Aim We aimed to evaluate clinical characteristics and 1‐year outcomes in hospitalized patients with heart failure with preserved ejection fraction (HFpEF) from China. Factors associated with outcomes (hospitalization for HF [HHF] and cardiovascular [CV] death) were assessed. Method and results Data were from the China Cardiovascular Association (CCA) Database‐HF Center Registry. Between January 2017 and June 2021, 41 708 hospitalized HFpEF patients with 1‐year follow‐up from 481 CCA Database‐HF Center certified secondary and tertiary hospitals across overall 31 provinces of mainland China were included in this study. Of study participants (mean age 72.2 years, 49.3% female), 18.2% had HHF in prior 1 year and 55.8% had New York Heart Association class III/IV. Median left ventricular ejection fraction was 59%. Ischaemia (26.6%), infection (14.4%) and arrhythmia (10.5%) were the three most common precipitating factors for index HHF. Nearly 67.4% had ≥3 comorbidities. Hypertension (65.2%), coronary heart disease (60.3%) and atrial fibrillation (41.2%) were the three most common comorbidities. Device and medication therapy non‐compliance with current HF guideline recommendation was observed. The 1‐year rate of clinical outcomes was 16.4%, the 1‐year rate of HHF was 13.6% and CV death was 3.1%. Factors associated with clinical outcomes included HHF in prior 1 year, serum level of sodium <135 mmol/L and N‐terminal pro‐B‐type natriuretic peptide >1800 pg/ml. Conclusion Patients with HFpEF from China were characterized by high comorbid burden and high 1‐year risk of HHF and CV death. Immediate efforts are needed to improve HFpEF management in China.

Background Lipoprotein(a) is genetically determined and increasingly recognized as a major risk factor for arteriosclerotic cardiovascular disease. We examined whether plasma lipoprotein(a) concentrations were associated with intraplaque neovascularization (IPN) grade in patients with carotid stenosis and in terms of increasing plaque susceptibility to haemorrhage and rupture. Methods We included 85 patients diagnosed with carotid stenosis as confirmed using carotid ultrasound who were treated at Guangdong General Hospital. Baseline data, including demographics, comorbid conditions and carotid ultrasonography, were recorded. The IPN grade was determined using contrast-enhanced ultrasound through the movement of the microbubbles. Univariate and multivariate binary logistic regression analyses were used to evaluate the association between lipoprotein(a) and IPN grade, with stepwise adjustment for covariates including age, sex, comorbid conditions and statin therapy (model 1), total cholesterol, triglyceride, low-density lipoprotein cholesterol calculated by Friedwald's formula, high-density lipoprotein cholesterol, apolipoprotein A and apolipoprotein B (model 2), maximum plaque thickness and total carotid maximum plaque thickness, degree of carotid stenosis and internal carotid artery (ICA) occlusion (model 3). Results Lipoprotein(a) was a significant predictor of higher IPN grade in binary logistic regression before adjusting for other risk factors (odds ratio [OR] 1.238, 95% confidence interval [CI] (1.020, 1.503), P = 0.031). After adjusting for other risk factors, lipoprotein(a) still remained statistically significant in predicting IPN grade in all model. (Model 1: OR 1.333, 95% CI 1.074, 1.655, P = 0.009; Model 2: OR 1.321, 95% CI 1.059, 1.648, P = 0.014; Model 3: OR 1.305, 95% CI 1.045, 1.628, P = 0.019). Lp(a) ≥ 300 mg/L is also significantly related to IPN compare to < 300 mg/L (OR 2.828, 95% CI 1.055, 7.580, P = 0.039) as well as in model 1, while in model 2 and model 3 there are not significant difference. Conclusions Plasma lipoprotein(a) concentrations were found to be independently associated with higher IPN grade in patients with carotid stenosis. Lowering plasma lipoprotein(a) levels may result in plaque stabilization by avoiding IPN formation.

Background: Previous studies have demonstrated a J-shaped association of alcohol consumption with all-cause mortality and hypertension, but the majority of these studies focus on a single measurement of alcohol intake and were conducted in a Western population. Whether long-term trajectories of alcohol consumption are associated with all-cause mortality, hypertension, and a change in blood pressure remains to be elucidated. Methods: In the large, population-based China Health and Nutrition Survey cohort from between 1993 and 2015, group-based trajectory modeling was conducted to identify distinct alcohol-consumption trajectory classes. We investigated their association with all-cause mortality and hypertension using Cox regression and binary logistics regression models. A restricted cubic spline was performed to determine the nonlinear relationships of mean alcohol intake with mortality and hypertension. Multivariate-adjusted generalized linear mixed-effects models were conducted to assess the change in blood pressure among alcohol-consumption trajectory classes. Results: Among the 5298 participants, 48.4% were women and the mean age was 62.6 years. After 22 years of follow-up, 568 (10.7%) of the participants died and 1284 (24.2%) developed hypertension. Long-term light and moderate drinkers had a lower risk of death than the non-drinkers, and a restricted cubic spline showed a J-shaped relationship between mean alcohol intake and mortality. Although blood pressure increased slower in light and moderate drinkers, a reduced risk of hypertension was only observed in the former. The long-term heavy drinkers had the highest blood pressure and death rate. Conclusions: Light alcohol intake might be protective even in the long run, while heavy drinking reversed the beneficial effect. The causality of such a connection needs to be further investigated.