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Associations of socioeconomic status with infectious diseases mediated by lifestyle, environmental pollution and chronic comorbidities: a comprehensive evaluation based on UK Biobank

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Infectious Diseases of Poverty 2023年第1期12卷 1-23页

作者： Xiangyu Ye Yidi Wang Yixin Zou Junlan Tu Weiming Tang Rongbin Yu Sheng Yang Peng Huang Department of Epidemiology Center for Global HealthSchool of Public HealthNanjing Medical UniversityNanjingChina institute of Global health and Infectious Diseases University of North CarolinaChapel HillCAUSA Department of Biostatistics Center for Global HealthSchool of Public HealthNanjing Medical UniversityNanjingChina

Background Socioeconomic status(SES)inequity was recognized as a driver of some certain infectious diseases.However,few studies evaluated the association between SES and the burden of overall infections,and even fewer identified preventable mediators.This study aimed to assess the association between SES and overall infectious diseases burden,and the potential roles of factors including lifestyle,environmental pollution,chronic disease history.Methods We included 401,009 participants from the UK Biobank(UKB)and defined the infection status for each participant according to their diagnosis records.Latent class analysis(LCA)was used to define SES for each participant.We further defined healthy lifestyle score,environment pollution score(EPS)and four types of chronic comorbidities.We used multivariate logistic regression to test the associations between the four above covariates and infectious diseases.Then,we performed the mediation and interaction analysis to explain the relationships between SES and other variables on infectious diseases.Finally,we employed seven types of sensitivity analyses,including considering the Townsend deprivation index as an area level SES variable,repeating our main analysis for some individual or composite factors and in some subgroups,as well as in an external data from the US National health and Nutrition Examination Survey,to verify the main results.Results In UKB,60,771(15.2%)participants were diagnosed with infectious diseases during follow-up.Lower SES[odds ratio(OR)=1.5570]were associated with higher risk of overall infections.Lifestyle score mediated 2.9%of effects from SES,which ranged from 2.9 to 4.0%in different infection subtypes,while cardiovascular disease(CVD)mediated a proportion of 6.2%with a range from 2.1 to 6.8%.In addition,SES showed significant negative interaction with lifestyle score(OR=0.8650)and a history of cancer(OR=0.9096),while a significant synergy interaction was observed between SES and EPS(OR=1.0024).In subgroup analysis,we found that males and African

关键词： Socioeconomic status Infectious diseases healthy lifestyle Environmental pollution Chronic comorbidities

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Mutagenic and Estrogenic Effects of Organic Compounds in Water Treated by Different Processes: A Pilot Study

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Biomedical and Environmental Sciences 2015年第8期28卷 571-581页

作者： LU Yi LYU Xue Min XIAO San Hua YANG Xiao Ming WANG Ya Zhou TANG Fei institute of Environmental Medicine MOE Key Laboratory of Environmental and Health School of Public HealthTongji Medical College of Huazhong Science and Technology University

Objective In this study, a pilot-scale investigation was conducted to examine and compare the biotoxicity of the organic compounds in effluents from five treatment processes (P1-P5) where each process was combination of preoxidation (O3), coagulation, sedimentation, sand filtration, ozonation, granular activated carbon, biological activated carbon and chlorination (NaClO). Methods Organic compounds were extracted by XAD-2 resins and eluted with acetone and dichlormethane (DCM). The eluents were evaporated and redissolved with DMSO or DCM. The mutagenicity and estrogenicity of the extracts were assayed with the Ames test and yeast estrogen screen (YES assay), respectively. The organic compounds were detected by GC-MS. Results The results indicated that the mutation ratio (MR) of organic compounds in source water was higher than that for treated water. GC-MS showed that more than 48 organic compounds were identified in all samples and that treated water had significantly fewer types and concentrations of organic compounds than source water. Conclusion To different extents, all water treatment processes could reduce both the mutagenicity and estrogenicity, relative to source water. P2, P3, and P5 reduced mutagenicity more effectively, while P1 reduced estrogenicity, most effectively. Water treatment processes in this pilot plant had weak abilities to remove Di-n-butyl phthalate or 1, 2-Benzene dicarboxylic acid.

关键词： Water treatment processes Organic compounds Yeast estrogen screen(YES assay) Ames test GC-MS

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Stair climbing,genetic predisposition,and the risk of incident type 2 diabetes:A large population-based prospective cohort study

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Journal of Sport and health Science 2023年第2期12卷 158-166页

作者： Yuanjue Wu Mengyun Luo Xiao Tan Liangkai Chen Department of Nutrition and Food Hygiene Hubei Key Laboratory of Food Nutrition and SafetySchool of Public HealthTongji Medical CollegeHuazhong University of Science and TechnologyWuhan 430030China Department of Clinical Nutrition Union HospitalTongji Medical CollegeHuazhong University of Science and TechnologyWuhan 430022China Sydney School of public health Faculty of Medicine and HealthUniversity of SydneyNew South WalesNSW 2006Australia Charles Perkins Centre the University of SydneyNew South WalesNSW 2006Australia School of public health School of MedicineShanghai Jiao Tong UniversityShanghai 200025China Department of medical Sciences Uppsala UniversityUppsala 78185Sweden Department of Clinical Neuroscience Karolinska InstituteStockholm 17165Sweden Ministry of Education Key Lab of Environment and health School of Public HealthTongji Medical CollegeHuazhong University of Science and TechnologyWuhan 430030China

Background:Cross-sectional evidence and small-scale trials suggest positive effects of stair climbing on cardiometabolic disease and glucose regulation.However,few studies have examined the long-term association between stair climbing and the incidence of type 2 diabetes(T2D).We aimed to prospectively evaluate the association of stair climbing with T2D and assess modifications by genetic predisposition to T2D.Methods:We included 451,699 adults(mean age=56.3±8.1 years,mean±SD;55.2%females)without T2D at baseline in the UK Biobank and followed up to March 31,2021.Stair climbing information was collected through the touchscreen questionnaire.Genetic risk score for T2D consisted of 424 single nucleotide polymorphisms.Results:During a median follow up of 12.1 years,14,896 T2D cases were documented.Compared with participants who reported no stair climbing,those who climbed stairs regularly had a lower risk of incident T2D(10-50 steps/day:hazard ratio(HR)=0.95,95%confidence interval(95%CI):0.89-1.00;60-100 steps/day:HR=0.92,95%CI:0.87-0.98;110-150 steps/day:HR=0.86,95%CI:0.80-0.91;>150 steps/day:HR=0.93,95%CI:0.87-0.99,p for trend=0.0007).We observed a significant interaction between stair climbing and genetic risk score on the subsequent T2D risk(p for interaction=0.0004),where the risk of T2D showed a downward trend in subjects with low genetic risk and those who reported stair climbing activity of 110-150 steps/day appeared to have the lowest overall T2D risk among those with intermediate to high genetic risk.Conclusion:A higher number of stairs climbed at home was associated with lower T2D incidence risk,especially among individuals with a low genetic predisposition to T2D.These findings highlight that stair climbing,as incidental physical activity,offers a simple and low-cost complement to public health interventions for T2D prevention.

关键词： Cohort Genetic risk score Stair climbing Type 2 diabetes UK Biobank

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Total and cause-specific mortality attributable to cold spells in China:A multicity and multicounty study

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Advances in Climate Change Research 2023年第6期14卷 827-835页

作者： He-Jia SONG Yi-Bin CHENG Yu WANG Yu-Shu HUANG Yan WANG Xue-Mei SU Shilu TONG Yong-Hong LI Xiao-Yuan YAO National institute of Environmental health Chinese Center for Disease Control and PreventionBeijing 100021China School of public Health Institute of Environment and Population HealthAnhui Medical UniversityHefei 230032China Center for Global health School of Public HealthNanjing Medical UniversityNanjing 211166China School of public health and Social Work Queensland University of TechnologyBrisbane 4000Australia Daxing Center for Disease Control and Prevention Beijing 102600China Department of Infectious Diseases Control and Prevention Jiaxing Center for Disease Control and PreventionJiaxing 314050China

Climate change has resulted in an increase in the frequency and intensity of extreme cold weather events,but few multicity or multicounty researches have explored the association between cold spells and mortality risk and burden.We collected daily data on climate,sociodemo-graphic factors and mortality in 18 cities/counties across 11 geographical regions for the period of November to March 2014-2018.A distributed lag nonlinear model was used to examine the association between cold spells and mortality after adjustment for confounding factors.Twelve definitions of cold spells were used.Multi-meta regression analysis was applied to pool the impacts over different regions.Cold spells were significantly associated with all-cause mortality at lag 0-21(CRR:1.38,95%CI:1.21,1.57).In addition to respiratory diseases and cir-culatory system diseases,digestive,endocrine and nervous system diseases and injury were also affected by cold spells.The magnitude of the impacts of cold spells on mortality varied among the diseases investigated,with the highest risk estimate found for influenza and pneumonia(CRR:2.00,95%CI:1.45,2.76)and the lowest estimate found for injury(CRR:1.26,95%CI:1.09,1.46).The fraction of all-cause mortality attributable to cold spells was 2.31%(95%CI:0.90%,3.46%).Among the regional differences,the attributable burden of all-cause mortality was higher in rural areas and subtropical monsoon climate zone,with attributable fractions of 2.85%(95%CI:1.23%,4.11%)and 3.36%(95%CI:0.55%,5.35%),respectively.Cold spells increased mortality from a range of diseases.Women,older adults and residents of rural areas and subtropical monsoon climate zone were more vulnerable to cold spells impacts.The findings may help to formulate preventive strategies and early warning response plans to reduce mortality burden of extreme cold events.

关键词： Cold spells Distributed lag nonlinear model Attributable fraction Mortality burden Sensitive diseases

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Edible mushrooms as a potent therapeutics of subclinical thyroid dysfunction among adults,especially in obese individuals:a prospective cohort study

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Food Science and Human Wellness 2023年第1期12卷 295-302页

作者： Juanjuan Zhang Sabina Rayamajhi Amrish Thapa Ge Meng Qing Zhang Li Liu Hongmei Wu Yeqing Gu Shunming Zhang Tingjing Zhang Xuena Wang Zhixia Cao Jun Dong Xiaoxi Zheng Xu Zhang Xinrong Dong Xing Wang Shaomei Sun Ming Zhou Qiyu Jia Kun Song Kaijun Niu Nutritional Epidemiology institute and School of public health Tianjin Medical UniversityTianjin 300070China Department of Toxicology and Sanitary Chemistry School of Public HealthTianjin Medical UniversityTianjin 300070China health Management Centre Tianjin Medical University General HospitalTianjin 300070China Nutrition and Radiation Epidemiology Research Center Institute of Radiation MedicineChinese Academy of Medical Sciences&Peking Union Medical CollegeTianjin 300192China Tianjin Key Laboratory of Environment Nutrition and Public HealthTianjin 300070China Center for International Collaborative Research on Environment Nutrition and Public HealthTianjin 300070China

Background:Mushrooms are a good source of many nutrients which are potentially beneficial for chronic diseases.We speculated that due to its abundant nutrients edible mushrooms might have a beneficial effect on the prevention of subclinical thyroid dysfunction(SCTD).Therefore,we designed a large-scale cohort study to examine whether mushrooms consumption is a protective factor for SCTD in adults.Methods:This prospective cohort study investigated 6631 participants(mean age:(45.0±10.2)years;55.1%men).Edible mushrooms consumption was measured at baseline using a validated food frequency questionnaire.SCTD was defined as abnormal serum thyroid-stimulating hormone levels and normal free thyroxine.Cox proportional hazards regression models were used to examine the association of edible mushrooms consumption with incident SCTD.Results:During follow-up period,a total of 262 new cases of SCTD were identified,the incidence rate of subclinical hypothyroidism was 8.9/1000 person-years and subclinical hyperthyroidism was 7.2/1000 person-years.After adjusting potential confounding factors,the multivariable hazard ratios(95%confidence intervals)for subclinical hypothyroidism were 1.00(reference)for almost never,0.53(0.29,0.97)for 1-3 times/week and 0.30(0.10,0.87)for≥4 times/week(P for trend=0.02).It also showed edible mushrooms consumption was inversely associated with subclinical hypothyroidism in obese individuals but not non-obese individuals,the final hazard ratios(95%confidence intervals)were 0.14(0.03,0.73)(P for trendhigher edible mushrooms consumption was significantly associated with lower incidence of subclinical hypothyroidism among general adult population,especially in obese individuals.

关键词： Edible mushrooms Subclinical thyroid dysfunction Obese individuals Cohort study

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Economic burden of premature deaths attributable to different heatwaves in China: A multi-site study, 2014-2019

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Advances in Climate Change Research 2023年第6期14卷 836-846页

作者： Cheng ZHAO Yong-Hong LI Shilu TONG Rong WANG Yu WANG Yi-Bin CHENG Yi-Ran LYU Yu-Shu HUANG Jiang HE Jia GUO Xiao-Yuan YAO China CDC Key Laboratory of Environment and Population health National Institute of Environmental HealthChinese Center for Disease Control and PreventionBeijing 100021China School of public health Institute of Environment and Population HealthAnhui Medical UniversityHefei 230032China School of public health and Social Work Queensland University of TechnologyBrisbane 4006Australia National Climate Center China Meteorological AdministrationBeijing 100081China

It has been well documented that heatwaves are linked to elevated mortality and morbidity.However,the selection of optimal heatwave definitions for subsequent risk assessment has been inconsistent and there is no full picture of the effects of heatwaves with different intensities on economic losses due to mortality,which can provide important insights for public health considerations.Hence,we used a two-stage time series analysis,combined with values of statistical life(VsL)based on the value of a statistical life year to assess the economic burden of deaths associated with heatwaves of different intensities and durations and to identify the vulnerable populations and regions.We further conducted stratified analyses by age,sex,and region.We found 2.9%(95%CI:0.0%,6.5%)-20.0%(95%CI:2.9%,34.2%)of VsL were attributable to heatwaves,corresponding to attributable economic losses(AELs)of 2.20(95%CI:0.32,3.77)-4.77(95%CI:1.53,7.63)billion CNY.The economic burden of death was most sensitive to heatwave H99P_2D(99th percentile,at last 2 consecutive days),while H97.5P_2D(97.5th percentile,at last 2 consecutive days)caused the highest attributable economic losses.Females and elderly people aged≥65 years were more sensitive.The AELs in the temperate zone and northern regions were larger than those in subtropical zone and southern regions during relatively low-intensity heatwaves,respectively.By contrast,the AELs in subtropical zone and southern regions were relatively higher than those in temperate zone and northern regions during relatively high-intensity heatwaves,respectively.The AELs were larger in urban areas than in rural areas.Tailored intervention strategies,primarily focusing on vulnerable populations and regions,should be formulated to reduce the economic loss due to heatwaves in the context of climate change.

关键词： Heatwaves Economic burden Mortality Values of statistical life

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Morbi-Mortality Linked to Unsafe Abortions—Difficulties in Accessing Safe Abortions in Cameroon: Meta-Analysis and Systematic Review

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Open Journal of Obstetrics and Gynecology 2023年第2期13卷 342-359页

作者： Florent Ymele Fouelifack Mosman Anyimbi Ofeh Jenny Ornella Manewoun Nsen Abeng Christophe Saha Lontsi Mvong Vendeline Amaelle Goretti Guy Sadeu Wafeu Robinson Enow Mbu Department of Surgery and Specialties at the higher institute of medical technology of nkolondom Yaoundé Cameroon Gynecology and Obstetrics Unit of the Yaoundé Central Hospital Yaoundé Cameroon Maga District Hospital Maga Cameroon Public Health of Higher Institute of Medical Technology of Nkolondom Yaoundé Cameroon CIVITAS Cameroon Human Rights and Humanitarian Action Yaoundé Cameroon public health Option Epidemiology Yaoundé Cameroon Information Communication and technology American University Yaoundé Cameroon Centre for the Development of Best Practices in health (CDBPSH) National Coordinator of Building Medical Research in Africa (BMR Africa) Yaoundé Cameroon Family health Ministry of Public Health Yaoundé Cameroon

Background: Unsafe abortions are one of the leading causes of maternal mortality, especially in developing countries. In Cameroon, the maternal mortality rate remains high, and the scarcity of data on abortions leads to a lack of solid evidence to advocate on the extent of the abortions related complications. Our objective was to evaluate the unsafe abortions related complications, and to assess the difficulties of accessing safe abortions in our setting. Methods: We carried out a meta-analytic and systematic review in the biomedical databases MEDLINE (Pubmed), Google Scholar and African Journal Online concerning unsafe abortions and/or difficulties in accessing safe abortions in Cameroon. The keywords used for the search are seen in table I. Selection of studies was simultaneously done by two authors. Data were extracted through a form designed on Google Form. We used a random-effect model for proportion estimation, and The I2 and Q statistics to assess the extent of heterogeneity. Results: A total of 430 studies were identified, from which 28 were included and analysed. About 5% (95% CI: 3 - 7) of unsafe abortions leads to death. The contribution of unsafe abortions in maternal deaths was 23% (95% CI: 20 - 27). The rate of severe bleeding and/or anemia were 40% (95% CI: 18 - 63) and the rate of infection was 17% (95% CI: 7 - 28), dominated by pelvic infections, pelviperitonitis, severe sepsis, and septic shock. Case reports described uterine perforations, uterine rupture during the following pregnancy. Abortion was performed in the practitioner’s or patient’s home in 41.4% of cases, in a health center in 35.1% of cases, in a private clinic in 21.2% of cases, drugs selling places and in traditional healer clinics. The restriction of abortion laws, the stigma surrounding abortion and its consequences at any level of the society, lead to the underreporting of unsafe abortions and a deep reluctance to advocate for safe abortion services. Conclusion: The strengthening of awareness campaigns for provider b

关键词： Morbi-Mortality Unsafe Difficulties Access Safe Abortion Cameroon

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Weather Variability,Socioeconomic Factors,and Pneumonia in Children Under Five-Years Old——Bangladesh,2012−2016

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China CDC weekly 2021年第29期3卷 620-623,I0001,I0002页

作者： Mohammad Zahid Hossain Shilu Tong Hilary Bambrick Md Alfazal Khan Wenbiao Hu School of public health and Social Work Institute of Health and Biomedical InnovationQueensland University of TechnologyBrisbaneQueenslandAustralia Infectious Diseases Division International Centre for Diarrhoeal Disease ResearchBangladeshMohakhaliDhakaBangladesh Shanghai Children’s medical Centre School of MedicineShanghai Jiao Tong UniversityShanghaiChina School of public health Institute of Environment and Population HealthAnhui Medical UniversityHefeiAnhuiChina Center for Global health School of Public HealthNanjing Medical UniversityNanjingJiangsuChina health System and Population Studies Division International Centre for Diarrhoeal Disease ResearchBangladeshMohakhaliDhakaBangladesh

Summary What is already known on this topic?Different socioecological factors were associated with childhood pneumonia in Bangladesh.However,previous studies did not assess spatial patterns,and socioecological factors and spatial variation have the potential to improve the accuracy and predictive ability of existing models.What is added by this report?

关键词： pneumonia Bangladesh ecological

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Fruit and vegetable consumption,cardiovascular disease,and all-cause mortality in China

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Science China(Life Sciences) 2022年第1期65卷 119-128页

作者： Jun Wang Fangchao Liu Jianxin Li Keyong Huang Xueli Yang Jichun Chen Xiaoqing Liu Jie Cao Shufeng Chen Chong Shen Ling Yu Fanghong Lu Xianping Wu Liancheng Zhao Ying Li Dongsheng Hu Jianfeng Huang Dongfeng Gu Xiangfeng Lu Department of Epidemiology Fuwai HospitalNational Center for Cardiovascular DiseasesChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijing 100037China Key Laboratory of Cardiovascular Epidemiology Chinese Academy of Medical SciencesBeijing 100037China Tianjin Key Laboratory of Environment Nutrition and Public Health/Department of Occupational and Environmental HealthSchool of Public HealthTianjin Medical UniversityTianjin 300070China Division of Epidemiology Guangdong Provincial People’s Hospital and Cardiovascular InstituteGuangzhou 510080China Department of Epidemiology and Biostatistics School of Public HealthNanjing Medical UniversityNanjing 211166China Department of Cardiology Fujian Provincial HospitalFuzhou 350014China Cardio-Cerebrovascular Control and Research Center Institute of Basic MedicineShandong Academy of Medical SciencesJinan 250062China Sichuan Center for Disease Control and Prevention Chengdu 610041China Department of Epidemiology and health Statistics College of Public HealthZhengzhou UniversityZhengzhou 450001China Department of Epidemiology and health Statistics School of Public HealthShenzhen University Health Science CentreShenzhen 518060China School of Medicine Southern University of Science and TechnologyShenzhen 518055China

Evidence about the response patterns of fruit and vegetable consumption with the risk of cardiovascular disease(CVD)and allcause mortality was inconsistent.These associations were examined using a large-scale,population-based Chinese cohort comprising 100,728 participants.A food-frequency questionnaire was used to assess fruit and vegetable consumption.Outcomes were ascertained by interviewing individuals or their proxies and checking hospital records or death certificates.Cox proportional hazards regression was used to calculate hazard ratios(HRs)with 95% confidence intervals(CIs).At the 736,668 person-years of follow-up,3,677 CVD cases and 5,466 deaths were identified.The multivariable-adjusted HRs for CVD across increasing quartiles of total fruit and vegetable consumption were 1(reference),0.94(95%CI=0.85-1.04),0.89(95%CI=0.80-0.98),and 0.85(95%CI=0.77-0.95).Moreover,participants in the highest quartile displayed a 13% lower risk of all-cause mortality(HR=0.87;95%CI=0.80-0.95).A nonlinear dose-response relation was found for CVD,without additional benefits beyond a consumption of600 g d-1,whereas the all-cause mortality risk decreased along with higher consumption,with a linear trend.These associations remained significant for fruit consumption but not for vegetable consumption.Our findings indicated that greater fruit and vegetable consumption was significantly associated with a lower risk of CVD and all-cause mortality.Increasing fruit and vegetable consumption,especially fruit,in the general population would prevent CVD and premature mortality.

关键词： fruit vegetable cardiovascular disease mortality

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Associations of tea consumption with blood pressure progression and hypertension incidence

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Journal of Geriatric Cardiology 2021年第8期18卷 645-653页

作者： Xiao-Ge NIU Can CAI Fang-Chao LIU Jian-Xin LI Ke-Yong HUANG Xue-Li YANG Jie CAO Shu-Feng CHEN Hong-Fan LI Chong SHEN Ying-Xin ZHAO Dong-Sheng HU Shu-Jun GU Jian-Feng HUANG Xiang-Feng LU Dong-Feng GU Department of Epidemiology State Key Laboratory of Cardiovascular DiseaseFuwai HospitalNational Center for Cardiovascular DiseasesChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijingChina Tianjin Key Laboratory of Environment Nutrition and Public HealthDepartment of Occupational and Environmental HealthSchool of Public HealthTianjin Medical UniversityTianjinChina Department of Epidemiology and Biostatistics School of Public HealthNanjing Medical UniversityNanjingChina Cardio-Cerebrovascular Control and Research Center Institute of Basic MedicineShandong First Medical University(Shandong Academy of Medical Sciences)JinanChina Department of Epidemiology and health Statistics College of Public HealthZhengzhou UniversityHenanChina Department of Biostatistics and Epidemiology School of Public HealthShenzhen University Health Science CentreShenzhenChina Changshu Center for Disease Control and Prevention JiangsuChina School of Medicine Southern University of Science and TechnologyShenzhenChina

BACKGROUND Association between tea consumption and incident hypertension remains uncertain.This study conducted to examine the health effects of tea consumption on blood pressure progression and hypertension incidence.METHODS A population-based cohort of 38,913 Chinese participants without hypertension at baseline were included in the current study.Information on tea consumption was collected through standardized questionnaires.Associations of tea consump-tion with blood pressure progression and incident hypertension were analyzed using logistic regression models and Cox propor-tional hazards regression models,respectively.RESULTS During a median follow-up of 5.9 years,17,657 individuals had experienced progression to a higher blood pressure stage and 5,935 individuals had developed hypertension.In multivariate analyses,habitual tea drinkers(≥3 times/week for at least six months)had a 17%lower risk for blood pressure progression[odds ratio(OR)=0.83,95%CI:0.79-0.88]and a 14%de-creased risk for incident hypertension[hazard ratio(HR)=0.86,95%CI:0.80-0.91]compared with non-habitual tea drinkers.In-dividuals in different baseline blood pressure groups could obtain similar benefit from habitual tea drinking.In terms of tea con-sumption amount,an inverse,linear dose-response relation between monthly consumption of tea leaves and risk of blood pres-sure progression was observed,while the risk of incident hypertension did not reduce further after consuming around 100 g of tea leaves per month.CONCLUSIONS Our study demonstrated that habitual tea consumption could provide preventive effect against blood pres-sure progression and hypertension incidence.

关键词： hypertension progression consuming

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