Our findings suggest that cholesterol-overloaded HDL particles are independently associated with the progression of carotid atherosclerosis. This may explain why in recent trials raising HDL cholesterol was not beneficial. This study strongly suggests that the combination of cholesterol content and particle number determines the antiatherogenic function of HDLs, rather than either parameter alone.

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ObjectivesTo evaluate the effects of a low-sodium and high-potassium salt-substitute on lowering blood pressure (BP) among Tibetans living at high altitude (4300 meters).MethodThe study was a patient-blinded randomized controlled trial conducted between February and May 2009 in Dangxiong County, Tibetan Autonomous Region, China. A total of 282 Tibetans aged 40 or older with known hypertension (systolic BP≥140 mmHg) were recruited and randomized to intervention (salt-substitute, 65% sodium chloride, 25% potassium chloride and 10% magnesium sulfate) or control (100% sodium chloride) in a 1: 1 allocation ratio with three months’ supply. Primary outcome was defined as the change in BP levels measured from baseline to followed-up with an automated sphygmomanometer. Per protocol (PP) and intention to treat (ITT) analyses were conducted.ResultsAfter the three months’ intervention period, the net reduction in SBP/DBP in the intervention group in comparison to the control group was −8.2/−3.4 mmHg (all p<0.05) in PP analysis, after adjusting for baseline BP and other variables. ITT analysis showed the net reduction in SBP/DBP at −7.6/−3.5 mmHg with multiple imputations (all p<0.05). Furthermore, the whole distribution of blood pressure showed an overall decline in SBP/DBP and the proportion of patients with BP under control (SBP/DBP<140 mmHg) was significantly higher in salt-substitute group in comparison to the regular salt group (19.2% vs. 8.8%, p = 0.027).ConclusionLow sodium high potassium salt-substitute is effective in lowering both systolic and diastolic blood pressure and offers a simple, low-cost approach for hypertension control among Tibetans in China.Trial RegistrationClinicalTrials.gov NCT01429246

During follow-up years from 1992 to 2010, 1,280 participants developed acute CVD events and 1,401 died. The lifetime CVD risk, up to age 80 for men and women at age 35, were 24.4% and 20.2% respectively. A very low lifetime risk was found in individuals with an optimal profile of risk factors which modified the effect of aging. By contrast, with two or more high risk factors the lifetime risk up to age 80 reached 51.1% for men and 38.6% for women at age 35. The integrated status of major CVD risk factors can determine lifetime cardiovascular health and CVD risk in Chinese. Early prevention with a goal of all risk factors at optimal levels should become the priority of CVD prevention in the future.

Autoimmune diseases are often treated by glucocorticoids and immunosuppressive drugs that could increase the risk for infection, which in turn deteriorate disease and cause mortality. Low-dose IL-2 (Ld-IL2) therapy emerges as a new treatment for a wide range of autoimmune diseases. To examine its influence on infection, we retrospectively studied 665 patients with systemic lupus erythematosus (SLE) including about one third receiving Ld-IL2 therapy, where Ld-IL2 therapy was found beneficial in reducing the incidence of infections. In line with this clinical observation, Ld-IL2 treatment accelerated viral clearance in mice infected with influenza A virus or lymphocytic choriomeningitis virus (LCMV). Noticeably, despite enhancing anti-viral immunity in LCMV infection, Ld-IL2 treatment exacerbated CD8+ T cell-mediated immunopathology. In summary, Ld-IL2 therapy reduced the risk of infections in SLE patients and enhanced the control of viral infection, but caution should be taken to avoid the potential risk of CD8+ T cell-mediated immunopathology in severe infections.

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Background: The longitudinal association between persistent moderate to severe pain and subsequent long-term cognitive decline remains inconclusive. Methods: Study population came from the English Longitudinal Study of Ageing, an ongoing prospective and nationally representative cohort of community-dwelling adults aged ≥50 years in England. At waves 1 (2002/2003) and 2 (2004/2005) of the study, pain severity was measured based on pain intensity scores ranged from 0 to 10. We defined moderate to severe pain as pain intensity scores ≥5 points. Persistent moderate to severe pain was defined as participants reported moderate to severe pain at both waves 1 and 2. Standardized global cognitive Z scores derived from verbal memory, temporal orientation and semantic fluency were used as the primary outcome. Results: A total of 6,869 individuals (3,896 women; mean age: 63.9 ± 9.5 years) who have accepted twice measurements of pain at waves 1 and 2 (baseline), and at least one reassessment of cognitive function at waves 3 (2006/2007) to 8 (2016/2017), were included in this study. Each 5-point increase in the sum of pain intensity scores was associated with a faster rate of -0.009 (95% CI: -0.013 to -0.006, p < .001) in global cognitive Z scores. Compared with no pain group, persistent moderate to severe pain group was associated with a significantly faster decline rate of -0.031 SD/year (95% CI: -0.043 to -0.018), in global cognitive Z scores. The relationships of persistent moderate to severe pain with verbal memory, temporal orientation and semantic fluency were similar. Conclusion: Cognitive function should be monitored in individuals with persistent moderate to severe pain.