Under a state of sustained relatively low inflammation, it is uncertain if cumulative high-sensitivity C-reactive protein (cumhs-CRP) can predict all-cause mortality, and its impact on it through cardiometabolic factors is also unknown.

This is a longitudinal national cohort study using CHARLS data. Specifically, we only included participants aged 45 and older with hs-CRP levels below 10mg/L in both 2012 and 2015. Cumhs-CRP derived through time-weighted averaging was employed as the key exposure. Death events were recorded as the primary outcome. All-cause mortality is defined as death occurring at any point from 2015 to 2018. Variables selection and interpretation were conducted by Boruta and Shapley Additive Explanations (SHAP). Further mediation analysis explored the possibility of cardiometabolic factors serving as mediators. Additional Mendelian randomization was conducted to demonstrate the robustness of the association.

5052 Chinese adults over 45 years of age with hs-CRP levels below 10mg/L over time were included. Boruta identified 16 possible variables, with SHAP confirming the importance of cumhs-CRP. Multivariate analysis showed a significant association between cumhs-CRP and mortality (OR 1.05, 95 % CI 1.02 1.09, p = 0.003), and a linear relationship was observed (p-nonlinear = 0.184). Importantly, cumhs-CRP indirectly may affect the risk of death through systolic and diastolic blood pressure, fasting glucose, and uric acid, with proportions of 17.4 %, 8.2 %, 5.2 %, and 17 %, respectively.

Cumhs-CRP levels are associated with increased mortality risk, even in individuals with lower baseline levels. Regular monitoring of hs-CRP levels may aid in identifying individuals with elevated mortality risk.

Both insufficient physical activity (PA) and excess body weight are important risk factors for cardiovascular disease (CVD), and PA is closely related to body weight. However, it remains unclear whether PA modifies or mediates the association of body mass index (BMI) with CVD.

We conducted a cross-sectional study of 35,406 adults participating in the National Health and Nutrition Examination Survey. The mediation and interaction effects of PA were assessed using a four-way decomposition approach. An additional two-step Mendelian randomization analysis was performed to verify the potential causal mediation effect.

A strong association was observed between PA and lower odds of CVD after adjusting for all confounders (odds ratio, 0.84; 95% confidence interval, 0.74-0.95). Increased BMI was associated with higher odds of CVD (odds ratio, 1.04; 95% confidence interval, 1.03-1.04). PA showed interaction and mediation effects on the association of BMI with CVD. The overall proportion attributable to interaction was -37.5%, whereas the overall proportion attributable to mediation was 22.2%. Mendelian randomization analysis further confirmed that PA causally mediated the pathway from BMI to CVD.

PA modified the association of BMI with CVD, suggesting that sufficient PA is needed to lower the impact of high BMI on CVD risk. Moreover, we found that PA served as a causal influence on the association of BMI with CVD, indicating that higher BMI led to a lower level of PA, which in turn increased the risk of CVD.

Although existing literature highlights obesity as a significant predictor for coronary artery disease (CAD), the impact of BMI on hospital outcomes among CAD patients remains unclear.

We extracted data from the National Inpatient Sample database for adult patients with CAD from 2018 to 2020. The study cohort was stratified into six BMI categories: underweight, normal weight, overweight, class I obesity, class II obesity, and class III obesity. Using multivariable logistic and linear regression, we assessed the impact of BMI on in-hospital mortality, length of stay (LOS), and inflation-adjusted total charges.

We identified a total of 3 693 570 hospitalizations (mean age: 69 ± 12 years). Underweight individuals had the highest in-hospital mortality rate (6.8%), followed by normal weight (5.2%), overweight (3.2%), class III obese (2.5%), class I obese (1.9%), and class II obese (1.8%) individuals. After adjusting for covariates, underweight patients had higher odds of in-hospital mortality compared to normal-weight individuals [odds ratio (OR), 1.38; 95% confidence interval (CI), 1.31-1.45; P < 0.001], while overweight or obese individuals had lower odds: overweight (OR, 0.75; 95% CI, 0.70-0.79; P < 0.001), obese class I: (OR, 0.54; 95% CI, 0.51-0.57; P < 0.001), obese class II: (OR, 0.56; 95% CI, 0.53-0.59; P < 0.001), obese class III: (OR, 0.78; 95% CI, 0.74-0.82; P < 0.001). Normal weight and underweight patients had the longest median LOS [5 days (3.0-9.0)]. Overweight patients incurred the highest total charges [$53 730 (28 587-105 184)].

Underweight patients experienced higher, while overweight and obese patients experienced lower in-hospital mortality than normal-weight patients, suggesting a protective effect of higher BMI against mortality in CAD.

This paper provides a comprehensive overview of cardiopulmonary events associated with the occurrence, development, and treatment of tumours, serving as a valuable resource for the clinical management of cancer patients. It explores the complex relationship between the heart and lungs, collectively discussing the cardiopulmonary implications linked to tumours. Common risk factors that connect tumours with cardiac and pulmonary conditions are delineated, highlighting their direct and indirect correlations. Additionally, the paper addresses the cardiopulmonary disorders and symptoms resulting from tumour progression and their subsequent manifestations. The final section focuses on the cardiopulmonary repercussions of various tumour treatments, including chemotherapy, targeted therapy, radiation therapy, and immunotherapy, elaborating on their associated cardiopulmonary effects. Effective management of aggressive proliferative diseases, such as tumours, requires selecting appropriate treatment modalities that balance therapeutic efficacy with vigilant monitoring of cardiopulmonary function and thorough assessment of treatment outcomes and related side effects.

Morbidity and mortality caused by cardiovascular and cerebrovascular diseases are increasing worldwide. This study aimed to analyze the factors affecting the risk assessment of cardiovascular and cerebrovascular diseases before COVID-19 and during the COVID-19 transition phase.

Among 132,305 individuals (mean age: 50.11 ± 12.21 years), 65.84% were women. Regression analysis indicated that age, overweight, smoking, diabetes, hypertension, and high cholesterol significantly increased 10-year cardiovascular disease risk (p < 0.001). No significant trend in risk levels was found between pre-COVID-19 and COVID-19 transition periods (p = 0.063). Given the impact of these factors, national-level planning, appropriate policies, and intersectoral coordination are essential to reduce cardiovascular and cerebrovascular risk.

Although visceral adiposity increases cardiovascular risk in the general population, the obesity paradox has been reported in critically ill patients. However, evidence for its prognostic role in patients undergoing coronary artery bypass grafting (CABG) is limited. This study evaluated the prognostic implications of visceral adiposity in patients who underwent CABG using computed tomography-based measurement of visceral fat.

A total of 2810 patients who underwent CABG from 2007 to 2017 were analyzed. The study population was classified into 3 groups according to visceral fat area index (VFAI) tertiles. VFAI was calculated as visceral fat area (cm2)/height2 (m2) at the L3 level. The primary outcome was all-cause mortality during follow-up.

Patients in the low VFAI group (lowest tertile) were younger and had a lower body mass index and less subcutaneous fat than those in the high VFAI group (highest tertile). During a median 8.7-year follow-up, VFAI was significantly associated with the risk of mortality in restricted cubic spline curve analysis (HR, 0.94 per 10 increases; 95%CI, 0.91-0.97; P<.001). Patients in the low VFAI group had a higher incidence of long-term mortality than those in the intermediate and high VFAI groups (T1 36.1%, T2 27.2%, and T3 29.1%; T1 vs T2; adjusted HR, 1.36; 95%CI, 1.15-1.61; P<.001; T1 vs T3; adjusted HR, 1.37; 95%CI, 1.16-1.62; P<.001). Similar results were obtained after inverse probability treatment-weighting analysis.

Low visceral adiposity was associated with an increased risk of long-term mortality in patients who underwent CABG.

Critical limb threatening ischemia (CLTI) is associated with a one-year mortality rate of up to 25% making prompt diagnosis essentially. This study aims to investigate if cardiac biomarkers may serve as an effective tool for risk stratification in patients with lower extremity artery disease (LEAD). For this cross-sectional retrospective analysis, 21712 patients with LEAD were screened for eligibility from 2004 to 2020. Out of these patients, 367 were included and subdivided into those with CLTI and those without CLTI. Cardiac biomarkers, including N-terminal prohormone of brain natriuretic peptide (NT-proBNP), troponin, NT-proBNP/troponin ratio, creatin kinase myocardial band (CK-MB) and myoglobin, were retrospectively analyzed. Fifty-nine patients had CLTI (16.1%) with higher rates of NT-proBNP, NT-proBNP/troponin ratio, CK-MB and myoglobin (all p < 0.05) compared to non-CLTI patients. In univariate analysis, NT-proBNP, NT-proBNP/troponin ratio, CK-MB, myoglobin, age, C-reactive protein and non-insulin dependent diabetes mellitus (NIDDM) were associated with CLTI (all p < 0.05). In multivariate analysis, age and NIDDM remained significant predictors (all p < 0.05) while cardiac biomarkers were not independently associated with CLTI. Troponin, NT-proBNP and myoglobin were associated with mortality in univariate analysis (all p < 0.05). In multivariate analysis, troponin only remains to be associated with mortality (p = 0.001). Selected cardiac biomarkers failed to demonstrate statistically significant differentiation between CLTI and non-CLTI patients with LEAD, while troponin may be potentially associated with mortality.

Transcatheter Aortic Valve Implantation (TAVI) has revolutionized severe aortic stenosis treatment, but risk stratification remains challenging. This systematic review examined the association between computed tomography (CT)-derived adipose tissue parameters and TAVI outcomes. We searched major databases for studies on visceral (VAT), subcutaneous (SAT), and intramuscular (IMAT) adipose tissue parameters and post-TAVI outcomes. Fourteen studies (9692 patients) were included. Higher SAT area/volume was consistently associated with better survival (5 studies, HR range: 0.83-2.77, p < 0.05). Lower SAT and VAT density also correlated with better survival (5 and 4 studies, respectively, HR range: 1.31-1.46, p < 0.05). VAT area showed mixed results. A VAT:SAT ratio < 1 was associated with better cardiovascular outcomes in one study. Lower IMAT index correlated with shorter hospital stays in a single study. This review reveals complex relationships between adipose tissue parameters and TAVI outcomes. Lower adipose tissue density and higher subcutaneous adiposity were most consistently associated with better outcomes. These findings suggest that detailed analysis of adipose tissue characteristics may enhance risk stratification in TAVI candidates.

Cardiovascular diseases as the leading cause of death and disability are increasing worldwide. The present study aimed to investigate the association between total body water, total fat percent, and trunk fat percent with electrocardiogram (ECG) parameters in the Persian Fasa Adult Cohort Study (FACS).

This cross-sectional study was performed on the baseline information obtained from 3217 35-70-year-old participants of the FACS, southern Iran. Various ECG and body composition parameters were obtained from the FACS baseline database. Independent t-test, Chi-square test and linear regression were used for data analysis.

Total body water (TBW) was positively associated with QRS length in men and women, and with PD and PR interval in women, exclusively. Additionally, in participants without chronic diseases (healthy group), TBW was shown to be positively associated with QRS length and PD; however, it was associated with QRS length and S wave in V3 lead (SV3) among those with type two diabetes, hypertension or ischemic heart disease (defined as unhealthy group). Total body fat percent (TBFP) was linearly associated with SV3 in unhealthy group. None of the studied ECG parameters was associated with TBFP in men, women and healthy group. Moreover, trunk fat percent was shown to be positive associated with R wave in aVL lead in women and unhealthy groups.

Body fat percentage and fat distribution may affect ECG parameters, and subsequently associated with cardiovascular diseases, such as arrhythmias. Thus, these indicators may carry the potential for screening high-risk individuals.

While physical performance is closely linked to cardiovascular health, further research is essential to elucidate the association of physical tests in the early screening for cardiovascular risk (CVR), underscoring the potential for these assessments to enhance preventive healthcare strategies.

To investigate the association between the Handgrip Strength (HGS) test and CVR in women with obesity, as well as to evaluate the predictive value of the HGS test as a CVR screening tool in this population.

Fifty-five eligible women with obesity, aged 40 to 65 years, were studied. The Framingham Global Risk Score was used to classify participants into low-risk and moderate/high-risk groups. Dual X-ray Absorptiometry was used to assess body composition. Additionally, clinical and biochemical parameters, along with HGS, were evaluated. Data were analyzed using the logistic regression analysis, and the positive and negative predictive values were calculated; accuracy was defined through the ROC curve and the Youden index. Statistical significance was set at 5%.

The prevalence of the moderate/high CVR was 49%. The menopause [0.14 (0.03-0.52), p = 0.003] and handgrip strength [0.90 (0.82-0.99), p = 0.046] were associated with cardiovascular risk, independent of the clinical and biochemical parameters. The optimal cutoff points for screening CVR were ≤ 37.8 kg for HGS [AUC = 0.73 (0.59-0.84), p = 0.003].

HGS and menopause are significantly associated with CVR in women with obesity, highlighting the importance of considering physical evaluation in early clinical screening for CVR. The simple measure of HGS emerged as a promising tool for cardiovascular prevention in this population.

Individuals who present with acute myocardial infarction in the absence of standard modifiable cardiovascular risk factors (ie, SMuRF-less) seem to have a significantly increased risk of mortality; however, it remains unclear whether the "SMuRF paradox" would be influenced by patients' baseline body mass index (BMI) status.

Using data from the CCC-ACS (Improving Care for Cardiovascular Disease in China-Acute Coronary Syndrome) project from November 2014 to July 2019, we analyzed patients with acute myocardial infarction with and without SMuRFs and categorized their BMI as underweight (<18.5 kg/m2), normal weight (18.5-24 kg/m2), overweight (24-28 kg/m2), and obese (>28 kg/m2). The primary outcome was in-hospital all-cause mortality. Multivariable logistic regression models were used to estimate BMI-stratified associations between SMuRF-less status and outcomes.

The study included 44 538 patients with first-presentation acute myocardial infarction, of whom 4454 were SMuRF-less. The incidence of SMuRF-lessness declined from 16.2% to 6.5% as BMI increased by category, and it prevailed more frequently among women and older people regardless of their BMI status. Patients who were SMuRF-less had a significant increase in in-hospital mortality than patients with ≥1 SMuRF (adjusted odds ratio [OR], 1.750 [95% CI, 1.057-2.896], P<0.001). The highest mortality rate was observed in the group who were SMuRF-less and underweight (3.5%). Considering patients with ≥1 SMuRF and obesity as the reference group, the group who were SMuRF-less underweight exhibited the highest increase in mortality (adjusted OR, 3.854 [95% CI, 2.130-6.973], P<0.001).

Among patients with first-presentation acute myocardial infarction, compared with those with ≥1 SMuRF, patients who were SMuRF-less have a significantly higher risk of in-hospital mortality, especially in those underweight, whereas in-hospital survival was the most favorable among patients with ≥1 SMuRF and obesity.

URL: https://www.clinicaltrials.gov; Unique identifier: NCT0230661.

This study aimed to investigate the effects of energy intake on activities of daily living (ADL) in patients with acute stroke, with a focus on the differences between obese and non-obese patients.

This retrospective observational study was conducted in a neurological hospital and included patients hospitalized for acute stroke. During the acute phase (1 week after admission), energy intake was assessed, and the main outcome was defined as the Functional Independence Measure in the motor domain (FIM-M) at discharge. All subjects were divided into two groups based on their body mass index (BMI) at admission, with BMI ≥ 25 defining the obese stroke group and BMI < 25 defining the non-obese stroke group. Linear regression analysis was performed to examine the relationship between energy intake and FIM-M in each group.

A total of 307 patients with acute stroke (median age: 72 years) were included in this study, with 118 patients (39%) in the obese stroke group. In the non-obese stroke group, a significant and independent relationship was observed between FIM-M and energy intake (β = 0.103, p = 0.031, adjusted R2 = 0.687). However, in the obese stroke group, no significant relationship was found between FIM-M and energy intake (β = 0.076, p = 0.302).

In patients with acute stroke, energy intake positively affects functional outcomes in non-obese patients but not in obese patients. This study highlights the importance of considering obesity as a potential factor in determining energy intake in patients with acute stroke.

The Visceral Obesity Index (VAI) is utilized as a metric employed to assess the distribution of abdominal adipose tissue as well as the functional status of adipose tissue. Nevertheless, the interplay between VAI and persistent pain has yet to be investigated. This cross-sectional analysis investigated the relationship between VAI and persistent pain among 1357 American adults from NHANES data. A logarithmic transformation of VAI was performed to adjust for skewness. Following the adjustment for relevant variables, logistic regression analysis showed a noteworthy association between VAI and chronic pain, suggesting that higher VAI values may be linked to an increased prevalence of persistent pain. Curve fitting analysis revealed a nonlinear correlation, with a breakpoint at a VAI value of 0.18. For VAI values below this threshold, each unit increase was notably correlated with an elevated prevalence of persistent pain, while increases in VAI beyond this threshold did not show a significant impact on chronic pain prevalence. Subgroup analyses indicated that the VAI may serve as a relatively independent risk factor for persistent pain. These findings highlight the possibility of incorporating abdominal adipose modification into pain management approaches and emphasize the critical importance of monitoring visceral fat accumulation to better identify patients more susceptible to chronic pain.

Background: As metabolic diseases continue to rise globally, there is a growing need to improve risk assessment strategies beyond traditional measures such as BMI and waist circumference, which may fail to identify individuals at risk. This study develops and validates a novel metabolic risk classification system that incorporates body fat percentage (%BF), waist circumference (WC), and grip strength (GS) in Mexican adults. It aims to improve risk stratification and evaluate the association with metabolic syndrome. Methods: This cross-sectional study involved 300 young adults (18-22 years) from a university in Mexico City, utilizing body composition (%BF) and anthropometric measures (WC, GS) to categorize them into four risk groups: protective, low risk, increased risk, and high risk. A retrospective cohort of 166 adults (18-65 years) with complete clinical records was used for validation. Results: The inclusion of GS in the risk assessment significantly shifted the distribution in the young adult cohort, reducing the "no risk" category (15.5% males, 11.6% females) and expanding the higher-risk categories (70.2% males, 69% females). Metabolic parameters such as fasting glucose, triglycerides, HDL cholesterol, and blood pressure worsened progressively across the risk categories (p < 0.001). The high-risk group exhibited a markedly increased odds ratio for metabolic syndrome at 28.23 (10.83-73.6, p < 0.001), with no cases in the protective and low-risk groups. Conclusions: Integrating grip strength with %BF and WC into a risk classification system substantially enhances metabolic risk stratification, identifies at-risk individuals not previously detected, and confirms a protective group. This validated system provides a robust tool for early detection and targeted interventions, improving public health outcomes in metabolic health.

Background/Objectives: The practice of physical activity contributes to obtaining adequate values of body composition and physical fitness, which is beneficial for people's health. However, a large part of the adult population does not comply with the recommendations for physical activity, due to factors such as lack of time and nearby sports venues. Immersive virtual reality is a tool that allows individuals to immerse themselves in a simulated world and perceive visual, auditory, and tactile sensations. Its use in physical activity interventions favors exercise in situations that, due to time and space, could be limited in real life. The objective of this case report is to measure the impact on body composition and physical fitness of an exercise program executed through immersive virtual reality. Methods: The design is a case study with a quantitative approach developed through a physical activity intervention with immersive virtual reality in which body composition was evaluated considering fat and muscle components, and physical fitness considering cardiorespiratory fitness, speed-agility, and hand grip strength, through pre- and post-testing. The physical exercise program based on immersive virtual reality lasted 8 weeks. The subject of the study was a 24-year-old man, a second-year student of Pedagogy in Physical Education at a Chilean university, with no previous experience in this virtual tool. Results: The results indicate that for body composition the study subject decreased the fat component and slightly improved the musculature, while for physical fitness cardiorespiratory fitness and speed-agility improved, but manual grip strength decreased. Conclusions: It is concluded that the training developed through immersive virtual reality proves to be a tool that can promote improvements in body composition and physical fitness; it is necessary to carry out more research to validate the potential of this instrument as a means of contributing to the health of the population.

The shared genetic basis offers very valuable insights into the etiology, diagnosis and therapy of complex traits. However, a comprehensive resource providing shared genetic basis using the accessible summary statistics is currently lacking. It is challenging to analyze the shared genetic basis due to the difficulty in selecting parameters and the complexity of pipeline implementation. To address these issues, we introduce GWAShug, a platform featuring a standardized best-practice pipeline with four trait level methods and three molecular level methods. Based on stringent quality control, the GWAShug resource module includes 539 high-quality GWAS summary statistics for European and East Asian populations, covering 54 945 pairs between a measurement-based and a disease-based trait and 43 902 pairs between two disease-based traits. Users can easily search for shared genetic basis information by trait name, MeSH term and category, and access detailed gene information across different trait pairs. The platform facilitates interactive visualization and analysis of shared genetic basic results, allowing users to explore data dynamically. Results can be conveniently downloaded via FTP links. Additionally, we offer an online analysis module that allows users to analyze their own summary statistics, providing comprehensive tables, figures and interactive visualization and analysis. GWAShug is freely accessible at http://www.gwashug.com.

Obesity is becoming a global pandemic with pandemic proportions. According to the WHO estimates, there were over 1.9 billion overweight individuals and over 650 million obese adults in the globe in 2016. In recent years, scientists have encountered difficulties in choosing acceptable animal models, leading to a multitude of contradicting aspects and incorrect outcomes. This review comprehensively evaluates different screening models of obesity and obesity-associated comorbidities to reveal the advantages and disadvantages/limitations of each model while also mentioning the time duration each model requires to induce obesity.

For this review, the authors have gone through a vast number of article sources from different scientific databases, such as Google Scholar, Web of Science, Medline, and PubMed.

In-vivo models used to represent a variety of obesity-inducing processes, such as diet-induced, drug-induced, surgical, chemical, stress-induced, and genetic models, are discussed. Animal cell models are examined with an emphasis on their use in understanding the molecular causes of obesity, for which we discussed in depth the important cell lines, including 3T3-L1, OP9, 3T3-F442A, and C3H10T1/2. Screening models of obesity-associated co-morbidities like diabetes, asthma, cardiovascular disorders, cancer, and polycystic ovarian syndrome (PCOS) were discussed, which provided light on the complex interactions between obesity and numerous health problems.

Mimicking obesity in an animal model reflects multifactorial aspects is a matter of challenge. Future studies could address the ethical issues surrounding the use of animals in obesity research as well as investigate newly developed models, such as non-mammalian models. In conclusion, improving our knowledge and management of obesity and related health problems will require ongoing assessment and improvement of study models.

Physical fitness has been extensively shown to strongly associate with general health status and major health risks. Here we tested the ability of a novel estimate of fitness age (FitAge) to differentiate aging trajectories.This study aimed at (1) testing the ability of FitAge to differentiate aging patterns among decelerated, normal, and accelerated agers in selected health domains, (2) estimating the risk for developing major health issues depending on the aging trajectory, and (3) comparing FitAge to body mass index (BMI) categorization in differentiating healthy from unhealthy aging patterns.A total of 176 volunteers participated in this cross-sectional study. Participants underwent clinical screening and a comprehensive assessment of body composition, nutritional and health-related status, cognitive functioning, and haematochemical analyses with routine tests, oxidative stress, and inflammation markers. Scores for major health risks were also computed.FitAge outperformed BMI in estimating major health risk scores and was able to differentiate decelerated from normal and accelerated agers for health risk profile and several physiological domains. Body composition, immune system activation, and inflammation markers emerged as those variables flagging the largest differences between decelerated and accelerated aging patterns.The novel estimate of biological aging can accurately differentiate both in women and men decelerated from accelerated agers in almost all the domains scrutinized. Overall, decelerated aging is linked to positively oriented features which associate with reduced risk of developing major health issues.The present findings have potential relevance and practical implications to identify individuals at higher risk of accelerated aging according to their FitAge estimated via simple and cost-effective motor tests.

Previous assessments suggest that surgical results of paraesophageal hernia (PEH) repair were negatively impacted by increasing levels of obesity. A better understanding of the association of obesity on outcomes of PEH repair will support surgeons making evidence-based decisions on the surgical candidacy of individual patients. This single institution retrospective cohort study included 884 consecutive patients with giant PEH undergoing surgical repair between 1 January 2000 and 30 June 2020. Preoperative body mass index (BMI) was documented at the time of surgery. Main outcomes included perioperative blood loss, length of hospital stay, major complications, early hernia recurrence, and mortality. The mean (standard deviation [SD]) age at surgery was 68.4 (11.1), and 645 (73.0%) were women. Among the 884 patients, 875 had a documented immediate preoperative BMI and were included in the analysis. Mean (SD) BMI was 29.24 (4.91) kg/m2. Increasing BMI was not associated with increased perioperative blood loss (coefficient, 0.01; 95% confidence interval [CI], -0.01 to 0.02), prolonged length of stay (coefficient, -0.01; 95% CI, -0.02 to 0.01), increased incidence of recurrent hernia (odds ratio [OR], 1.03; 95% CI, 0.95-1.10), or increased major complications (OR, 0.93; 95% CI, 0.82-1.05). The 90-day mortality rate was 0.3%. Furthermore, when compared with the normal weight group, overweight and all levels of obesity were not related to unfavorable outcomes. No association was found between BMI and perioperative outcomes or short-term recurrence in patients undergoing PEH repair. Although preoperative weight loss is advisable, a higher BMI should not preclude or delay surgical management of giant PEH.

The triglyceride glucose (TyG) related index, a metric used to evaluate assessing insulin resistance (IR), has received limited attention in its association with sarcopenia. Our study aims to explore the predictive potential of the TyG index for sarcopenia. This study utilized data from the China Health and Retirement Longitudinal Study, a nationally representative, community-based cohort study, including a sample size of 10,537 participants aged 45 years and older. Associations between TyG related index and sacopenia was explored using multivariate logistic regression. Analysis of the predictive value of TyG related index for sarcopenia using receiver-operating characteristic curve (ROC). We evaluated the correlation between the TyG related index and the risk of sarcopenia using Cox proportional hazards models. Additionally, we utilized restricted cubic spline (RCS) regression analyses to explore the connections between the TyG-related index and sarcopenia. Logistic regression analysis showed an association between TyG (OR 0.961[0.955,0.968], P < 0.001), TyG-body mass index (TyG-BMI) (OR 0.872[0.867,0.878], P < 0.001), TyG- waist circumference (TyG-WC) (OR 0.896[0.890,0.902], P < 0.001) and sarcopenia. The results of the ROC analysis indicated that the area under the curve values for TyG, TyG-BMI, and TyG-WC were 0.659, 0.903, and 0.819, respectively. Compared to those without sarcopenia, patients with sarcopenia had a 37.7% (HR 0.623[0.502,0.774], P < 0.001), 4.8% (HR 0.952[0.947,0.958], P < 0.001), and 0.4% (HR 0.996[0.995,0.996], P < 0.001) lower risk with increasing TyG, TyG-BMI, and TyG-WC, respectively. RCS results show nonlinear relationship between TyG-BMI (P < 0.001) and TyG-WC (P < 0.001) and risk of sarcopenia. We observed a correlation between the TyG-related index and sarcopenia, with the TyG-BMI index demonstrating strong predictive capability for sarcopenia.

Obesity is a global health issue that is intricately linked to the development and progression of chronic liver disease (CLD). This bidirectional connection, coupled with the obesity paradox (OP), presents a management dilemma. The established influence of obesity on the development and progression of chronic liver disease (CLD) is surpassed by the liver's impact on the onset and advancement of obesity. Patients with CLD always experience increased energy expenditure, reduced appetite, and low protein synthesis, all of which might lead to weight loss. However, metabolic disturbances, hormonal imbalances, inflammatory signaling, immobility, drugs, and alterations in nutrient metabolism can contribute to the development and exacerbation of obesity. Despite the propagation of the OP concept, none of the guidelines has changed, recommending being overweight. Research bias and confounders might be the lifebuoy explanation. Additionally, overlooking the lethal morbidities of obesity for survival benefits full of suffering seems to be an illogical idea. Therefore, rather than endorsing an overweight status, emphasis should be placed on improving cardiorespiratory fitness and preventing sarcopenia to achieve better outcomes in patients with CLD. Accordingly, the complex interplay between obesity, CLD, and the concept of OP requires a sophisticated individualized management approach. Maximizing cardiorespiratory fitness and mitigating sarcopenia should be considered essential strategies for attaining the most favourable outcomes in patients with chronic liver disease (CLD).

Heart failure (HF) is a global health concern with rising incidence and poor prognosis. While the essential role of nutritional and dietary strategies in HF patients is acknowledged in the existing scientific guidelines and clinical practice, there are no comprehensive nutritional recommendations for optimal dietary management of HF.

In this review, we discuss results from recent studies on the obesity paradox and the effects of calorie restriction and weight loss, intermittent fasting, the Western diet, the Mediterranean diet, the ketogenic diet, and the DASH diet on HF progression.

Many of these strategies remain under clinical and basic investigation for their safety and efficacy, and there is considerable heterogeneity in the observed response, presumably because of heterogeneity in the pathogenesis of different types of HF. In addition, while specific aspects of cardiac metabolism, such as changes in ketone body utilization, might underlie the effects of certain dietary strategies on the heart, there is a critical divide between supplement strategies (i.e., with ketones) and dietary strategies that impact ketogenesis.

This review aims to highlight this gap by exploring emerging evidence supporting the importance of personalized dietary strategies in preventing progression and improving outcomes in the context of HF.

Sarmentosin (SA) and Quercetin (QC) are two active components of Sedum Sarmentosum Bunge, which is a traditional Chinese herbal medicine. This study aimed to investigate the role and regulatory mechanism of SA and QC in fatty liver of Genetic Improvement of Farmed Tilapia (GIFT) tilapia. GIFT tilapia were randomly divided into two groups with three replicates per treatment (30 fish in each replicate): normal diet group (average weight 3.51±0.31 g) and high-fat diet group (average weight 3.44±0.09 g). After 8 weeks feeding trial, growth index, lipid deposition, and biochemical indexes were measured. Lipid deposition, and lipid and inflammation-related gene expression were detected in a primary hepatocyte model of fatty liver of GIFT tilapia treated with SA or QC. Our results showed that high-fat diet caused lipid deposition and peroxidative damage in the liver of GIFT tilapia. The cell counting kit-8 assay results indicated that 10 μM SA and 10 μM of QC both had the least effect on hepatocyte proliferation. Moreover, both 10 μM of SA and 10 μM of QC showed lipolytic effects and inhibited the expression of lipid-related genes (FAS, Leptin, SREBP-1c, and SREBP2) in fatty liver cells. Interestingly, QC induced autophagosome-like subcellular structure and increased the expression of IL-8 in fatty liver cells. In conclusion, this study confirmed that SA and QC improved fatty liver caused by high-fat diet, providing a novel therapeutic approach for fatty liver of GIFT tilapia.

Final infarct size (IS) after ST segment elevation myocardial infarction (STEMI) is a major predictor of mortality. Seeking early predictors for final IS can guide individualized therapeutic strategies for those recognized to be at higher risk.

Eighty STEMI patients successfully treated with primary percutaneous coronary intervention (pPCI) underwent baseline (within 48 h) 2D, 3D echocardiography with speckle tracking and then underwent cardiac magnetic resonance (CMR) at 3 months to assess the final IS. After recruitment, 4 patients were excluded for uncontainable claustrophobia while 76 patients completed the final analysis. The mean ± standard deviation age was 54.1 ± 10.9 years, 84% were males, 25% had diabetes, 26% were hypertensives, 71% were current smokers, 82% had dyslipidemia, and 18% had a family history of premature coronary artery disease. By 3 months, CMR was performed to accurately evaluate the final IS. In univariate regression analysis, the admission heart rate, baseline and post-pPCI ST elevation, STEMI location (anterior vs. inferior), highest peri-procedural troponin, large thrombus burden, baseline thrombolysis in myocardial infarction flow grade, the final myocardial blush grade, the 2D and 3D left ventricular ejection fraction (LVEF), and the 2D and 3D global longitudinal strain (GLS) parameters were significant predictors for the final IS. In the multivariate regression analysis, four models were constructed and recognized the residual post-PCI ST segment elevation, the highest peri-procedural troponin, the 2D-LVEF, 3D-LVEF, and 2D-GLS as significant independent predictors for final IS.

In STEMI patients who underwent successful pPCI, early predictors for the final IS are vital to guide therapeutic decisions. The residual post-pPCI ST elevation, the highest peri-procedural troponin, and the baseline 2D-LVEF, 3D-LVEF, and 2D-GLS can be excellent and timely tools to predict the final IS.

Protein Tyrosine Phosphatase 1B (PTP1B) has emerged as a significant regulator of metabolic and cardiovascular disease. It is a non-transmembrane protein tyrosine phosphatase that negatively regulates multiple signaling pathways integral to the regulation of growth, survival, and differentiation of cells, including leptin and insulin signaling, which are critical for development of obesity, insulin resistance, type 2 diabetes, and cardiovascular disease. Given PTP1B's central role in glucose homeostasis, energy balance, and vascular function, targeted inhibition of PTP1B represents a promising strategy for treating these diseases. However, challenges, such as off-target effects, necessitate a focus on tissue-specific approaches, to maximize therapeutic benefits while minimizing adverse outcomes. In this review, we discuss molecular mechanisms by which PTP1B influences metabolic and cardiovascular functions, summarize the latest research on tissue-specific roles of PTP1B, and discuss the potential for PTP1B inhibitors as future therapeutic agents.

The global escalation of obesity has made it a worldwide health concern, notably as a leading risk factor for cardiovascular disease (CVD). Extensive evidence corroborates its association with a range of cardiac complications, including coronary artery disease, heart failure, and heightened vulnerability to sudden cardiac events. Additionally, obesity contributes to the emergence of other cardiovascular risk factors including dyslipidaemia, type 2 diabetes, hypertension, and sleep disorders, further amplifying the predisposition to CVD. To adequately address CVD in patients with obesity, it is crucial to first understand the pathophysiology underlying this link. We herein explore these intricate mechanisms, including adipose tissue dysfunction, chronic inflammation, immune system dysregulation, and alterations in the gut microbiome.Recent guidelines from the European Society of Cardiology underscore the pivotal role of diagnosing and treating obesity to prevent CVD. However, the intricate relationship between obesity and CVD poses significant challenges in clinical practice: the presence of obesity can impede accurate CVD diagnosis while optimizing the effectiveness of pharmacological treatments or cardiac procedures requires meticulous adjustment, and it is crucial that cardiologists acknowledge the implications of excessive weight while striving to enhance outcomes for the vulnerable population affected by obesity. We, therefore, sought to overcome controversial aspects in the clinical management of heart disease in patients with overweight/obesity and present evidence on cardiometabolic outcomes associated with currently available weight management interventions, with the objective of equipping clinicians with an evidence-based approach to recognize and address CVD risks associated with obesity.

Visceral adiposity index (VAI) is a reliable indicator of visceral adiposity. However, no stu-dies have evaluated the association between VAI and DKD in US adults with diabetes. Theref-ore, this study aimed to explore the relationship between them and whether VAI is a good pr-edictor of DKD in US adults with diabetes. Our cross-sectional study included 2508 participan-ts with diabetes who were eligible for the National Health and Nutrition Examination Survey (NHANES) from 2007 to 2018. Univariate and multivariate logistic regression were used to an-alyze the association between VAI level and DKD. Three models were used to control for pot-ential confounding factors, and subgroup analysis was performed for further verification. A tot-al of 2508 diabetic patients were enrolled, of whom 945 (37.68%) were diagnosed with DKD. Overall, the VAI was 3.36 ± 0.18 in the DKD group and 2.76 ± 0.11 in the control group. VAI was positively correlated with DKD (OR = 1.050, 95% CI 1.049, 1.050) after fully adjusting for co-nfounding factors. Compared with participants in the lowest tertile of VAI, participants in the highest tertile of VAI had a significantly increased risk of DKD by 35.9% (OR = 1.359, 95% CI 1.355, 1.362). Through subgroup analysis, we found that VAI was positively correlated with the occurrence of DKD in all age subgroups, male(OR = 1.043, 95% CI 1.010, 1.080), participants wit-hout cardiovascular disease(OR = 1.038, 95% CI 1.011, 1.069), hypertension (OR = 1.054, 95% CI 1.021, 1.090), unmarried participants (OR = 1.153, 95% CI 1.036, 1.294), PIR < 1.30(OR = 1.049, 95% CI 1.010, 1.094), PIR ≧ 3 (OR = 1.085, 95% CI 1.021, 1.160), BMI ≧ 30 kg/m2 (OR = 1.050, 95% CI 1.016, 1.091), former smokers (OR = 1.060, 95% CI 1.011, 1.117), never exercised (OR = 1.033, 95% CI 1.004, 1.067), non-Hispanic white population (OR = 1.055, 95% CI 1.010, 1.106) and non-Hipanic black population (OR = 1.129, 95% CI 1.033, 1.258). Our results suggest that elevated VAI levels are closely associated with the development of DKD in diabetic patients. VAI may be a simpl-e and cost-effective index to predict the occurrence of DKD. This needs to be verified in furt-her prospective investigations.

Obesity is a risk factor for left ventricular hypertrophy (LVH) and diastolic dysfunction. Available evidence on impaired myocardial deformation in obese patients without apparent systolic dysfunction assessed by LV ejection fraction (LVEF) is based on single studies. The aim of the present meta-analysis was to provide a comprehensive and updated information on this issue.

The PubMed, OVID-MEDLINE, and Cochrane library databases were analysed to search English-language articles published from the inception up to 31 December 2023. Studies were identified by using MeSH terms and crossing the following search items: ' myocardial strain', 'left ventricular mechanics', 'longitudinal global strain', 'speckle tracking echocardiography', 'systolic dysfunction', 'left ventricular ejection fraction', and 'obesity'.

Twenty-four studies including 5792 obese and 5518 nonobese individuals from different clinical settings were considered for the analysis. LV global longitudinal strain (GLS) was significantly impaired in the obese group [standard means difference (SMD): -0.86 ± 0.08; confidence interval (CI) -1.02 to -0.69, P  < 0.0001] and this was paralleled by a significant difference in pooled LVEF between obese and controls (SMD -0.27 ± 0.06; CI -0.40 to -0.15, P  < 0.0001). Unlike GLS, however, the majority of the selected studies failed to show statistically significant differences in LVEF. Furthermore, in patients with advanced obesity (BMI > 35 kg/m 2 , data from six studies), LV systolic dysfunction was more significantly detected by GLS (SMD -1.24 ± 0.19, CI -1.61/-0.87, P  < 0.0001) than by LVEF (SMD -0.54 ± 0.27, CI -1.07 to -0.01, P  = 0.046).

The present meta-analysis suggests that GLS may unmask systolic dysfunction often undetected by conventional LVEF in the obese setting; thus, this parameter should be incorporated into routine work-up aimed to identify obesity-mediated subclinical cardiac damage.

Large-scale, population-based investigations primarily investigating the association between body mass index (BMI) and cardiovascular disease (CVD) mortality among older and younger adults in the United States (U.S.) are lacking.

To evaluate the relationship between BMI and CVD mortality in older (≥65 years) and younger (<65 years) adults and to identify the nadir for CVD mortality.

This cohort study used serial cross-sectional data from the 1997 to 2018 National Health Interview Survey (NHIS) linked with the National Death Index. NHIS is an annual nationally representative household interview survey of the civilian noninstitutionalized U.S.

Residential units of the civilian noninstitutionalized population in the U.S.

The target population for the NHIS is the civilian noninstitutionalized U.S. population at the time of the interview. We included all adults who had BMI data collected at 18 years and older and with mortality data being available. To minimize the risk of reverse causality, we excluded adults whose survival time was ≤2 years of follow-up after their initial BMI was recorded and those with prevalent cancer and/or CVD at baseline.

We used the BMI record obtained in the year of the NHIS survey. Total CVD mortality used the NHIS data linked to the latest National Death Index data from the survey inception to December 31, 2019. We performed multivariable Cox proportional hazards regression models to estimate adjusted hazard ratios (aHRs) and 95 % confidence intervals (CIs).

The study included 425,394 adults; the mean (SD) age was 44 (16.7) years. During a median follow-up period of 11 years, 12,089 CVD-related deaths occurred. In older adults, having overweight was associated with a lower risk of CVD mortality (aHR 0.92 [95 % CI, 0.87-0.97]); having class I obesity (1.04 [0.97-1.12]) and class II obesity (1.12 [1.00-1.26]) was not significantly associated with an increased CVD mortality; and having class III obesity was associated with an increased risk of CVD mortality (1.63 [1.35-1.98]), in comparison with adults who had a normal BMI. Yet, in younger adults, having overweight, class I, II, and III obesity was associated with a progressively higher risk of CVD mortality. The nadir for CVD mortality is 28.2 kg/m2 in older adults and 23.6 kg/m2 in younger adults.

This U.S. population-based cohort study highlights the significance of considering age as a crucial factor when providing recommendations and delivering self-care educational initiatives for weight loss to reduce CVD mortality.

Non-alcoholic fatty liver disease (NAFLD) increases the risk of cardiovascular diseases independently of other risk factors. However, data on its effect on cardiovascular outcomes in coronavirus disease 2019 (COVID-19) hospitalizations with varied obesity levels is scarce. Clinical management and patient care depend on understanding COVID-19 admission results in NAFLD patients with varying obesity levels.

To study the in-hospital outcomes in COVID-19 patients with NAFLD by severity of obesity.

COVID-19 hospitalizations with NAFLD were identified using International Classification of Disease -10 CM codes in the 2020 National Inpatient Sample database. Overweight and Obesity Classes I, II, and III (body mass index 30-40) were compared. Major adverse cardiac and cerebrovascular events (MACCE) (all-cause mortality, acute myocardial infarction, cardiac arrest, and stroke) were compared between groups. Multivariable regression analyses adjusted for sociodemographic, hospitalization features, and comorbidities.

Our analysis comprised 13260 hospitalizations, 7.3% of which were overweight, 24.3% Class I, 24.1% Class II, and 44.3% Class III. Class III obesity includes younger patients, blacks, females, diabetics, and hypertensive patients. On multivariable logistic analysis, Class III obese patients had higher risks of MACCE, inpatient mortality, and respiratory failure than Class I obese patients. Class II obesity showed increased risks of MACCE, inpatient mortality, and respiratory failure than Class I, but not significantly. All obesity classes had non-significant risks of MACCE, inpatient mortality, and respiratory failure compared to the overweight group.

Class III obese NAFLD COVID-19 patients had a greater risk of adverse outcomes than class I. Using the overweight group as the reference, unfavorable outcomes were not significantly different. Morbid obesity had a greater risk of MACCE regardless of the referent group (overweight or Class I obese) compared to overweight NAFLD patients admitted with COVID-19.

Considerable and convincing global data from cohorts across the health spectrum (i.e. apparently healthy to known disease) indicate that cardiorespiratory fitness (CRF) is a major predictor of overall and cardiovascular disease (CVD)-survival, seemingly with greater prognostic resolution compared to other traditional CVD risk factors. Therefore, the assessment of CRF in research and clinical settings is of major importance.

In this manuscript, we review the technology of measuring CRF assessed by the 'gold standard,' cardiopulmonary exercise testing (CPET), as well as with various other methods (e.g. estimated metabolic equivalents, 6-minute walk tests, shuttle tests, and non-exercise equations that estimate CRF), all of which provide significant prognostic information for CVD- and all-cause survival. The literature through May 2024 has been cited.

The promotion of physical activity in efforts to improve levels of CRF is needed throughout the world to improve lifespan and, more importantly, healthspan. The routine assessment of CRF should be considered a vital sign that is routinely assessed in clinical practice.

The association of the combination of body mass index (BMI) and weight change at admission with prognoses in patients with heart failure (HF) is unclear. Therefore, we investigated whether BMI and weight changes at admission affect mortality in patients with HF.

This retrospective cohort study lasted 99 months, starting in April 2014, and included 4,862 patients with HF from a Japanese real-world database. Cubic and thin-plate smoothing spline analyses were performed to investigate the association of BMI and weight changes with mortality. The percentage weight change was calculated every 6 months. The study outcome was the presence or absence of death.

The patients' mean age was 81.5±9.6 years, and 1,239 (25.5%) patients died. Cubic spline analysis revealed a negative correlation of BMI with mortality hazard ratio (HR) (BMI of 18.5 kg/m2 and 25 kg/m2; HR=1.3 [1.2-1.4] and 0.8 [0.7-0.9], respectively). Cubic spline analysis of weight change showed that weight loss tended to increase the mortality HR (each 6% decrease in weight change rate was associated with a 1.1 times higher mortality risk (95% CI [1.0-1.2]) Thin-plate smoothing spline analysis showed that the odds ratio (OR) negatively correlated with BMI (1-year mortality: BMI of 18.5 kg/m2, 22 kg/m2, and 25 kg/m2; OR at 0% weight change=1.5, 1.0, and 0.7, respectively; 2-year mortality: BMI=18.5 kg/m2, 22 kg/m2, and 25 kg/m2; OR at 0% weight change=1.4, 0.9, and 0.7, respectively).

A low BMI in patients with HF was associated with a higher risk of mortality. Weight loss in patients, regardless of BMI, was associated with a higher OR for mortality.

Amidst an aging population and escalating obesity prevalence, elucidating the impact of obesity on transcatheter aortic valve replacement (TAVR) outcomes becomes paramount. The so-called "obesity paradox"-a term denoting the counterintuitive association of obesity, typically a risk factor for cardiovascular diseases, with improved survival outcomes in TAVR patients relative to their leaner or normal-weight counterparts-merits rigorous examination. This review comprehensively investigates the complex relationship between obesity and the clinical outcomes associated with TAVR, with a specific focus on mortality and periprocedural complications. This study aims to deepen our understanding of obesity's role in TAVR and the underlying mechanisms of the obesity paradox, thereby optimizing management strategies for this patient demographic, tailored to their unique physiological and metabolic profiles.

Background: Obesity is a public health problem which prevalence has increased worldwide and is associated with different degrees of hemodynamic alterations and structural cardiac changes. The aim of the study is to investigate the impact of body mass index (BMI) on left atrial function using standard and advanced echocardiography in a population of patients with non-valvular atrial fibrillation (AF). Methods: 395 adult patients suffering from non-valvular AF, divided into three tertiles based on BMI value, carry out a cardiological examination with standard and advanced echocardiography. Results: Peak atrial longitudinal strain (PALS), a measure of left atrial function, is lower in the tertile with highest BMI (14.3 ± 8.2%) compared to both the first (19 ± 11.5%) and the second tertile (17.7 ± 10.6%) in a statistically significant manner (p < 0.002). Furthermore, BMI is significantly associated independent with the PALS by multilinear regression analysis, even after correction of the data for CHA2DS2-VASc score, left ventricular mass index, left ventricular ejection fraction, E/E' ratio and systolic pulmonary arterial pressure (coefficient standardized β = -0.127, p < 0.02; Cumulative R2 = 0.41, SEE = 0.8%, p < 0.0001). Conclusions: BMI could be considered an additional factor in assessing cardiovascular risk in patients with non-valvular atrial fibrillation, in addition to the well-known CHA2DS2-VASc score.

Background: Ischemic stroke is the second, and pulmonary embolism (PE) is the third most common cardiovascular cause of death after myocardial infarction. Data regarding risk factors for ischemic stroke in patients with acute PE are limited. Methods: Patients were selected by screening the German nationwide in-patient sample for PE (ICD-code I26) and were stratified by ischemic stroke (ICD code I63) and compared. Results: The nationwide in-patient sample comprised 346,586 hospitalized PE patients (53.3% females) in Germany from 2011 to 2014; among these, 6704 (1.9%) patients had additionally an ischemic stroke. PE patients with ischemic stroke had a higher in-hospital mortality rate than those without (28.9% vs. 14.5%, p < 0.001). Ischemic stroke was independently associated with in-hospital death (OR 2.424, 95%CI 2.278-2.579, p < 0.001). Deep venous thrombosis and/or thrombophlebitis (DVT) combined with heart septal defect (OR 24.714 [95%CI 20.693-29.517], p < 0.001) as well as atrial fibrillation/flutter (OR 2.060 [95%CI 1.943-2.183], p < 0.001) were independent risk factors for stroke in PE patients. Systemic thrombolysis was associated with a better survival in PE patients with ischemic thrombolysis who underwent cardio-pulmonary resuscitation (CPR, OR 0.55 [95%CI 0.36-0.84], p = 0.006). Conclusions: Ischemic stroke did negatively affect the survival of PE. Combination of DVT and heart septal defect and atrial fibrillation/flutter were strong and independent risk factors for ischemic stroke in PE patients. In PE patients with ischemic stroke, who had to underwent CPR, systemic thrombolysis was associated with improved survival.

Our aim was to examine the independent and joint associations of estimated cardiorespiratory fitness (CRF) and its changes and obesity with risk of hypertension in a rural Chinese population. A prospective cohort including 9848 adults without hypertension at baseline was enrolled. Odds ratios (ORs) and 95% confidence intervals (95% CIs) were estimated by logistic regression models. Restricted cubic splines were used to model the dose-response relationship. During 6 years follow-up, 2,019 individuals developed hypertension. A negative association between estimated CRF and hypertension incidence was observed, with the risk being 0.87 (0.84-0.90) per MET increment. For estimated CRF change, the risks of hypertension were 1.50 (1.27-1.77) and 0.75 (0.59-0.97) for decreasers and increasers, respectively, compared to maintainers. Joint analyses showed individuals in the overweight/obesity-fourth quartile of estimated CRF had a 2.08 times higher risk of hypertension than those in the normal weight-first quartile (Pinteraction < 0.05). Those overweight/obesity-decreasers had the highest risk (OR: 2.19, 95%CI: 1.71-2.81; Pinteraction < 0.05) compared to the normal-maintainers. Similar results for abdominal obesity were also observed. Estimated CRF and its dynamic changes showed a negative association with hypertension incidence in the rural Chinese population.