ObjectivesTo systematically review the relationship between cadmium exposure and the risk of hypertension.MethodsPubMed, EMbase, The Cochrane Library, CBM, WanFang Data, VIP and CNKI databases were searched online to collect studies of cadmium exposure and hypertension from inception to March 2018. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies. Meta-analysis was then performed by Stata 12.0 software.ResultsA total of 9 studies were included, of which 19 841 cases were patients of hypertension, and 27 578 cases were in the control group. The results of meta-analysis showed that blood cadmium was associated with risk of hypertension (OR=1.23, 95%CI 1.17 to 1.30, P<0.001). However, no significant association was found between urinary cadmium and the risk of hypertension (OR=0.77, 95%CI 0.55 to 1.07,P=0.61). The results of subgroup analysis showed non-smokers (OR=1.19, 95%CI 1.09 to 1.31, P<0.001), males (OR=1.19, 95%CI 1.11 to 1.28,P<0.001), females (OR=1.28, 95%CI 1.18 to 1.40,P<0.001), yellow race (OR=1.26, 95%CI 1.19 to 1.34,P<0.001), and the literatures published after 2010 (OR=1.24, 95%CI 1.17 to 1.31,P<0.001) were associated with risk of hypertension in blood cadmium. The current smokers (OR=0.72, 95%CI 0.56 to 0.93,P=0.013), yellow race (OR=0.65, 95%CI 0.50 to 0.83, P=0.001), and the literatures published before 2010(OR=0.61, 95%CI 0.50 to 0.75, P<0.001) were associated with risk of hypertension in urinary cadmium.ConclusionsBlood cadmium is associated with risk of hypertension and high level of blood cadmium is a risk factor for hypertension. The levels of blood cadmium of non-smokers, males, females, yellow race are associated with risk of hypertension in blood cadmium. Urinary cadmium was not significantly associated with the risk of hypertension. The above conclusions are required to be verified by more high quality studies.
Objective To identify clinical risk factors for early major adverse cardiovascular events (MACEs) following surgical correction of supravalvar aortic stenosis (SVAS). Methods Patients who underwent SVAS surgical correction between 2002 and 2019 in Beijing and Yunnan Fuwai Cardiovascular Hospitals were included. The patients were divided into a MACEs group and a non-MACEs group based on whether MACEs concurring during postoperative hospitalization or within 30 days following surgical correction for SVAS. Their preoperative, intraoperative, and postoperative clinical data were collected for multivariate logistic regression. Results This study included 302 patients. There were 199 males and 103 females, with a median age of 63.0 (29.2, 131.2) months. The incidence of early postoperative MACEs was 7.0% (21/302). The multivariate logistic regression model identified independent risk factors for early postoperative MACEs, including ICU duration (OR=1.01, 95%CI 1.00-1.01, P=0.032), intraoperative cardiopulmonary bypass (CPB) time (OR=1.02, 95%CI 1.01-1.04, P=0.014), aortic annulus diameter (OR=0.65, 95%CI 0.43-0.97, P=0.035), aortic sinus inner diameter (OR=0.75, 95%CI 0.57-0.98, P=0.037), and diameter of the stenosis (OR=0.56, 95%CI 0.35-0.90, P=0.016). Conclusion The independent risk factors for early postoperative MACEs include ICU duration, intraoperative CPB time, aortic annulus diameter, aortic sinus inner diameter, and diameter of the stenosis. Early identification of high-risk populations for MACEs is beneficial for the development of clinical treatment strategies.