| BackgroudOldest old is defined as subjects aged 80 years or over. As the life expectancy is steadily increasing, the number of subjects reaching an age of 80 years or over represents a rapidly growing segment of the population. Meanwhile, the prevalence of age-related diseases, such as hypertension, cognitive impairment, dementia, brain white matter lesions (WML), atherosclerosis, etc., are becoming higher and higher. This is obviously represents an important factor affecting quality of life for the oldest old, and markedly imposing new health and economic challenges in dealing with a geriatric population.Hypertension in the Very Elderly Trial (HYVET), one of multicenter, randomized, active-controlled, double blind trial, is the first study to investigate the effects of antihypertensive treatment on oldest old. Oldest old were eligible recruited if they met the following criteria:systolic blood pressure (SBP) was over 160 mm Hg. The target blood pressure of the trial was less than 150 mm Hg for SBP and 90 mm Hg for diastolic blood pressure (DBP). The results were published in April,2008. It verified that antihypertensive treatment could significantly reduce the occurrence of stroke and the mortality rate. However,2013 European Society of Hypertension/European Society of Cardiology (ESH/ESC) guidelines for the management of arterial hypertension indicated that there were serious limitations, although it provided a theoretical basis for antihypertensive treatment of oldest old. The physical condition and mental state of oldest old recruited in HYVET were very well. On the other hand, the subjects with weak physical condition and other diseases were excluded from the study. Moreover, the period of follow-up was short. Thus, these conditions may induce serious bias of results.Brain WML and cognitive impairment are seriously affecting the quality of life for the oldest old. Hypertension is one of the most important and independently risk factors of brain WML and cognitive impairment. However, it is still unclear about whether antihypertensive treatment, target blood pressure, and the effects of antihypertensive treatment on brain WML and cognitive impairment in oldest old with hypertension. So, the above problems need to be further investigated and verified.Objectives1. To investigate the effect of antihypertensive treatment on brain WML and cognitive impairment in oldest old with hypertension;2. To explore the best target blood pressure and the best decline of blood pressure of antihypertensive treatment in oldest old with hypertension.Methods1. This study was a longitudinal observational study. As the present study was to observe the effect of blood pressure for brain white matter and cognitive function in hypertensive oldest old, the antihypertensive treatment schedule was base on the subject’s intention. Hence, no unified antihypertensive treatment schedule was made in the present study.294 eligible hypertensive oldest old were enrolled in the present study between May 2006 and September 2006. The inclusion criteria were:(1) aged 80 and over, (2) a sitting SBP was 160 mm Hg or over and a standing SBP was 140 mm Hg or over. If patients met any of the following reasons at baseline, they will be excluded:secondary hypertension, diabetes mellitus, stroke, end-stage heart disease, dementia, seizures, Parkinson disease, bipolar disorder, schizophrenia, claustrophobia, contraindication to magnetic resonance imaging scans, and unwilling to provide informed consent;2. After providing informed consent, all patients underwent a clinic visit, a medical history, neurological and cognitive assessment, gait laboratory assessment, and magnetic resonance imaging (MRI) scans of the brain. Assessors were blinded to clinical and imaging outcomes. Education level was categorized into 4 levels (level 1 indicates as less than 5 years education; level 2, from 6 to 8 years; level 3, from 9 to 11 years; level 4, equal or over 12 years) by the number of years at school. Smoking habits and smoking status was classified as current, former, or never. Alcohol intake was quantified as units per week. Eligible participants were receiving tailored and ongoing antihypertensive treatment by a cardiologist during a home interview;3. Clinical blood pressure was measured at baseline and 6 monthly thereafter. Cognitive performances were assessed at baseline and annual visit using the Mini-Mental State Examination (MMSE). Brain MRI scans was performed at baseline and end follow-up visit;4. To find the most appropriate target of blood pressure, the strata of 4-year SBP were split into 5 mm Hg intervals from 130 to 170 mm Hg. SBP than 130 mm Hg and higher than 170 mm Hg were classified into lowest and highest strata, respectively. Similarly, a stratification of the SBP reduction achieved by antihypertensive treatment was also split into 5 mm Hg intervals. Locally weighted scatterplot smoother with LOWESS curves was performed to investigate whether or not there were any threshold levels of SBP, either declined or targeted during the antihypertensive period, which may be associated with the progression of brain white matter hyperintensities (WMH) and cognitive function.Results1. Of 294 oldest old hypertensive patients who were eligible recruited in the study, 31 died,5 occurred stroke, and 8 withdrew during 4-year follow-up visit period. Finally,250 patients completed 4 years follow-up, and were used for statistical analyses;2. Compared to baseline, body mass index (BMI), alcohol consumption, SBP, DBP and MMSE were significantly declined, and fasting plasma glucose (FPG), WMH volume, and WMH/total intracranial volume (TIV) ratio were significantly increased at 4-year follow-up visit (all P< 0.05). The change percentage of MMSE, TIV, WMH and WMH/TIV ratio during 4 years follow-up period were calculated. MMSE declined 6.65%(SD:8.69%). TIV declined 19.76%(SD: 6.99%). WMH increased 29.96%(SD:15.18%). WMH/TIV ratio increased 64.01%(SD:28.89%);3. The relationships of declined percentages in MMSE, TIV, and increased percentages in WMH, and WMH/TIV ratio with SBP decline and SBP at 4-year follow-up visit are performed. Analyses were adjusted for age, sex, education level, BMI, smoking, alcohol consumption, baseline SBP, total cholesterol (TC), triglycerides (TG), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), fasting plasma glucose (FPG), baseline TIV, and baseline WMH in models:(1) For models base on strata of SBP declined level, the stratum of < 5 mm Hg was used as reference, MMSE declined significant lower in strata of 6-10, 11-15,16-20, and 21-25 mm Hg; WMH increased significant lower in strata of 6-10,11-15,16-20,21-25,26-30, and 31-35 mm Hg; WMH/TIV ratio increased significant lower in strata of 6-10,11-15,16-20,21-25,26-30, 31-35,36-40,41-45, and 46-50 mm Hg; TIV declined significant lower in strata of 6-10,11-15,16-20,21-25,26-30,31-35,36-40,41-45, and 46-50 mm Hg. For MMSE decline,β(SE)6-10= 8.234 (1.959), P6-10< 0.001; β(SE)11-15= 8.539 (2.198), P11-15< 0.001; β(SE)16-20= 7.205 (2.991), P16-20= 0.017; β(SE)21-25= 5.313 (2.588), P21-25= 0.041, respectively. For WMH increasing,β(SE)6-10=-11.356 (3.326), P6-10= 0.001;β(SE)11-15=-13.159 (3.731), P11-15= 0.001; β(SE)16-20=-17.042 (5.078), P16-20= 0.001; β(SE)21-25 =-15.477 (4.393), P21-25= 0.001; β(SE)26-30=-20.573 (4.279), P26-30< 0.001; β(SE)31-35=-16.442(4.477),P31-35<0.001.For WMH/TIV ratio increasing, β(SE)6-10=-29.172(5.806),P6-10<0.001;β(SE)11-15=-28.921(6.512),P11-15 <0.001;β(SE)16-20=-41.811(8.864),P16-20<0.001;β(SE)21-25=-45.391 (7.668),P21-25<0.001;β(SE)26-30=-49.521(7.469),P26-30<0.001;β(SE)31-35 =-42.593(7.815),P31-35<0.001;β(SE)36-40=-22.610(10.491),P36-40=0.032; β(SE)41-45=-29.443(10.547),P41-45=0.006;β(SE)46-50=-31.574(9.812), P46-50=0.001;(2) For models base on strata of 4-year SBP,the stratum of>170 mm Hg was used as reference,MMSE declined significant lower in strata 146-150 and 156-160 mm Hg;WMH increased significant lower in strata of 146-150, 156-160, and 166-170 mm Hg;WMH/TIV ratio increased significant lower in strata of 136-140,141-145,146-150,151-155,156-160,and 166-170 mm Hg;TIV declined significant lower in strata of 136-140,141-145,146-150, 151-155, and 156-160 mm Hg.For MMSE change percentage,β(SE)146-150= 5.911(2.970),P146-150=0.048;β(SE)156-160=5.517(2.475),P156-160=0.027. For WMH change percentage,β(SE)146-150=-10.707(5.285),P146-150=0.044; β(SE)156-160=-12.793(4.404),P156-160=0.004;β(SE)166-170=-8.732(4.349), P166-170=0.046.For WMH/TIV ratio change percentage,β(SE)136-140=-23.214(10.119),P136-140=0.023;β(SE)141-145=-20.072(9-309),P141-145= 0.032;β(SE)146-150=-29.587(9.722),P146-150=0.003;β(SE)151-155=-25.587 (11.733),P151-155=0.030;β(SE)156-160=-30.532(8.101),P156-160<0.001; β(SE)166-170=-16.062(8.000),P166-170=0.046;4.To explore the possibility of thresholds in SBP level defining change percentages of MMSE,TIV,WMH, and WMH/TIV ratio,we constructed smoothed scatterplots with LOWESS;5. We also performed further analyses using SBP declined threshold cut point as above described.Patients were classified into 3 groups,ie,<15mm Hg group, 15-35 mm Hg group, and>35 mm Hg group.There were markedly differences in change percentages in MMSE,TIV WMH and WMH/TIV ratio among 3 groups (P<0.05).In 15-35 mm Hg group,MMSE,TIV,WMH and WMH/TIV ratio increased statistically lower compared to < 15mm Hg group, and TIV declined and WMH and WMH/TIV ratio increased statistically lower compared to> 35 mm Hg group (P< 0.05);6. We also classified patients into 3 groups by 4-year SBP, ie,< 140mm Hg group, 140-160 mm Hg group, and> 160 mm Hg group according to target SBP threshold cut point as above described. In 140-160 mm Hg group, MMSE and TIV declined significantly lower than those in< 140mm Hg group and > 160 mm Hg group (P< 0.05). Compared to> 160 mm Hg group, WMH/TIV ratio increased significantly lower in 140-160 mm Hg group (P< 0.05).Conclusion1. Appropriate antihypertensive treatment maybe ameliorates the progression of brain WML and cognitive impairment in oldest old with hypertension;2. In oldest old with hypertension, the most beneficial target of SBP for improving or delaying the progression of brain WML and cognitive impairment was 140-160mmHg, too high or too low will accelerate the development of cognitive decline and WML;3. In oldest old with hypertension, the most beneficial target of SBP lowing for improving or delaying the progression of brain WML and cognitive impairment was 15-35mmHg, there exists beneficial targets for SBP and SBP lowering.BackgroudEpidemiological studies have demonstrated that cardiovascular disease risk doubles for each 20/10 mmHg increase above a baseline blood pressure of 115/75 mmHg. In 2005, the Chinese guidelines for the management of hypertension classified blood pressure levels of 120-139/80-89 mmHg as high normal. The high-normal blood pressure is associated with metabolic disorders, including obesity, abnormal glucose and lipid metabolism, that lead to the development of metabolic syndrome (MS) and other metabolic diseases.Currently, the main prevention and treatment of high-normal blood pressure is lifestyle intervention. However, outside of strict experimental conditions, the effectiveness has been inconsistent due to poor patient compliance. Currently, both at home and abroad, the studies of drug treatment in high-normal blood pressure is rarely, The TROPHY and PHARAO study found that the relative risk of developing hypertension was reduced and the progression to hypertension was delayed in high-normal blood pressure individuals who were treated with antihypertensives, In all cases, their primary endpoint was hypertension. Because high-normal blood pressure is often associated with metabolic disorders that lead to MS, whether application of drugs, and which drug is beneficial to high-normal blood pressure is worth to explore. Studies have suggested that angiotensin Ⅱ receptor blockers (ARB) and diuretics are more effective in lowering blood pressure in hypertensive patients with obesity. However, diuretics have been associated with adverse effects on glucose and lipid metabolism, whereas ARBs have been shown to be beneficial. Telmisartan is an orally effective and specific ARB for the treatment of essential hypertension and the prevention of cardiovascular disease and diabetes, and involved in the regulation of glucose and lipid metabolism. Indapamide is a thiazide-like diuretic that lowers blood pressure primarily through its natriuretic diuretic effect. It has little influence on glucose and lipid metabolism compared with other thiazide diuretics. At present, the acquisition cost of indapamide is lower than telmisartan. Until now, no previous study has evaluated the effects on metabolism of these two drugs when used as an intervention for high-normal blood pressure. Determining the nature of the effects in the population, especially in individuals with abdominal obesity, and determining which drug will be maximally beneficial needs to be verified.Objectives1. To explored the effect of telmisartan and indapamide on high-normal blood pressure individuals;2. To observe the impact of telmisartan and indapamide on the prevalence of MS in high-normal blood pressure individuals;3. To compare effect of telmisartan and indapamide on high-normal blood pressure individuals with abdominal obesity;4. To compare the pharmacoeconomics of these two drugs.Methods1. Participants were recruited from Shandong Province of China. (1) male or female aged 50 to 79 years; (2) systolic blood pressure (SBP) of 130 to 139 mm Hg and diastolic blood pressure (DBP) less than 90 mm Hg; DBP of 85 to 89 mm Hg and SBP less than 140 mm Hg. Exclusion criteria included the presence of diabetes, hypertension, advanced hepatic renal diseases, stroke, myocardial infarction, cancer, pregnancy and intolerance to the study drugs;2. According to random sampling, a total of 664 eligible subjects were randomly divided into three groups,221 were assigned to telmisartan,213 to indapamide and 230 to placebo;3. Medical history, medication use, family history and other clinical data were assessed by questionnaire. The subjects underwent 3 years follow-up. At the baseline and the end of the study, basic clinical data of all subjects such as age, height, weight and blood pressure were collected; biochemical parameters such as fasting plasma glucose and lipids were measured;4. The lifestyle intervention was used during the follow-up period;5. Record the medications and cost of the study drugs.Results1. Drug efficacy comparison:After three years of treatment, the percent change from baseline characteristics was lower in waist circumference (WC), SBP, DBP, triglycerides (TG), low-density lipoprotein cholesterol (LDL-C) and fasting plasma glucose (FPG), but higher in high-density lipoprotein cholesterol (HDL-C). Statistically significant differences were found in SBP, DBP and FPG among the three groups (P< 0.05). Compared with placebo group, the SBP and DBP were significantly lower in the telmisartan group and indapamide group (P< 0.001). There was a statistically significant difference in FPG (P= 0.022). The FPG in the telmisartan group was significantly lower than the FPG in the placebo group and the indapamide group (P< 0.05);2. Drug efficacy on the prevalence of metabolic syndrome:In the first and third year, statistically significant differences were observed in the prevalence of MS among the three groups (P= 0.001). In the first year, the prevalence of MS was significantly decreased in the telmisartan and indapamide groups(P< 0.05). In the third year, the prevalence of MS in the telmisartan group was lower than the placebo group(P= 0.006);3. Drug efficacy on abdominal obesity:After three years of treatment, the percent change from baseline characteristics was lower in WC, SBP, DBP, TG, LDL-C and FPG, but higher in HDL-C. Statistically significant differences were found in SBP and DBP among the three groups in those with abdominal obesity (P< 0.001). Compared with the placebo group, the SBP and DBP were significantly lower in the telmisartan and indapamide groups (P< 0.001);4. Drug efficacy on the prevalence of metabolic syndrome in subjects with abdominal obesity;In the first and third year, statistically significant differences were observed in the prevalence of MS among the three groups in subjects with abdominal obesity (P< 0.001) and was only significantly decreased in the telmisartan group;5. Drug side effects evaluation:All antihypertensive regimens were generally well tolerated. The telmisartan could slightly decrease the uric acid and increase the potassium level, while the indapamide could slightly decrease the potassium level, but the mean uric acid and potassium level were both within the normal range during follow-up;6. Pharmacoeconomics:For the same antihypertensive effect, the three-year total cost was Y2155 per patient for telmisartan and ￥754 per patient for indapamide. Thus, the acquisition cost for telmisartan was approximately 1.86 times higher than indapamide, and the duration of treatment with indapamide was 2.72 times longer than telmisartan.Conclusion1. Telmisartan and indapamide were equally effective in lowering the SBP and DBP to the optimal levels, with little effect of metabolism. Telmisartan could slightly reduced FPG, indapamide did not significantly affect glucose and lipid metabolism;2. the two drugs appeared to be effective in reducing the percentage of individuals with MetS while telmisartan was better for high-normal blood pressure individuals who with abdominal obesity;3. While there was no difference in the antihypertensive effect, the pharmacoeconomics benefit of indapamide was better than telmisartan.BackgroudMetabolic syndrome (MS) is a clustering of some cardioavascular risk factros, including obesity, hypertension, hyperglycemia and dyslipidemia. With the development of society and changes of life style, the prevalence of MS is increased, that lead to the development of cardiovascular and cerebrovascular diseases, diabetes and other complication. Therefore, interventions aimed at the prevention and treatment of MS are highly needed. Currently, the treatment of MS is mainly in view of the different components of MS, which lack of comprehensive treatment. However, The pathogenesis of MS is caused by genetic and environmental factors, the role of gene in the pathogenesis of MS attracts more and more attention, which help to provide new idea and means for the comprehensive treatment of MS. TBXAS1 gene encoding thromboxane synthase (TS), which catalyzes the conversion of the prostaglandin H2 into thromboxane A2 (TXA2), a potent vasoconstrictor and inducer of platelet aggregation. In concert with prostacyclin, thromboxane A2 plays a pivotal role in regulating blood vessel tension and the maintenance of hemostasis. Therefore, TBXAS1 gene become a research hotspot in recent years. studies have demonstrated that, TBXAS 1 gene polymorphism is associated with the complication of MS, such as myocardial infarction and ischemic stroke. However, whether TBXAS1 gene is a susceptibility gene of MS or its components, and play a role in the related damages is unknown. and the single nucleotide polymorphism (SNP) of TBXAS1 gene have differences among different races and regions. Does TBXAS1 have SNPs in Chinese Han population residing in Shandong Province? And does this gene polymorphism provide new idea and means for the comprehensive treatment of MS? Nowadays, there are few studies referring to these questions. Therefore, we carried out the present study and tried to find satisfying answers to all the above problems.Objectives1. To investigate the genotypic and allelic distributions of TBXAS1 gene in Chinese Han population residing in Shandong Province and determine the association of the TBXAS1 gene polymorphism with MS;2. To explore the relationship between the TBXAS1 gene polymorphisms and the endpoints of MS;3. To investigate clinical efficacy and cost effect of mode of individualized treatment by gene oriented treatment of blood glucose, lipid and blood pressure in patients with MS.Methods1. Participants were recruited from Shandong Province of China. According to random sampling, a total of 3072 eligible subjects were obtained, of which 1079 cases were normal controls,1993 cases were patients with MS;2. Medical history, medication use, family history and other clinical data were assessed by questionnaire. The subjects underwent 5 years follow-up. At the baseline and the end of the study, basic clinical data of all subjects such as age, height, weight and blood pressure were collected; biochemical parameters such as fasting plasma glucose and lipids were measured. Record the condition of medication and cost;3. Endpoints:all-cause death, ischemic stroke, coronary heart disease, myocardial infarction and hospitalization for ischemic stroke, new-onset diabetes, new-onset hypertension and new-onset MS;4. The lifestyle intervention was used during the follow-up period;5. DNA was obtained from blood samples using paramagnetic particle method and centrifugal column method. The gene polymorphisms of TBXAS1 including -212515A/G in intron were detected using Sequenom MassARRAY methods.6. Analyze the relationship between the TBXAS1 gene polymorphisms and MS.Results1. Clinical characteristic of control group and MS group of the entire population in 2007:In the entire population,1079 cases were in control group,1993 cases were in MS group; compare with the control group, the body mass index (BMI), waist circumference (WC), systolic blood pressure (SBP), diastolic blood pressure (DBP), total cholesterol (TC), triglycerides (TG), low-density lipoprotein cholesterol (LDL-C) and fasting plasma glucose (FPG) were significantly higher in MS group (P< 0.05). the high-density lipoprotein cholesterol (HDL-C), smoking were significantly lower (P< 0.05). during the 5 year follow-up period, 325 subjects lost to follow-up, the lost rate was 10.57%,93 subjects underwent endpoints. At last,2654 subjects completed follow up,1615 in MS group,1039 in control group. The gender and age in MS group and control group could match. Compared with control group, the BMI, WC, SBP, DBP, TC, TG and FPG were significantly higher, the HDL-C were significantly lower;2. Comparison of SNPs genotypic and allelic distribution frequencies between MS group and controls:There were no significant differences in the distribution of genotypic frequencies of-212515A/G between MS group and controls (all P> 0.05).3. Comparison of clinical characteristics among genotypes of -212515A/G of the follow-up population:(1) Comparison of clinical characteristics among genotypes of -212515 A/G of the follow-up population in 2007:In MS group, there was no significant differences among genotypes (all P> 0.05). In control group, compared with those with AA genotypes, LDL-C in patients with AG genotypes were significantly higher (P< 0.05);(2) Comparison of clinical characteristics among genotypes of -212515 A/G of the follow-up population in 2012:In control group and MS group, there was no significant differences among genotypes (all P> 0.05);4. The relationships between the -212515 A/G polymorphism of TBXAS1 gene and components of MS:there was no significant differences in TG, blood pressure, FPG, abdominal obesity and HDL-C among the three genotypes;5. Comparison of the drug costs among genotypes of -212515 A/G of the MS group:there was no significant differences in the cost of antihypertensives, lipid-lowering drugs and antidiabetic among the three genotypes;6. The relationships between the -212515A/G polymorphism of TBXAS1 gene and endpoints in different populations:(1) In the whole population, there was significant differences between the -212515A/G polymorphism of TBXAS1 gene and ischemic stroke, hospitalization for ischemic stroke, but no significant differences between the -212515A/G polymorphism of TBXAS1 gene and other endpoints;(2) In MS population, there was significant differences between the -212515A/G polymorphism of TBXAS1 gene and ischemic stroke, hospitalization for ischemic stroke, but no significant differences between the -212515A/G polymorphism of TBXAS1 gene and other endpoints;(3) There was no significant differences between the -212515A/G polymorphism of TBXAS1 gene and endpoints in the normal population;7. Screening the risk factors of the onset of ischemic stroke:The Logistic regression analysis was performed, using the -212515A/G polymorphism of TBXAS1 gene, gender, age, BMI, WC, SBP, DBP, TC, TG, HDL-C, LDL-C, FPG, smoking, alcohol consumption, the total cost of antihypertensives, lipid-lowering drugs and antidiabetic as the independent variable, the onset of ischemic stroke as a dependent variable, the results showed:(1) In the whole population, gender and age is the protective factors of the onset of ischemic stroke, the risk of ischemic stroke is decreased when the individual is women or younger.-212515A/G polymorphism of TBXAS1 gene and SBP is the risk factor for the onset of ischemic stroke, the risk of ischemic stroke is increased when the individual has-212515A/G polymorphism of TBXAS1 gene or the SBP is higher;(2) In the MS population, gender is the protective factors of the onset of ischemic stroke, the risk of ischemic stroke is decreased when the individual is women. -212515A/G polymorphism of TBXAS1 gene is the risk factor for the onset of ischemic stroke, the risk of ischemic stroke is increased when the -212515 A/G polymorphism of TBXAS 1 gene is changing;(3) In the normal population, gender is the protective factors of the onset of ischemic stroke, the risk of ischemic stroke is decreased when the individual is women;8. Screening the risk factors of the onset of ischemic stroke:The Logistic regression analysis was performed, using the -212515 A allele and G allele of TBXAS1 gene, gender, age, BMI, WC, SBP, DBP, TC, TG, HDL-C, LDL-C, FPG, smoking, alcohol consumption, the total cost of antihypertensives, lipid-lowering drugs and antidiabetic as the independent variable, the onset of ischemic stroke as a dependent variable, the results showed:(1) In the whole population,-212515 A allele of TBXAS1 gene and gender is the protective factors of the onset of ischemic stroke, the risk of ischemic stroke is decreased when the individual is women or with A allele. SBP is the risk factor for the onset of ischemic stroke, the risk of ischemic stroke is increased when the SBP is higher;(2) In the MS population,-212515 A allele of TBXAS1 gene and gender is the protective factors of the onset of ischemic stroke, the risk of ischemic stroke is decreased when the individual is women or with A allele;(3) In the normal population, gender is the protective factors of the onset of ischemic stroke, the risk of ischemic stroke is decreased when the individual is women;9. The interaction effect between -212515A/G polymorphism of TBXAS1 gene and the clinical characteristics on the onset of ischemic stroke:(1) In the whole population, there are positive interactions between -212515A/G polymorphism of TBXAS1 gene and BMI, WC, SBP, DBP, TC, TG, HDL-C, LDL-C and FPG;(2) In the MS population, there are positive interactions between -212515A/G polymorphism of TBXAS1 gene and age, BMI, WC, SBP, DBP, TC, HDL-C, LDL-C and FPG;10. The interaction effect between -212515 A allele of TBXAS1 gene and the clinical characteristics on the onset of ischemic stroke:(1) In the whole population, there are negative interactions between -212515 A allele of TBXAS1 gene and age, gender, BMI, WC, SBP, DBP, TC, TG, HDL-C, LDL-C and FPG;(2) In the MS population, there are negative interactions between -212515 A allele of TBXAS1 gene and age, gender, BMI, WC, SBP, DBP, TC, TG, HDL-C, LDL-C and FPG;Conclusion1. The -212515A/G polymorphism of TBXAS1 gene could be identified in Chinese Han population residing in Shandong Province;2. No significant differences in the distribution of genotypic frequencies of -212515A/G are found between MS group and controls, so there are no relationship between MS and genotypes of -212515 A/G polymorphism of TBXAS1 gene;3. In the case of same clinical characteristics, prevention and control measures, economic cost, the individuals who with -212515A/G polymorphism of TBXAS 1 gene is more likely to have ischemic stroke;4. In the case of same WC, BMI, SBP, DBP, TC, HDL-C, LDL-C and so on, the change of the genotypes of -212515A/G polymorphism of TBXAS 1 gene, lead to the risk of ischemic stroke increases in the population;5. The individuals who with -212515 A allele of TBXAS 1 gene have low risk and low cost of ischemic stroke, especially combined with MS;6. Although the treatment decisions, cost of treatment for individuals are different from each genotype of -212515 of TBXAS 1 gene, the clinical outcomes are similar. |
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