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The increases in blood pressure and cardio-cerebrovascular event morbidity were attenuated in months when central heating was fully provided. selleck Participants with hypertension have higher risks of cardio-cerebrovascular disease (hazard ratio 1.347; 95% CI 1.281--1.415), CVD (hazard ratio 1.347; 95% CI 1.282--1.416), MACE (hazard ratio 1.670; 95% CI 1.560--1.788) and stroke (hazard ratio 1.683; 95% CI 1.571--1.803). Mediation analysis demonstrated that the association between outdoor temperature and cardio-cerebrovascular events risk was potentially mediated by blood pressure. CONCLUSION Temperature-driven blood pressure potentially mediates the association between outdoor temperature and cardio-cerebrovascular events risk. Indoor heating in winter is probably beneficial to cardio-cerebrovascular disease prevention by inhibition of blood pressure increase.BACKGROUND The method of evaluating office blood pressure (OBP) varies greatly among different guidelines. OBJECTIVES We performed a cohort study to compare the association of various directly transferred attended automated OBP (AOBP) estimations with all-cause and cardiovascular mortalities. METHODS Overall, 475 181 sets of OBPs from 35 622 participants aged 35 years or older were extracted from the electronic health record of the Xinzhuang town hospital in the Minhang District, Shanghai, China. Each set of OBPs contained three consecutive AOBPs that were transferred directly to the electronic health record. The mean of three OBPs, mean of the last two OBPs, and alternative average OBP were calculated. RESULTS The difference between the first and average OBPs changed along with the calendar month, and it was highest in December (5.3/2.1 mmHg) and lowest in July (3.8/2.0 mmHg). The subjects older than 80 years of age displayed the largest discrepancy in the blood pressure control rate according to the first OBP or average OBP (12.1%). During the 3.9-year follow-up, 1055 deaths occurred. The alternative average SBP was associated with both all-cause [hazard ratio 1.07, 95% confidence interval (CI) 1.04-1.11] and cardiovascular (hazard ratio 1.17, 95% CI 1.11-1.23) mortalities. The uncontrolled alternative average OBP remained significantly associated with an increasing risk of all-cause (hazard ratio 1.24, 95% CI 1.09-1.40) and cardiovascular (hazard ratio 1.53, 95% CI 1.25-1.86) mortality, but not the average of the last two or mean of three readings. CONCLUSION We observed an obvious discrepancy in the OBP level and OBP control rate according to different AOBP estimations. The alternative average OBP seemed to be more powerful in predicting both all-cause and cardiovascular mortalities than the average of the last two or mean of three readings.BACKGROUND Arterial stiffness influences the contour of the digital pressure pulse wave. METHOD Here, we investigated whether the digital pulse propagation index (DPPI), based on the digital pressure pulse wave, DPPI is associated with cardiovascular events, heart failure, and mortality in a large population-based cohort. Between 2001 and 2003, DPPI was measured with a PortaPres noninvasive hemodynamic monitoring device (FinaPres Medical Systems, Amsterdam, The Netherlands) in participants of the Prevention of Renal and Vascular End-stage Disease study, a community-based cohort. We assessed the main determinants of the DPPI and investigated associations of DPPI with cardiovascular events and mortality. RESULTS The study included 5474 individuals. Mean age was 52.3 ± 11.8 years and 50.5% was male. Median baseline DPPI was 5.81 m/s (interquartile range 5.47-6.20). Higher age, mean arterial blood pressure, body height, heart rate, current smoking, and lower HDL cholesterol levels and waist circumference were independent determinants of the DPPI (r = 0.43). After adjustment for heart rate, highlogDPPI was associated with all-cause mortality [hazard ratio 1.67, 95% confidence interval (1.55-1.81) per SD; P  less then  0.001], cardiovascular mortality [hazard ratio 1.95 (1.72-2.22); P  less then  0.001], and incident heart failure with reduced ejection fraction [hazard ratio 1.81 (1.60-2.06); P  less then  0.001]. These associations remained independent upon further adjustment for confounders. Optimal cutoff values for DPPI ranged between 6.1 and 6.3 m/s for all endpoints. After multivariable adjustment, DPPI was no longer associated with coronary artery disease events or cerebrovascular events. CONCLUSION The DPPI is associated with an increased risk of development of new onset heart failure with reduced ejection fraction and all-cause and cardiovascular mortality, but not with coronary artery events or cerebrovascular events.BACKGROUND Smokers may smoke cigarettes during ambulatory or home blood pressure (BP) monitoring but not clinic measurement. We investigated the prevalence of masked hypertension in relation to cigarette smoking in Chinese outpatients enrolled in a multicenter registry. METHODS Our study included 1646 men [494 (30.0%) current smokers]. We defined masked hypertension as a normal clinic SBP/DBP ( less then 140/90 mmHg) and elevated daytime (≥135/85 mmHg) or night-time (≥120/70 mmHg) ambulatory or morning or evening home SBP/DBP (≥135/85 mmHg). RESULTS In all men, multiple logistic regression showed that current cigarette smoking was significantly associated with daytime [prevalence 18.7%, odds ratio (OR) 1.69, 95% confidence interval 1.27-2.25, P = 0.0003] but not night-time (prevalence 27.1%, P = 0.32) ambulatory masked hypertension and associated with evening (prevalence 14.6%, OR 1.81, confidence interval 1.33-2.47, P = 0.0002) but not morning (prevalence 17.6%, P = 0.29) home masked hypertension. The associations were more pronounced for heavy smoking (≥20 cigarettes/day) relative to never smoking for both masked daytime ambulatory (OR 1.97, P = 0.001) and evening home hypertension (OR 2.40, P  less then  0.0001) or in patients over 55 years of age (P for interaction in relation to daytime ambulatory masked hypertension = 0.005). In men with clinic normotension (n = 742), the associations were also significant (P  less then  0.01), particularly in those with a normal to high-normal clinic BP (n = 619, P  less then  0.04). CONCLUSION Cigarette smoking was associated with increased odds of masked daytime ambulatory and evening home hypertension, especially in heavy smoking or older men.