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Background Metabolic syndrome (MetS) is characterized by a cluster of signs of metabolic disturbance and has caused a huge burden on the health system. The study aims to explore the prevalence and characteristics of MetS defined by different criteria in the Chinese population. Methods Using the data of the China Hypertension Survey (CHS), a nationally representative cross-sectional study from October 2012 to December 2015, a total of 28,717 participants aged 35 years and above were included in the analysis. The MetS definitions of the International Diabetes Federation (IDF), the updated US National Cholesterol Education Program Adult Treatment Panel III (the revised ATP III), and the Joint Committee for Developing Chinese Guidelines (JCDCG) on Prevention and Treatment of Dyslipidemia in Adults were used. Multivariable logistic regression was used to identify factors associated with MetS. Results The prevalence of MetS diagnosed according to the definitions of IDF, the revised ATP III, and JCCDS was 26.4%, 32.3%, and 21.5%, respectively. The MetS prevalence in men was lower than in women by IDF definition (22.2% vs. 30.3%) and by the revised ATP III definition (29.2% vs. 35.4%), but the opposite was true by JCDCG (24.4%vs 18.5%) definition. The consistency between the three definitions for men and the revised ATP III definition and IDF definition for women was relatively good, with kappa values ranging from 0.77 to 0.89, but the consistency between the JCDCG definition and IDF definition (kappa = 0.58) and revised ATP III definition (kappa = 0.58) was poor. Multivariable logistic regression showed that although the impact and correlation intensity varied with gender and definition, area, age, education, smoking, alcohol use, and family history of cardiovascular disease were factors related to MetS. Conclusions The prevalence and characteristics of the MetS vary with the definition used in the Chinese population. The three MetS definitions are more consistent in men but relatively poor in women. On the other hand, even if estimated according to the definition of the lowest prevalence, MetS is common in China.

Hypertension and prehypertension may have important roles in the etiology of cardiovascular disease. However, the risk factors of hypertension and prehypertension have not been thoroughly elucidated to date. This study intended to explore the relative effects between reproductive history and the prevalence of hypertension and prehypertension. A population-based cross-sectional survey of postmenopausal women (n=6252), aged 41-93 years, was conducted from August 2013 to August 2015. All subjects, selected by the multistage random sampling method in Henan province, were categorized as normotension, prehypertension and hypertension according to blood pressure (BP) levels. Ordinal logistic regression models were used to estimate the risks of prehypertension and hypertension with three categories of BP as dependent variables. Hypertension was associated with a positive history of induced abortion (adjusted odds ratio (OR)=1.190, 95% confidence interval (CI): 1.020, 1.388), but there was no association between hypertension and a positive history of spontaneous abortion (adjusted OR=1.126, 95% CI: 0.973, 1.303) after adjusting for age, alcohol consumption, education status, smoking, body mass index, physical activity and occupation. Compared with women with one or no children, those with two or three children were at a lower risk of hypertension (adjusted OR=0.605, 95% CI: 0.434, 0.845). In addition, individuals with an age of menopause between 46 and 51 years may have a decreased risk of both prehypertension and hypertension, especially in terms of systolic BP. In conclusion, a positive history of induced abortion may be a predictive risk factor for hypertension and prehypertension. However, a menopausal age of 46-51 years or having two children may be protective factors against hypertension and prehypertension.

Background To compare the efficiency of bioelectrical indices (visceral fat index [VFI], percentage body fat [PBF]) and anthropometric indices (body mass index, waist circumference, waist‐to‐height ratio, a body shape index ) in the relation to prehypertension (120‐139/80‐89 mm Hg) among the Chinese population. Methods Using stratified multistage random sampling method, a general population‐based sample of 11 175 adults in Henan province were selected from 2013 to 2015. The individuals were divided into three categories by blood pressure levels: normotension (<120 and 80 mm Hg), stage 1 prehypertension (120‐129/80‐84 mm Hg) and stage 2 prehypertension (130‐139/85‐89 mm Hg). Results VFI and PBF tended to increase with age in men and women. However, for each age‐specific group, men tended to have higher VFI than women (all P < 0.01) and women tended to have greater PBF (all P < 0.0001). The odds ratios (OR) and area under the receiver operating characteristic curves for prehypertension associated with adiposity indices declined with age. VFI and PBF showed higher standardized adjusted ORs for prehypertension in young (~40 years) men (VFI: 2.02‐3.05; PBF: 1.82‐2.80) and young women (VFI: 1.90‐2.58; PBF:1.70‐2.29). Moreover, based on Youden's index, VFI and PBF exhibited the superiority for identifying prehypertension in men (0.20‐0.32) and women (0.31‐0.39), respectively. Conclusion In summary, there was stronger association of VFI and PBF with prehypertension in men than in women, respectively, especially for young adults.

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