- [Show abstract] [Hide abstract] ABSTRACT: OSA is a common condition associated with cardiovascular (CV) morbidity. It remains underdiagnosed globally in part due to the limited availability and technical requirements of polysomnography (PSG). The aim of this study was to test the accuracy of two simple methods for diagnosing OSA. Consecutive subjects identified from a community register with high CV risk were invited to complete the Berlin Sleep Questionnaire and undergo simultaneous, home, overnight PSG and ApneaLink device oximetry and nasal pressure recordings. The relative accuracies of the Berlin Questionnaire, oximetry and nasal pressure results in diagnosing PSG-defined moderate-severe OSA were assessed. Of 257 eligible high CV risk subjects enrolled, 190 completed sleep studies and 143 subjects' studies were of sufficient quality to include in final analyses. Moderate-severe OSA was confirmed in 43% of subjects. The Berlin Questionnaire had low overall diagnostic accuracy in this population. However, ApneaLink recordings of oximetry and nasal pressure areas had high diagnostic utility with areas under the receiver operating characteristic curves of 0.933 and 0.933, respectively. At optimal diagnostic thresholds, oximetry and nasal pressure measurements had similar sensitivity (84% vs 86%) and specificity (84% vs 85%). Technical failure was lower for oximetry than nasal pressure (5.8% vs 18.9% of tests). In patients with high CV risk overnight single-channel oximetry and nasal pressure measurements may provide high diagnostic accuracy and offer an accessible alternative to full PSG.
- [Show abstract] [Hide abstract] ABSTRACT: Objective There is little population-based data on the prevalence and the environmental or genetic determinants of left ventricular hypertrophy (LVH) in China. The purpose of this paper is to study LVH in relation to systolic blood pressure and the angiotensin converting enzyme (ACE) insertion/deletion(I/D) polymorphism in Chinese. Methods We recorded 12-lead ECG (CardioSoft, v4.2) in 1365 residents in the Jingning County, Zhejiang Province, China. LVH was defined according to the gender-specific Sokolow-Lyon and Cornell product ECG criteria. Results Regardless of whether the Sokolow-Lyon or Cornell product ECG criteria was used, the prevalence of LVH (20.7% and 4.8%, respectively) significantly (P<0.0001) increased with male gender (odds ratio [OR] 2.33 and 7.15) and systolic blood pressure (per 10 mm Hg increase, OR 1.46 and 1.33). If the Sokolow-Lyon criteria was used, the prevalence of LVH was also influenced by alcohol intake (OR 1.44, P=0.03) and body mass index (OR 0.83, P=0.0005). The association between the Sokolow-Lyon voltage amplitude and the ACE I/D polymorphism was dependent on antihypertensive therapy (P=0.01). In 1262 untreated subjects, but not 103 patients on antihypertensive medication, the ACE DD compared with II subjects had significantly higher Sokolow-Lyon voltage amplitudes (29.8±0.6 vs. 28.0±0.5 mV, P=0.02) and higher risk of LVH (OR 1.74, 95% CI: 1.12-2.69, P=0.01). Conclusion LVH is prevalent in Chinese, and is associated with systolic blood pressure and the ACE D allele. The genetic association might be modulated by antihypertensive therapy(J Geriatr Cardiol 2009; 6:131-136) .
- [Show abstract] [Hide abstract] ABSTRACT: The purpose of this study was to investigate the elasticity of large and small arteries in relation to the components of the metabolic syndrome in a Chinese population. Arterial elasticity indices were derived from pulse wave analysis based on a modified Windkessel model in 688 subjects, aged 33-65 years, who volunteered to participate in our study. The study population included 420 (61.0%) men and 433 (62.9%) hypertensive patients, of whom 197 (28.6%) took antihypertensive medication. Overall, the presence of the metabolic syndrome was 20.5%. In univariate analysis, both large artery elasticity index (C1) and small artery elasticity index (C2) were higher in men than in women (P < or = 0.008) and were inversely (P < or = 0.05) correlated with age, systolic and diastolic blood pressure (BP), pulse pressure, pulse rate, and plasma glucose concentration, and positively (P < 0.0001) correlated with body height and body weight. In men, smokers, compared with nonsmokers, had significantly lower C2 (P = 0.007), but they had similar C1 (P = 0.33). In adjusted analysis, patients with the metabolic syndrome, compared with those without, had significantly (P < 0.01) lower C1 and C2. In continuous adjusted analysis, both C1 and C2 were significantly (P < 0.0001) associated with systolic and diastolic BP, whereas in addition, C1 was also significantly associated with plasma glucose concentration (P = 0.007), and C2 with serum high-density lipoprotein (HDL) cholesterol (P = 0.02). Conclusions: The metabolic syndrome is indeed a risk factor for reduced arterial elasticity.