Purpose: Hypertension is associated with incident atrial fibrillation (AF) and AF-related complications. We investigated the associations between average systolic blood pressure (SBP) and outcomes in a nationwide cohort of Asian patients with non-valvular atrial fibrillation (NVAF). Patients and Methods: A multicenter nationwide registry of patients with NVAF in Thailand was conducted during 2014-2017. Clinical data, including blood pressure, were recorded at baseline and then every 6 months. Average SBP was calculated from the average of SBP from every visit. Cox regression models were used to calculate the rate of clinical outcomes of interest, ie ischemic stroke or transient ischemic attack (TIA), intracerebral hemorrhage (ICH), and all-cause death. Average SBP was categorized into three groups: <120, 120-140, and ≥140 mmHg. Results: A total of 3402 patients were included, and the mean age was 67.4±11.3 years. The mean (±SD) baseline and average SBPs were 128.5±18.5 and 128.0±13.4 mmHg, respectively. The mean follow-up duration was 25.7±10.6 months. The median rate of ischemic stroke/TIA, ICH, and all-cause death was 1.43 (1.17-1.74), 0.70 (0.52-0.92), and 3.77 (3.33-4.24) per 100 person-years, respectively. The rate of ischemic stroke/TIA and ICH was lowest in patients with average SBP <120 mmHg, and highest among those with average SBP ≥140 mmHg. The death rates were consistent with a J-curve effect, being lowest in patients with an average SBP 120-140 mmHg. Sustained SBP control is more important than the SBP from a single visit. Conclusion: Sustained control of SBP was significantly associated with a reduction in adverse clinical outcomes in patients with NVAF.
Objective: The prevalence of Metabolic Syndrome (MetS) in Thai police officers is unknown. This study aims to accurately determine the prevalence of MetS in this population compared to the Thai general population.
Materials and Methods: We conducted a population-based cross-sectional study of 107,933 Thai police officers during the 2012 annual Police Health Care Center check-up. Metabolic syndrome was defined using the harmonized criteria of six international expert groups.
Results: The prevalence of MetS among Thai police officers was 39.24%, with a higher prevalence among males compared to female police officers (40.9% male and 14.3% female). The prevalence was higher in male police officers (40.65% versus 23.80%, P<0.001), whereas it was lower in female officers (16.30% versus 31.59%, P<0.001) when compared to the general population. High blood pressure was the most common abnormal metabolic component in both genders (male 67.4 % female 33.3%). Whereas observation of low high-density lipoprotein cholesterol (HDL) in males (11.6%) and high fasting plasma glucose (FG) in females (16.3%). The adjusted odds ratio for MetS increased with age, wide pulse pressure, male gender, lower rank, alcohol drinking, and being in a non-metropolitan city.
Conclusion: The prevalence of MetS is higher among Thai police officers compared to the general Thai population. These findings underscore the need for effective preventive measures and continuous monitoring to reduce the risk and burden of cardiovascular diseases.
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