literature, extracted data, and assessed methodological quality. Then, meta-analysis was performed using RevMan 5.0 software. Results A total of 6 case-control studies were included, involving 437 patients and 2 102 controls. The results of meta-analysis showed that, the risk factors of progressive exacerbation of secondary TR after left-sided valve surgery included preoperative atrial fibrillation (OR=3.90, 95%CI 3.00 to 5.07; adjusted OR=3.04, 95%CI 2.21 to 4.16), age (MD=5.36, 95%CI 3.49 to 7.23), huge left atrium (OR=5.17, 95%CI 3.12 to 8.57; adjusted OR=1.91, 95%CI 1.49 to 2.44) or left atrium diameter (MD=4.85, 95%CI 3.18 to 6.53), degradation of left heart function (OR=2.97, 95%CI 1.73 to 5.08), rheumatic pathological change (OR=3.06, 95%CI 1.66 to 4.68), preoperative TR no less than 2+ (OR=3.52, 95%CI 1.26 to 9.89), and mitral valve replacement (MVR) (OR=2.35, 95%CI 1.68 to 3.30). Sex (OR=1.54, 95%CI 0.94 to 2.52) and preoperative pulmonary arterial hypertension (OR=1.28, 95%CI 0.77 to 2.12) were not associated with secondary TR after left-sided valve surgery. Conclusion The risk factors of progressive exacerbation of secondary TR after left-sided valve surgery include preoperative atrial fibrillation, age, huge left atrium or left atrium diameter, degradation of left heart function, rheumatic pathological change, preoperative TR no less than 2+, and MVR. Understanding these risk factors helps us to improve the long-time effectiveness of preventing and treating TR after left-sided valve surgery.
Objective To study the risk factors of lung cancer and provide scientific evidence for preventing and managing such disease. Methods?The database of MEDLINE, CNKI, and CBM were searched and literature domestically and internationally from January 1997 to January 2007 was collected. The RevMan 4.2 software was used for meta-analysis. Results A total of 40 studies involving 16 559 cases and 25 119 controls were included. The pooled OR values and population attributable risk percentage (PARP) for smoking, female passive smoking from husband, female passive smoking from colleague, chronic bronchitis, emphysema, pulmonary tuberculosis, family history of cancer, and family history of lung cancer were 5.75 (69.16%), 1.32 (14.52%), 1.21 (5.87%), 1.68 (7.45%), 2.70 (10.18%), 1.58 (1.91%), 1.24 (8.92%), and 1.59 (5.33%), respectively. Conclusion Risk factors related to the incidence of lung cancer are smoking, female passive smoking from husband and colleague, chronic bronchitis, emphysema, pulmonary tuberculosis, family history of cancer, family history of lung cancer and so on. Besides, the results of PARP indicate that smoking is the most important factor, followed by female passive smoking from husband, emphysema, family history of cancer sequentially, which suggest that environmental and genetic factors play important roles in the development of lung cancer.
Some statistical measures in evidence-based medicine, such as RRR, ARR and NNTwere introduced.
Objective To find out what risk factors are related to hypertension in China, and whether there are differences in studies from different years. Methods We retrieved all of the hypertension-related case-control studies which were published in CNKI and PubMed since 1990 and used meta-analysis to calculate the pooled OR and 95%CI. Then all the studies were divided into two groups according to whether they were published before 2000 or after, and results of different group were compared. Results Fourteen studies were included in which the relationship was assessed between hypertension and risk factors such as drinking, smoking, being overweight, and other relevant risk factors. The results of meta-analysis showed that hypertension had a relationship with being overweight, family history of hypertension, and high salt intake. The pooled OR and 95%CI were 3.26 (2.87, 3.70), 4.79 (2.81, 8.14), and 2.33 (1.55, 3.51), respectively. And the same results were obtained in subgroups analysis. The effect of smoking, irritable personality, and literacy between case group and control group showed no significant difference. Their pooled OR values (95%CI) of smoking, irritable personality, and literacy were 1.20 (0.84, 1.72), 2.73 (0.76, 9.82), and 1.22 (0.51, 2.95), respectively, and the same results were obtained in subgroups analysis. Although the effect of drinking between case group and control group showed a difference, its OR value (95%CI) was 1.61 (1.06, 2.45), and the subgroup analysis showed drinking was not related to hypertension. Conclusion Being overweighed, family history of hypertension, and high salt intake have relationship with hypertension, and these conclusions do not differ depending on the time of the studies conducted.