1
2024, 37(9): 949-992.
doi: 10.3967/bes2024.162
Since 1990, China has made considerable progress in resolving the problem of “treatment difficulty” of cardiovascular diseases (CVD). The prevalent unhealthy lifestyle among Chinese residents has exposed a massive proportion of the population to CVD risk factors, and this situation is further worsened due to the accelerated aging population in China. CVD remains one of the greatest threats to the health of Chinese residents. In terms of the proportions of disease mortality among urban and rural residents in China, CVD has persistently ranked first. In 2021, CVD accounted for 48.98% and 47.35% of deaths in rural and urban areas, respectively. Two out of every five deaths can be attributed to CVD. To implement a national policy “focusing on the primary health institute and emphasizing prevention” and truly achieve a shift of CVD prevention and treatment from hospitals to communities, the National Center for Cardiovascular Diseases has organized experts from relevant fields across China to compile the “Report on Cardiovascular Health and Diseases in China” annually since 2005. The 2024 report is established based on representative, published, and high-quality big-data research results from cross-sectional and cohort population epidemiological surveys, randomized controlled clinical trials, large sample registry studies, and typical community prevention and treatment cases, along with data from some projects undertaken by the National Center for Cardiovascular Diseases. These firsthand data not only enrich the content of the current report but also provide a more timely and comprehensive reflection of the status of CVD prevention and treatment in China.
2
2025, 38(8): 891-892.
doi: 10.3967/bes2025.098
3
2025, 38(8): 893-917.
doi: 10.3967/bes2025.099
Cardiovascular diseases (CVD) and their risk factors are exerting an increasingly significant impact on public health, and the incidence rate of CVD continues to rise. This article provides an interpretation of essentials from the newly published Annual Report on Cardiovascular Health and Diseases in China (2024), aiming to offer scientific evidence for CVD prevention, treatment, and the formulation of relevant policies.
4
2026, 39(4): 396-407.
doi: 10.3967/bes2026.027
Objective To characterize long-term transition probabilities in waist circumference (WC) status from childhood into early adulthood and identify critical age windows for the development, persistence, and reversal of central obesity. Methods Using the China Health and Nutrition Survey data (1993–2022), 7,007 WC measurements from 2,440 participants aged 6–17 years at baseline were analyzed. Participants were grouped by baseline age: 6–11, 12–14, and 15–17 years. Generalized linear mixed-effects models were used to estimate WC transition probabilities, adjusting for sociodemographic factors. Results Central obesity prevalence increased from age 6, declined in early adulthood (approximately 22 years), and subsequently increased again. The 6–14-year age window exhibited dynamic, bidirectional transitions; specifically, the 10-year reversal probabilities from central obesity to normal WC were 44.19% (ages 6–11) and 41.39% (ages 12–14), decreasing to 26.93% for ages 15–17. Among those aged 15–17 years with central obesity, boys had a > 80% probability of maintaining increased WC for 20 years. Conclusion Ages 6–14 years represent a critical “reversal period” for central obesity. Interventions should prioritize this window using age- and sex-specific strategies to maximize normalization and curb long-term obesity risk.
5
2026, 39(4): 418-426.
doi: 10.3967/bes2025.160
Objective The study aims to prospectively examine the association between the minimum dietary diversity for women (MDD-W) score and risk of gestational diabetes mellitus (GDM). Methods All participants were pregnant women enrolled in the Tongji Maternal and Child Health Cohort. Dietary intake was assessed using a food frequency questionnaire (FFQ) or 24-h dietary recall. The MDD-W score was constructed by categorizing all food items into 10 food groups, following the Food and Agriculture Organization guidelines. Oral glucose tolerance tests (OGTT) were conducted during 24−28 weeks of gestation to screen for GDM. Poisson regression models were used to assess the association between MDD-W scores and GDM risk. Results In total, 357 (11.8%) of the 3,026 women were diagnosed with GDM. Compared with participants whose MDD-W score was ≥ 8, those with a score of 5−7 had an increased risk of GDM (relative risk (RR): 1.32; 95% confidence interval (CI): 1.03, 1.69), and those with a score ≤ 4 had a significantly higher GDM risk (RR: 1.58; 95% CI: 1.12, 2.26). Furthermore, these findings indicate that pregnant women with MDD-W scores < 8, in conjunction with being overweight or obese before pregnancy and excessive gestational weight gain, have the highest risk of developing GDM. Conclusions These data suggest that a higher MDD-W score during pregnancy is independently associated with a lower GDM risk. Therefore, promoting dietary diversity and weight management is recommended to protect pregnant women from developing gestational diabetes.
6
2026, 39(1): 82-104.
doi: 10.3967/bes2025.104
Human cardiac organoids have revolutionized the study of cardiac development, disease modeling, drug discovery, and regenerative therapies. This review systematically discusses strategies and progress in the construction of cardiac organoids, categorizing them into three main types: cardiac spheroids, self-organizing/assembloid organoids, and organoid-on-a-chip systems. This review uniquely integrates the advances in vascularization, organ-on-chip design, and environmental cardiotoxicity modeling within cardiac organoid platforms, offering a critical synthesis that is absent in the literature. In the context of escalating environmental threats to cardiovascular health, there is an urgent need for physiologically relevant models to accurately identify cardiac toxicants and elucidate their underlying mechanisms of action. This review highlights advances in cardiac organoid applications for disease modeling—including congenital heart defects and acquired cardiovascular diseases—drug development, toxicity screening, and the study of environmentally induced cardiovascular pathogenesis. In addition, it critically examines ongoing challenges and underscores opportunities brought by bioengineering approaches. Finally, we propose future directions for developing standardized cardiac organoid platforms with clinical predictability, aiming to expand the utility of this technology across broader research applications.
7
2026, 39(4): 476-481.
doi: 10.3967/bes2026.026
Whether adherence to the Planetary Health Diet (PHD) benefits human and environmental health is less known. We included 131,130 adults from the National Health and Nutrition Examination Survey and UK Biobank. Adherence to the PHD was measured using the Planetary Health Diet Index (PHDI) and mortality was ascertained by linking to national registries. Cox proportional hazards and linear/ordinal logistic regression models were used to analyze the association between PHD and the risk of mortality and environmental impacts, respectively. During a median follow-up of 10.6 years, participants in higher adherence groups (Quartile 2: hazard ratio = 0.88, 95% confidence interval = 0.82–0.95; Quartile 3: 0.87, 0.82–0.93; Quartile 4: 0.70, 0.54–0.92) had a lower risk of mortality, compared to Quartile 1. The relationship between the PHDI and mortality showed linearity in the two cohorts (P = 0.1877 and 0.5456, respectively), and body mass index mediated 11.88% of the relationship. A higher PHDI was associated with lower greenhouse gas emissions but higher freshwater use. Our findings suggest that greater compliance with the PHD reduces mortality risk; however, its benefits for environmental sustainability are less certain.
8
2016, 29(11): 773-781.
doi: 10.3967/bes2016.104
Objective In this study, the ameliorative effects of gold nanoparticles (gold NP) on the renal tissue damage in Schistosoma mansoni (S. mansoni)-infected mice was investigated.
Methods High-resolution transmission electron microscopy was used for the characterization of NP. The gold NP at concentrations of 250, 500, and 1000 μg/kg body weight were inoculated into S. mansoni-infected mice.
Results The parasite caused alterations in the histological architecture. Furthermore, it induced a significant reduction in the renal glutathione levels; however, the levels of nitric oxide and malondialdehyde were significantly elevated. The parasite also managed to downregulate KIM-1, NGAL, MCP-1, and TGF-βmRNA expression in infected animals. Notably, gold NP treatment in mice reduced the extent of histological impairment and renal oxidative damage. Gold NP were able to regulate gene expression impaired by S. Mansoni infection.
Conclusion The curative effect of gold NP against renal toxicity in S. mansoni-infected mice is associated with their role as free radical scavengers.
9
Mengen Guo,
Jiangmei Liu,
Guanhao He,
Jinlei Qi,
Jianxiong Hu,
Peng Yin,
Sujuan Chen,
Yulin Zhuo,
Yi Lin,
Xuelong Gu,
Tao Liu,
Ziqiang Lin,
Fengrui Jing,
Jinling You,
Wenjun Ma,
Fanna Liu,
Maigeng Zhou
2026, 39(4): 464-475.
doi: 10.3967/bes2026.013
Objective Although many studies have examined temperature-related non-accidental mortality, the impact of heat waves on the mortality burden of chronic kidney disease (CKD) remains poorly understood. This study aimed to assess the CKD mortality burden associated with heat waves in China under global warming. Methods Mortality data on CKD from 2,790 counties/districts in China from 2004 to 2022 were collected from the Chinese Center for Disease Control and Prevention; meteorological data for the same period were obtained from the fifth-generation European Reanalysis Land dataset. A time-stratified case-crossover design combined with a distributed lag nonlinear model was used to examine the association between heat waves and CKD mortality. Future CKD mortality burdens attributable to heat waves under climate change and future population scenarios were projected. Results In total, 236,260 CKD deaths were included in this study. Compared to that during non–heat wave days, CKD mortality increased by 3.48% (95% confidence interval [CI]: 1.67% to 5.33%) during heat waves, and the mortality risk escalated by 2.48% (95% confidence interval [CI]: 0.12% to 4.91%) for each 1 °C increment during heat wave days. Stratified analyses revealed that CKD mortality risks were greater for women (Excess Risk [ER] = 5.52%, 95% CI: 2.71% to 8.40%), individuals aged 65 years and older (ER = 4.60%, 95% CI: 2.30% to 6.96%), and people in mesic/cold regions (ER = 6.20%, 95% CI: 1.13% to 11.53%). The projections showed that the attributable fraction(AF) of CKD mortality due to heat waves would rise from 0.64% (95% CI: 0.52% to 0.78%) in the 2020s to 2.44% (95% CI: 1.97% to 2.95%) in the 2090s under the SSP5-8.5 scenario, with the highest burden in southeastern China, including Hainan (3.31%, 95% CI: 1.66% to 5.02%), Yunnan (3.05%, 95% CI: 1.46% to 4.75%), and Guangdong Province (2.84%, 95% CI: 1.24% to 4.41%). Conclusion This nationwide study demonstrated that exposure to heat waves significantly increased the mortality risk of CKD, and that women, older individuals, and people in mesic/cold regions are more susceptible to heat waves. Global warming will significantly increase the future CKD mortality burden attributed to heat waves, particularly in southeastern China. Our findings emphasize the need to address CKD in the context of ongoing climate change.
10
Milan Jia,
Chenxia Zhou,
Hui Li,
Jing Lan,
Wenbo Zhao,
Lingyun Jia,
Sijie Li,
Changhong Ren,
Chen Zhou,
Lu Liu,
Xunming Ji
2026, 39(2): 192-201.
doi: 10.3967/bes2025.118
Objective Cerebral venous outflow disorders (CVOD) can impair cerebral perfusion and produce diverse, often debilitating symptoms, substantially reducing quality of life. Intermittent hypoxia-hyperoxia training (IHHT) has demonstrated therapeutic potential across various pathologies and may represent a promising non-pharmacological approach for CVOD management. Methods Patients with imaging-confirmed CVOD underwent 14 IHHT sessions, each comprising four cycles of 10-minute hypoxia (11% O2) stimulation and 20-minute hyperoxia (38% O2). Physiological parameters and adverse events were monitored throughout the intervention. Clinical scales, 24-hour ambulatory blood pressure, blood tests, jugular ultrasound, and perfusion imaging were assessed pre- and post-intervention. Results No participants experienced intolerable discomfort or severe adverse events; vital signs remained within normal ranges. No significant changes were observed in 24-hour blood pressure, blood cell counts, lipid profiles, or other blood markers. Notably, 60% of patients (n = 12) reported overall symptom improvement on the Patient Global Impression of Change scale. Headache severity, as measured by the visual analogue scale, significantly decreased (6.33 ± 1.22 vs. 4.89 ± 2.03, P = 0.016). In patients with internal jugular vein (IJV) stenosis, significant improvements were observed in regional cerebral blood flow (including the insula, occipital lobe, internal capsule, and lenticula) and left J3-segment IJV flow volume (107.27 [47.50, 160.00] vs. 140.83 [55.00, 210.00] mL/min, P = 0.011). Conclusion The current IHHT protocol is safe and well-tolerated in patients with CVOD. IHHT may alleviate CVOD-related symptoms by improving oxygen saturation, cerebral perfusion, and venous outflow pattern, supporting its potential as a non-invasive therapeutic strategy.
11
2025, 38(7): 867-872.
doi: 10.3967/bes2025.083
12
ZHANG Yu Tong,
HUANG Tao,
ZHOU Fang,
HUANG Ao Di,
JI Xiao Qi,
HE Lu,
GENG Qiang,
WANG Jia,
MEI Can,
XU Yu Jia,
YANG Ze Long,
ZHAN Jian Bo,
CHENG Jing
2022, 35(7): 648-651.
doi: 10.3967/bes2022.084
13
2026, 39(2): 146-157.
doi: 10.3967/bes2025.121
Objective Post tuberculosis lung disease (PTLD) manifests in various forms, including tuberculosis-associated chronic obstructive pulmonary disease (TB-COPD), yet the clinical features of PTLD remain undercharacterized. This study aimed to assess longitudinal changes in lung function over a 5-year period and to identify predictors of airflow obstruction in a cohort of patients treated for active pulmonary TB. Methods Patients with active pulmonary TB were enrolled in this study and were followed during treatment, at treatment completion and five years post-treatment. Assessments included lung function and chest CT, analyzing longitudinal trends and airflow obstruction risk factors. Results Among 53 patients (mean age 36.9 ± 13.9 years; 64.2% male), 7 patients (13.2%) exhibited airflow obstruction. At the 5-year follow-up, the mean FEV1/FVC declined significantly (76.27% ± 12.04% vs. 80.23% ± 11.02%, P < 0.001) and 9 patients (17.0%) exhibited airflow obstruction. Seven of these patients predominantly showed air trapping consistent with small airway disease on chest CT, aligning with TB-COPD phenotype. Notably, four young-to-middle-aged patients (< 60 years old) had persistent obstruction over the five years. Conclusion The initial test revealed that 13.2% of patients presented with airflow obstruction. By the 5-year follow-up, this proportion had increased to 17.0%, with most cases demonstrating imaging findings aligning with TB-COPD, even among younger, non-smoking individuals. These findings emphasize the importance of long-term follow-up and routine lung function assessments in TB survivors.
14
Qiaoqiao Zhao,
Yanjie Zhao,
Jing Ju,
Liming Zhang,
Xueqing Jia,
Duoduo Fu,
Jiening Yu,
Kaili Sun,
Liying Chen,
Xiaoting Liu,
Zuyun Liu,
Yan Zhang,
Yangzhen Lu,
Xuan Ge
2026, 39(3): 259-269.
doi: 10.3967/bes2025.166
Objective This study examined the associations between multidimensional body composition modalities and brain aging in Chinese adults. Methods Brain age was estimated using ridge regression based on 24 head computed tomography-derived neuroanatomical indicators in a Chinese cohort (n = 557). Brain age gap (BAG), the deviation between the predicted brain age and chronological age (CA), was categorized into brain age acceleration (BAG > 0) and deceleration (BAG < 0) groups. Principal component analysis of 22 correlation-independent body composition indicators identified different body composition modalities. Logistic regression was used to examine the associations between these modalities and the BAG groups. Results The mean absolute error of brain age in predicting CA was 6.41 years. Three body composition modalities were identified: fat mass dominant (characterized by high loading coefficients of body fat mass, fat mass index, visceral fat level, and fat-to-lean mass ratio); fat-free mass dominant; and trunk-leg contrast distribution. The fat mass dominant modality was significantly associated with brain age acceleration (odds ratio [OR] = 1.40, 95% confidence interval [CI]: 1.15‒1.71), and the association was robust in sensitivity analyses. Conclusion The fat mass dominant modality was significantly associated with accelerated brain aging. This study suggests integrating deep body composition indicators into clinical and community health screening could aid in targeted prevention of brain aging.
15
2023, 36(6): 517-526.
doi: 10.3967/bes2023.063
Objective Current clinical evidence on the effects of home blood pressure telemonitoring (HBPT) on improving blood pressure control comes entirely from developed countries. Thus, we performed this randomized controlled trial to evaluate whether HBPT plus support (patient education and clinician remote hypertension management) improves blood pressure control more than usual care (UC) in the Chinese population. Methods This single-center, randomized controlled study was conducted in Beijing, China. Patients aged 30–75 years were eligible for enrolment if they had blood pressure [systolic (SBP) ≥ 140 mmHg and/or diastolic (DBP) ≥ 90 mmHg; or SBP ≥ 130 mmHg and/or DBP ≥ 80 mmHg with diabetes]. We recruited 190 patients randomized to either the HBPT or the UC groups for 12 weeks. The primary endpoints were blood pressure reduction and the proportion of patients achieving the target blood pressure. Results Totally, 172 patients completed the study, the HBPT plus support group (n = 84), and the UC group (n = 88). Patients in the plus support group showed a greater reduction in mean ambulatory blood pressure than those in the UC group. The plus support group had a significantly higher proportion of patients who achieved the target blood pressure and maintained a dipper blood pressure pattern at the 12th week of follow-up. Additionally, the patients in the plus support group showed lower blood pressure variability and higher drug adherence than those in the UC group. Conclusion HBPT plus additional support results in greater blood pressure reduction, better blood pressure control, a higher proportion of dipper blood pressure patterns, lower blood pressure variability, and higher drug adherence than UC. The development of telemedicine may be the cornerstone of hypertension management in primary care.
16
2026, 39(4): 408-417.
doi: 10.3967/bes2025.144
Objective To develop hemoglobin (Hb) percentiles and thresholds for defining anemia among infants aged 0–5 months in China. Methods The National Nutrition and Health Systematic Survey for children aged 0–17 years in China, a nationwide cross-sectional study, was conducted between 2019 and 2021. Hb levels were measured in infants using the HemoCue 201+ analyzer. Age- and sex-specific Hb distributions were constructed for “healthy infants”, defined as those with adequate iron reserves at birth, exclusive breastfeeding, normal weight-for-age Z-score and weight growth velocity, normal neuropsychological development, and absence of acute or chronic diseases. A generalized additive model for location, scale, and shape was applied to fit the Hb percentiles. The 5th percentile of the Hb distribution was defined as the threshold for anemia. Results A total of 10,174 infants aged 0–5 months participated in the study, among whom 2,155 healthy infants were included in the analysis. Hb levels peaked at birth, gradually decreased to a nadir around 60 days after birth, and then rose to a plateau. The Hb thresholds defining anemia were 102.7 g/L, 96.3 g/L, 92.8 g/L, 95.4 g/L, 97.1 g/L, and 95.8 g/L for the 0-, 1-, 2-, 3-, 4-, and 5-month age groups, respectively. Conclusion This study establishes hemoglobin thresholds for defining anemia in infants aged 0–5 months based on a nationwide, population-based dataset in China.
17
2026, 39(4): 427-436.
doi: 10.3967/bes2026.005
Objective To investigate the association between thyroid hormone sensitivity indices and metabolic dysfunction-associated fatty liver disease (MAFLD) in euthyroid Chinese adults. Methods This cohort study included 5,356 euthyroid patients. The peripheral and central thyroid hormone sensitivity indices were calculated. Cox regression models were used to evaluate associations with MAFLD risk, and restricted cubic splines were used to assess potential nonlinearity. Mediation analyses based on an accelerated failure-time model were used to examine the role of the triglyceride-glucose (TyG) index. Results MAFLD incidence in euthyroid participants was 18.26%. After adjustment, higher free thyroxine (FT4) levels were inversely associated with MAFLD (HR = 0.973, 95% CI: 0.948 to 0.999, P = 0.043), whereas higher free triiodothyronine (FT3) levels increased MAFLD risk (HR = 1.118, 95% CI: 1.000 to 1.250, P = 0.050). Enhanced thyroid hormone sensitivity, as reflected by elevated FT3/FT4 levels and lower total thyroxine resistance index (TT4RI), thyroid stimulating hormone index (TSHI), and thyroid feedback quantile-based index (TFQIFT4), was also associated with a higher incidence (all P < 0.05). Mediation analyses indicated that TyG partially mediated the FT3/FT4-MAFLD and TFQIFT4-MAFLD associations, with indirect effects of –96.27 (95% CI: –124.67 to –70.42) and –4.95 (95% CI: –8.29 to –2.10), respectively. Conclusion Increased FT3/FT4 and decreased TFQIFT4 levels were significantly associated with a higher MAFLD risk in euthyroid adults, with TyG acting as a partial mediator.
18
2026, 39(4): 447-463.
doi: 10.3967/bes2025.141
Objective This study investigates the global, regional, and national cardiovascular disease (CVD) burden caused by household air pollution (HAP) from 1990 to 2021 across regions, time periods, sexes, and age groups. Methods The global CVD mortality and disability-adjusted life years (DALYs) attributable to HAP are analyzed to assess their current status and historical trends. Quantitative methods are used to assess health inequalities. Projections up to the year 2040 are made using the Nordpred method. Results In 2021, 0.758 million deaths and 18.175 million DALYs were attributed to HAP-related CVD, with age-standardized rates (ASR) for mortality and DALYs of 8.950 and 210.354 per 100,000 individuals, respectively. The disease burden increased with age and was higher in men. While mortality and DALYs rates have decreased over the past three decades, with more significant reductions in low- and middle-income regions, health inequalities persist despite improvements. Projections indicate a slow increase in the CVD burden attributable to HAP by 2040, even as the per capita rates decline. Conclusion Although significant reductions in CVD attributable to HAP have occurred globally, particularly in low- and middle-income countries, disparities persist. Health inequalities have improved but remain significant. As the global population grows and ages, total cases will increase, highlighting the need for continued, targeted interventions.
19
2026, 39(4): 482-485.
doi: 10.3967/bes2026.028
20
Jing Shi,
Ziyi Zhou,
Baiyu Zhou,
Yongkang Tao,
Yan Cen,
Luyao Zhang,
Sainan Li,
Ying Li,
Botao Sang,
Xiangfei Liu,
Qinan Ma,
Xuezhai Zeng,
Pulin Yu,
Jing Li,
Deping Liu
2026, 39(3): 270-284.
doi: 10.3967/bes2026.020
Objective Frailty is becoming increasingly common among aging adults. Frailty transitionis shaped by biological, social, psychological, and environmental factors. This study investigated combined effects of protective factors on frailty transition by constructing a Protection Index (PI) to guide targeted interventions. Methods Data were extracted from the 4th Sample Survey of the Aged Population in Urban and Rural China, including baseline (2017) and follow-up (2019) surveys. Frailty was assessed using the Frailty Index (FI), whereas the PI measured protective factors. Frailty transitions over 2 years were analyzed prospectively. Pearson’s correlation examined the relationship between FI and PI, and logistic regression assessed the effects of PI on frailty transitions. Results This study included 9,093 older adults. FI values increased with age and were higher in women, whereas PI values decreased with age and were higher in men. Over 2 years, 56.2% of the participants showed a stable frailty status, 14.2% improved, and 29.6% worsened. Negative transitions were more common than positive transitions, with transitions occurring most frequently between adjacent states. The PI was moderately negatively correlated with the FI (r = −0.349, P < 0.001). A higher PI was associated with a lower risk of negative transitions among robust and prefrail individuals (OR = 0.989, 0.981, both P < 0.05), but showed no significant effect among those with existing frailty. Conclusion Negative frailty transitions were more common with advancing age. Enhancing PI may help prevent negative frailty transitions among robust and pre-frail older adults, underscoring the value of early interventions.
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