Background. Studies on bidirectional associations between hypertension and insomnia are inconclusive. The purpose of this meta-analysis was to systematically review and summarize the current evidence from epidemiological studies that evaluated this relationship. Materials and Methods. PubMed, Embase, China National Knowledge Infrastructure (CNKI), Wan Fang, and VIP databases were searched for studies published up to May 2021. Prospective cohort studies that reported the relationship between hypertension and insomnia in adults were included. Data were extracted or provided by the authors according to the prevalence rate, incidence rate, unadjusted or adjusted odds ratio (OR), and 95 confidence interval (CI). Heterogeneity was assessed by I2 statistics. ORs were pooled by using random-effects models. Results. A total of 23 prospective studies were identified. Twenty cohort studies recorded OR-adjusted value with the outcome for hypertension (OR=1.11, 95 CI: 1.071.16; I2=83.9), and three cohort studies reported OR-adjusted value with the outcome for insomnia (OR=1.20, 95CI: 1.081.32; I2=35.1). Subgroup analysis showed that early morning awakening and composite insomnia were significantly associated with hypertension. Conclusions. The result indicates a possible bidirectional association between hypertension and insomnia. Early identification and prevention of insomnia in hypertension patients are needed, and vice versa.

Background: The evidence on the association between the triglyceride glucose (TyG) index and the risk of death in the general population remains controversial. This study aims to investigate the relationship between the TyG index and all-cause and cardiovascular mortality in the general population, with a focus on sex differences. Methods: This prospective cohort study analyzed data from the National Health and Nutrition Examination Survey (1999–2002), comprising 7,851 US adults. The study employed multivariate Cox proportional hazards regression and two-segment Cox hazard regression models to evaluate the sex-specific differences in the relationship between the TyG index and all-cause and cardiovascular mortality. Results: After 11,623 person-years of follow-up, there were 539 deaths, with 10.56% due to all-cause mortality and 2.87% due to cardiovascular mortality. After adjusting for multiple variables, our study found a U-shaped association of the TyG index with all-cause and cardiovascular mortality, with inflection points at 9.36 and 9.52. A significant sex difference was observed in the association between the TyG index and mortality. Below the inflection point, the relationship between the TyG index and mortality was consistent in males and females. However, above the inflection point, only males exhibited a positive association between the TyG index and all-cause mortality (adjusted hazard risk [HR], 1.62, 95% confidence interval [CI], 1.24–2.12) and cardiovascular mortality (adjusted HR, 2.28, 95% CI, 1.32–3.92). Conclusions: Our study showed a U-shaped association between the TyG index and all-cause and cardiovascular mortality in the general population. Furthermore, sex differences were observed in the association between the TyG index and mortality once it exceeded a certain threshold.

Purpose: The links between obesity and dementia remain equivocal. Therefore, this study aimed to explore the association between weight-adjusted waist index (WWI), a new anthropometric indicator reflecting obesity, and dementia in the Chinese population with hypertension. Methods: A total of 10,289 participants with hypertension were enrolled in this cross-sectional study, a subset of the China H-type hypertension registry study. WWI was calculated as waist circumference (WC) divided by the square root of bodyweight. Chinese adapted MMSE (CAMSE) scale was performed to evaluate the cognitive function. According to educational background, different MMSE cut-off values were applied to define dementia: < 24 for participants with ≥ 7 years of education, < 20 for those with 1–6 years of education, and < 17 for illiterate participants. Multivariable linear regression and multivariable binary logistic regression analyses were conducted to assess the associations between WWI and MMSE and dementia, respectively. Results: Overall, the mean age was 63.7 ± 9.7 years, and 49.0% were males. Multivariate linear regression analyses showed that WWI was negatively associated with MMSE (β, -1.09; 95% confidence interval [CI]: -1.24, -0.94). Consistently, multivariable binary logistic regression analyses found a positive association between WWI and the risk of dementia (odds ratio [OR], 1.45; 95% CI: 1.35, 1.56). Compared with individuals in quartile 1 of WWI, the adjusted β and OR values of WWI for MMSE and dementia were -2.28 (95% CI: -2.62, -1.94) and 2.12 (95% CI: 1.81, 2.48), respectively. Results of smoothing curve fitting confirmed the linear association between WWI and MMSE and dementia. Subgroup analysis showed a stronger association between WWI and dementia in participants with hypertension with midday napping. Conclusion: WWI was independently and positively associated with dementia among the population with hypertension, especially in those with midday napping. The data suggests that WWI may serve as a simple and effective tool for the assessment of the risk of dementia in clinical practice.

Background: This study systematically reviewed injury death and causes in the elderly population in China from 2000 to 2020, to prevent or reduce the occurrence of injuries and death. Methods: The CNKI, VIP, Wan Fang, MEDLINE, Embase, SinoMed, and Web of Science databases were searched to collect epidemiological characteristics of injury death among elderly over 60 years old in China from January 2000 to December 2020. Random effects meta-analysis was performed to pool injury mortality rate and identify publication bias, with study quality assessed using the AHRQ risk of bias tool. Results: (1) A total of 41 studies with 187 488 subjects were included, covering 125 million elderly. The pooled injury mortality rate was 135.58/10⁵ [95%CI: (113.36 to 162.14)/10⁵], ranking second in the total death cause of the elderly. (2)Subgroup analysis showed that male injury death (146.00/10⁵) was significantly higher than that of females (127.90/10⁵), and overall injury mortality increased exponentially with age (R² = 0.957), especially in those over 80 years old; the spatial distribution shows that the injury death rate in the central region is higher than that in the east and west and that in the countryside is higher than that in the city; the distribution of death time shows that after entering an aging society (2000–2020) is significantly higher than before (1990–2000). (3) There are more than 12 types of injury death, and the top three are falling, traffic accidents, and suicide. Conclusions: China's elderly injury death rate is at a high level in the world, with more males than females, especially after the age of 80. There are regional differences. The main types of injury death are falling, traffic, and suicide. During the 14th Five-Year Plan period, for accidental injuries and death, a rectification list for aging and barrier-free environments was issued. PROSPERO Registration: The systematic review was registered in PROSPERO under protocol number CRD42022359992.

There is a paucity of prior research on residual cholesterol (RC) and hyperuricemia, and it remains unclear whether body mass index (BMI) functions as a mediating factor between them or intensifies lipid metabolic dysregulation, thereby elevating the risk of hyperuricemia. This study aims to investigate whether BMI mediates the association between RC and hyperuricemia, as well as the interaction or joint effect of BMI and RC on hyperuricemia. This is a cross-sectional study, involving a total of 14,218 hypertensive patients. Exposure factors include RC and BMI. The outcome was Hyperuricemia, defined as serum uric acid (SUA) ≥ 420 µmol/L. Multivariable logistic regression models and causal mediation analysis were used to examine the association between RC and BMI and the prevalence of hyperuricemia. A total of 14,218 hypertensive patients were enrolled in this cross-sectional study, comprising 6,713 (47.2%) males, with a mean age of 63.8 (9.36) years. The prevalence of diabetes mellitus was found to be 10.4% (1,473), while hyperuricemia accounted for approximately 44.4% (6,319). The results show that there is a linear positive correlation between RC and hyperuricemia (P for trend < 0.01). RC and BMI only had significant additive interaction on hyperuricemia, but there was no multiplicative interaction (Additive: RERI = 0.45, 95%CI: 0.13–0.78; Multiplicative, OR = 1.09, 95% CI 0.92–1.3, P = 0.308). There are direct and indirect effects between RC and hyperuricemia [estimate (95% CI): DE = 0.063 (0.048, 0.070), IE = 0.005 (0.003, 0.001)]. In the aforementioned causal mediation analysis, among the hyperuricemia caused by RC, BMI mediates 7.1%. The intermediary role of BMI and its interaction with RC play a pivotal role in augmenting the prevalence of hyperuricemia. Registered prospectively in the Chinese Clinical Trial Registry (ChiCTR1800017274) on July 20, 2018. Access at https://www.chictr.org.cn/showproj.html?proj=28262 .