Journal of Geriatric Cardiology最新文献

{"title":"Optimal timing of invasive intervention for high-risk non-ST-segment-elevation myocardial infarction patients.","authors":"Juan-Juan Zheng, Yue-Qiao Si, Tian-Yang Xia, Bing-Jun Lu, Chun-Yu Zeng, Wei-Eric Wang","doi":"10.26599/1671-5411.2024.08.003","DOIUrl":"10.26599/1671-5411.2024.08.003","url":null,"abstract":"<p><strong>Objective: </strong>To compare the immediate, early, and delayed percutaneous coronary intervention (PCI) strategies in non-ST-segment-elevation myocardial infarction (NSTEMI) patients with high-risk.</p><p><strong>Methods: </strong>Medical records of patients treated at the Daping Hospital, Third Military Medical University, Chongqing, China between 2011 and 2021 were retrospectively reviewed. Only patients with complete available information were included. All patients assigned into three groups based on the timing of PCI including immediate (< 2 h), early (2-24 h) and delayed (≥ 24 h) intervention. Multivariable Cox hazards regression and simpler nonlinear models were performed.</p><p><strong>Results: </strong>A total of 657 patients were included in the study. The median follow-up length was 3.29 (interquartile range: 1.45-4.85) years. Early PCI strategy improved the major adverse cardiac event (MACE) outcome compared to the immediate or delayed PCI strategy. Early PCI, diabetes mellitus, and left main or/and left anterior descending or/and left circumflex stenosis or/and right coronary artery ≥ 99% were predictors for MACE outcome. The optimal timing range for PCI to reduce MACE risk is 3-14 h post-admission. For high-risk NSTEMI patients, early PCI reduced primary clinical outcomes compared to immediate or delayed PCI, and the optimal timing range was 3-14 h post-admission. Delayed PCI was superior for NSTEMI with chronic kidney injury.</p><p><strong>Conclusions: </strong>Delayed invasive strategy was helpful to reduce the incidence of MACE for high-risk NSTEMI with chronic kidney injury. An immediate PCI strategy might increase the rate of MACE.</p>","PeriodicalId":51294,"journal":{"name":"Journal of Geriatric Cardiology","volume":"21 8","pages":"807-815"},"PeriodicalIF":1.8,"publicationDate":"2024-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11411260/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142300337","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lipid-lowering effects of gefarnate in statin-treated patients with residual hypertriglyceridemia: a randomized controlled study.","authors":"Jing Shi, Ming-Lu Xu, Mei-Jiao He, Wan-Lan Bo, Hai-Yu Zhang, Dang-Hui Sun, Ding-Yu Wang, Xiao-Yu Wang, Qun Shao, Yu-Jiao Pan, Yu Zhang, Chen-Guang Dai, Jing-Ying Wang, Lin-Wei Zhang, Guang-Zhong Liu, Yue Li","doi":"10.26599/1671-5411.2024.08.001","DOIUrl":"10.26599/1671-5411.2024.08.001","url":null,"abstract":"<p><strong>Background: </strong>The prevention of coronary artery disease (CAD) faces dual challenges: the aspirin-induced gastrointestinal injury, and the residual cardiovascular risk after statin treatment. Geraniol acetate (Gefarnate) is an anti-ulcer drug. It was reported that geraniol might participate in lipid metabolism through a variety of pathways. The aim of this study was to assess the lipid-lowering effects of gefarnate in statin-treated CAD patients with residual hypertriglyceridemia.</p><p><strong>Methods: </strong>In this prospective, open-label, randomized, controlled trial, 69 statin-treated CAD patients with residual hypertriglyceridemia were randomly assigned to gefarnate group and control group, received gefarnate (100 mg/3 times a day) combined with statin and statin alone, respectively. At baseline and after one-month treatment, the levels of plasma triglyceride, high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C) and total cholesterol were tested.</p><p><strong>Results: </strong>After one-month gefarnate treatment, triglyceride level was significantly lowered from 2.64 mmol/L to 2.12 mmol/L (<i>P</i> = 0.0018), LDL-C level lowered from 2.7 mmol/L to 2.37 mmol/L (<i>P</i> = 0.0004), HDL-C level increased from 0.97 mmol/L to 1.17 mmol/L (<i>P</i> = 0.0228). Based on statin therapy, gefarnate could significantly reduce the plasma triglyceride level (<i>P</i> = 0.0148) and increase the plasma HDL-C level (<i>P</i> = 0.0307). Although the LDL-C and total cholesterol levels tended to decrease, there was no statistically significant difference.</p><p><strong>Conclusions: </strong>The addition of gefarnate to statin reduced triglyceride level and increased HDL-C level to a significant extent compared to statin alone in CAD patients with residual hypertriglyceridemia. This suggested that gefarnate might provide the dual benefits of preventing gastrointestinal injury and lipid lowering in CAD patients.</p>","PeriodicalId":51294,"journal":{"name":"Journal of Geriatric Cardiology","volume":"21 8","pages":"791-798"},"PeriodicalIF":1.8,"publicationDate":"2024-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11411259/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142300335","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Accelerated aging and frailty in cardiovascular diseases.","authors":"Xue-Hua Cheng, Tao Wu, Li Han","doi":"10.26599/1671-5411.2024.08.005","DOIUrl":"10.26599/1671-5411.2024.08.005","url":null,"abstract":"","PeriodicalId":51294,"journal":{"name":"Journal of Geriatric Cardiology","volume":"21 8","pages":"828-830"},"PeriodicalIF":1.8,"publicationDate":"2024-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11411263/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142300331","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pulmonary embolism and deep venous thrombosis in China.","authors":"Sheng-Shou Hu","doi":"10.26599/1671-5411.2024.08.007","DOIUrl":"10.26599/1671-5411.2024.08.007","url":null,"abstract":"<p><p>The <i>Annual Report on Cardiovascular Health and Diseases in China</i> (2022) intricate landscape of cardiovascular health in China. In connection with the previous section, this eighth section of the report offers a comprehensive analysis of pulmonary embolism and deep venous thrombosis. In recent years, research in the field of pulmonary vessel in China has made great progress. A number of nationwide multi-center registry research results have filled the gaps in the epidemiology, diagnosis and treatment of pulmonary hypertension and venous thromboembolism. Different types of pulmonary hypertension still need attention to the identification of risk factors and/or risk stratification, and venous thromboembolism needs attention in the prevention and the overall management inside and outside hospital. In the future, we look forward to the publication of more high-quality research in China, which could be able to improve relevant guidelines for pulmonary vascular diseases both domestically and internationally.</p>","PeriodicalId":51294,"journal":{"name":"Journal of Geriatric Cardiology","volume":"21 8","pages":"775-778"},"PeriodicalIF":1.8,"publicationDate":"2024-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11411264/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142300338","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Consensus on glycemic management for patients with coronary heart disease and type 2 diabetes.","authors":"Li-Nong Ji, Yun-Dai Chen","doi":"10.26599/1671-5411.2024.07.007","DOIUrl":"10.26599/1671-5411.2024.07.007","url":null,"abstract":"<p><p>The prevalence of patients with coronary heart disease (CHD) and diabetes mellitus is notably high, posing significant residual cardiovascular risks even after routine interventions such as antihypertensive, lipid-lowering, and antithrombotic treatments. Recent studies have demonstrated that certain glucose-lowering medications confer cardiovascular benefits for patients with type 2 diabetes. However, a survey indicates that cardiologists may not be fully acquainted with the optimal screening timing, indicators, and diagnostic criteria for type 2 diabetes, and there is insufficient awareness and a low rate of prescription of novel glucose-lowering medications with proven cardiovascular efficacy, such as glucagon-like peptide-1 receptor agonists (GLP-1 RAs) and sodium-glucose co-transporter-2 inhibitors (SGLT-2i). In this context, based on domestic and international guidelines or consensus and the latest evidence-based evidence, this consensus aims to standardize the glycemic management for patients with acute coronary syndrome, chronic coronary syndrome, and perioperative management for percutaneous coronary intervention. It highlights the key points of screening and diagnosis of type 2 diabetes, and the comprehensive management of cardiovascular risk in patients with CHD. The consensus elaborates on the principles and algorithms of glycemic management for CHD patients, without involving acute complications of diabetes, clarifies the clinical practice of glucose-lowering medications with cardiovascular benefits, and promotes the standardized use of these medications in cardiovascular and other related specialty fields. Additionally, it addresses the glucose-lowering treatment to comprehensively reduce cardiovascular risks.</p>","PeriodicalId":51294,"journal":{"name":"Journal of Geriatric Cardiology","volume":"21 7","pages":"689-702"},"PeriodicalIF":1.8,"publicationDate":"2024-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11341531/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142057274","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Disorders of cardiac rhythm in China.","authors":"Sheng-Shou Hu","doi":"10.26599/1671-5411.2024.07.012","DOIUrl":"10.26599/1671-5411.2024.07.012","url":null,"abstract":"<p><p>The <i>Annual Report on Cardiovascular Health and Diseases in China</i> (2022) intricate landscape of cardiovascular health in China. In connection with the previous section, this seventh section of the report offers a comprehensive analysis of disorders of heart rhythm in China. In 2021, China has achieved significant development and gratifying results in many aspects of the field of arrhythmia. Left bundle branch pacing (LBBP), as an emerging pacing technique originating from China, has received widespread attention. New research results have emerged on its indications, surgical procedures, clinical evaluation, and comparison with other pacing techniques. Its feasibility, effectiveness, and safety have been basically verified, but its long-term prognosis still needs further confirmation from larger samples and longer follow-up time research results. Leadless pacemakers have begun to be used in a wider range of clinical applications, and related large sample cohort studies have been reported. In addition, there are also noteworthy new achievements in the fields of pacemaker remote programming, anticoagulation and radiofrequency catheter ablation (RFCA) therapy for atrial fibrillation, and implantable cardioverter defibrillator prevention of sudden cardiac death. In terms of clinical practice, due to COVID-19 pandemic, the number of RFCA procedures and other device implantations in China has fluctuated, but it has gradually recovered since 2020.</p>","PeriodicalId":51294,"journal":{"name":"Journal of Geriatric Cardiology","volume":"21 7","pages":"703-712"},"PeriodicalIF":1.8,"publicationDate":"2024-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11341525/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142057275","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predicting cardiovascular events in out-of-hospital patients presenting with atypical chest pain and complete left bundle branch block: role of CTA and echocardiographic Global Longitudinal Strain.","authors":"Guido Pastorini, Fabio Anastasio, Anna Botto, Valentina Tardivo, Mauro Feola","doi":"10.26599/1671-5411.2024.07.004","DOIUrl":"10.26599/1671-5411.2024.07.004","url":null,"abstract":"<p><strong>Background: </strong>Out-of-hospital patients presenting with atypical chest pain and complete left bundle branch block (LBBB) have to be stratified for the presence of coronary artery disease and the risk of developing heart failure (HF). We investigated the prognostic role of coronary CT-angiography (CTA) and echocardiographic global longitudinal strain (GLS) in those patients in a mid-term follow-up.</p><p><strong>Methods: </strong>Out-of-hospital patients with LBBB underwent echocardiography and a 64-slice CT angiography were evaluated retrospectively. Development of HF or a cardiovascular death were the events scheduled.</p><p><strong>Results: </strong>Seventy-eight patients (32 female; mean age: 66.0 ± 10.4 years were enrolled. During a follow-up of 33 months (IQR: 17-77), one patient (1.5%) experienced a cardiovascular death, 14 patients (17.9%) required urgent outpatient visits due to acute decompensated HF (12 hospitalizations). Echocardiography showed a slightly reduced left ventricular ejection fraction (LVEF) (50.0% ± 9.8%) and GLS within the normal range (-16.2% ± 4.1%). CTA analysis showed coronary stenosis > 50% in 28 patients (35.9%). A high Agatston score (> 100) was observed in 29.5%. Notably, 25 patients (32.1%) were diagnosed with left main coronary artery disease and 15 patients (16.7%) underwent revascularization during the follow up. Significant associations were observed between events and LVEF (<i>P</i> = 0.001), diastolic dysfunction grade ≥ 2 (<i>P</i> = 0.02), GLS (<i>P</i> < 0.001), multiple coronary stenosis (<i>P</i> = 0.04) and Agatston score (<i>P</i> = 0.05). Multivariate analysis confirmed the relationships with LVEF (R² = 0.89, <i>P</i> < 0.001), diastolic dysfunction (R² = 3.30, <i>P</i> = 0.04), GLS (R² = 1.43, <i>P</i> < 0.001), and Agatston score (R² = 1.01, <i>P</i> = 0.05).</p><p><strong>Conclusions: </strong>In patients with complete LBBB, CTA and GLS identified those at a high risk of development HF.</p>","PeriodicalId":51294,"journal":{"name":"Journal of Geriatric Cardiology","volume":"21 7","pages":"760-767"},"PeriodicalIF":1.8,"publicationDate":"2024-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11341527/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142057278","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical profile and outcomes in very elderly patients with atrial fibrillation anticoagulated with rivaroxaban: data from the EMIR study.","authors":"Francisco Marín, Manuel Anguita Sánchez, Iñaki Lekuona, Marcelo Sanmartín Fernández, Vivencio Barrios, Carlos Perez Muñoz, Juan Cosín-Sales, Alejandro I Pérez Cabeza, Vanesa Roldán Schilling, Carles Rafols Priu, Esteban Orenes-Piñero, María Asunción Esteve-Pastor","doi":"10.26599/1671-5411.2024.07.003","DOIUrl":"10.26599/1671-5411.2024.07.003","url":null,"abstract":"<p><strong>Objectives: </strong>To analyze the clinical profile, adequacy of treatment with rivaroxaban and outcomes in octogenarians with atrial fibrillation (AF), taking rivaroxaban in clinical practice.</p><p><strong>Methods: </strong>Observational and non-interventional study that included AF adults recruited from 79 Spanish centers, anticoagulated with rivaroxaban ≥ 6 months before being included. Data were analyzed according to age (≥ 80 <i>vs</i>. < 80 years) at baseline.</p><p><strong>Results: </strong>Out of 1433 patients, 453 (31.6%) were octogenarians at baseline. Compared to younger patients, octogenarians had more comorbidities, higher CHA₂DS₂-VASc (4.5 ± 1.3 <i>vs</i>. 3.0 ± 1.4; <i>P</i> < 0.001) and HAS-BLED scores (2.0 ± 1.0 <i>vs.</i> 1.4 ± 1.0; <i>P</i> < 0.001). Overall, the dose of rivaroxaban was adequately prescribed in 83.4% of patients, but more frequently in the younger population (71.1% <i>vs.</i> 89.1%; <i>P</i> = 0.039). After a mean follow-up of 2.2 ± 0.6 years, annual rates of stroke + systemic embolism + transient ischemic attack, MACE, cardiovascular death and major bleeding were 1.03%, 1.24%, 1.03% and 1.75%, respectively, in octogenarian patients. Except for progressive heart failure death and major bleeding, rates of outcomes in octogenarians were similar compared to younger patients. In octogenarians, the concomitant use of antiplatelet agents and non-severe dementia were independently associated with the development of ischemic stroke, whereas previous coronary revascularization and heart failure with MACE, and higher HAS-BLED score with major bleeding.</p><p><strong>Conclusions: </strong>In clinical practice, around one third of patients taking rivaroxaban are octogenarians. These patients have many comorbidities and a high thromboembolic risk. Despite that, rates of adverse events remain low. Rivaroxaban is adequately prescribed in the majority of octogenarians.</p>","PeriodicalId":51294,"journal":{"name":"Journal of Geriatric Cardiology","volume":"21 7","pages":"723-732"},"PeriodicalIF":1.8,"publicationDate":"2024-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11341529/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142057273","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Trends in mortality among the geriatric population undergoing Surgical aortic valve replacement (SAVR) and potential racial disparities: a 20-year perspective via the National (Nationwide) Inpatient Sample.","authors":"Nomesh Kumar, Kamleshun Ramphul, Fnu Bawna, Nitish Behary Paray, Mansimran Singh Dulay, Jasninder Singh Dhaliwal, Shruti Aggarwal, Sebastian Mactaggart, Suma Sri Chennapragada, Shaheen Sombans, Renuka Verma, Hemamalini Sakthivel, Raheel Ahmed","doi":"10.26599/1671-5411.2024.07.002","DOIUrl":"10.26599/1671-5411.2024.07.002","url":null,"abstract":"<p><strong>Background: </strong>Racial disparities in cardiovascular conditions are well documented. Whether similar race-based discrepancies in health outcomes also exist among elderly patients undergoing surgical aortic valve replacement (SAVR) for aortic stenosis remains understudied.</p><p><strong>Methods: </strong>We abstracted data from the National (Nationwide) Inpatient Sample over a 20-year period from 2001 to 2020 using specific ICD-9 and ICD-10 codes. We included patients aged ≥ 60 and ≤ 80 years with races recorded as White, African American, or Hispanic at the time of their hospitalization for surgery. We analyzed and reported the baseline characteristics, risk-adjusted in-hospital mortality, and complications stratified by race.</p><p><strong>Results: </strong>Of 420,181 patients studied, 90.0% identified as White, 4.0% as African American and 6.0% as Hispanic. Despite a decrease in overall in-hospital mortality rates from 3.8% between 2001-2005 to 1.8% between 2016-2020, African Americans had higher odds of all-cause in-hospital deaths compared to Whites (aOR = 1.390, <i>P</i> < 0.001). Additionally, they were more likely to experience cardiogenic shock (aOR = 1.241, <i>P</i> < 0.001) and acute kidney injury (aOR = 1.314, <i>P</i> < 0.001) as well as more likely to require organ support such as IABP use (aOR = 1.336, <i>P</i> < 0.001) or invasive mechanical ventilation (aOR = 1.342, <i>P</i> < 0.001). Interestingly, African Americans were less likely to report events of acute ischemic stroke compared to Whites (aOR = 0.852, <i>P</i> < 0.001).</p><p><strong>Conclusions: </strong>Despite a reassuring reduction in overall in-hospital mortality rates of geriatric patients undergoing SAVR for aortic stenosis, racial disparities in health outcomes remain pervasive with minorities more likely to report higher in-hospital morbidity and mortality.</p>","PeriodicalId":51294,"journal":{"name":"Journal of Geriatric Cardiology","volume":"21 7","pages":"716-722"},"PeriodicalIF":1.8,"publicationDate":"2024-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11341532/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142057280","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Variations, effectiveness and its associated factors of a nationwide web-based hypertension management training project in China: insights from a government-led campaign for 1.2 million lay health workers.","authors":"Wei Wang, Hai-Bo Zhang, Jia-Min Liu, Yan Li, Na Tian, Lei Yan, Jin-Xiao Song, Mei-Li Li, Yue Peng, Jing Li","doi":"10.26599/1671-5411.2024.07.010","DOIUrl":"10.26599/1671-5411.2024.07.010","url":null,"abstract":"<p><strong>Objectives: </strong>To evaluate the effectiveness of a large-scale, web-based, in-service hypertension management training project among lay health workers (LHWs) at primary care health (PHC) settings in China, and to examine the factors contributing to the variations of effectiveness.</p><p><strong>Methods: </strong>We used data from a web-based national hypertension management training project implemented in 2018, it was designed to facilitate LHWs to learn, understand, and apply the relevant knowledge and skills in hypertension management through providing training courses by use of the web-based platform with unified standards. All LHWs were required to participate in the exams before and after training to acquire scores for the use of evaluating their performance of hypertension management knowledge. We first used descriptive analysis to present the variations of effectiveness in hypertension management knowledge among LHWs by important subgroups. Afterwards, we used multilevel logistic regression to examine the individual and regional factors contributing to the variations and quantify the magnitude of how these factors affected training effectiveness.</p><p><strong>Results: </strong>There were 1,208,610 LHWs who completed training and were certificated. Nationally, the scores of LHWs increased significantly from 62.87 ± 21.14 out of 100 in the pre-test to 88.30 ± 11.31 in the post-test by 25.43 (95% confidence interval [CI]: 25.40-25.47). Training contents involved in antihypertensive medication showed the lowest score (54.36) in the pre-test and soared the most after training, up to 84.22 by 54.94%. Individual factors associated with disparities in the knowledge of hypertension management decreased substantially after training, which included sex, age, education, practice type, professional level, and hierarchy of working institutions. Geographical variations were shown at the provincial level, with the majority of them being explained by factors at the regional level.</p><p><strong>Conclusions: </strong>Accessible web-based training modality, government efforts, accompanied with experiences derived from the training, could be generalized to other low- and middle-income countries in facilitating the hypertension management capacity of LHWs. Localization and evaluation is warranted on the way to its further application.</p>","PeriodicalId":51294,"journal":{"name":"Journal of Geriatric Cardiology","volume":"21 7","pages":"733-750"},"PeriodicalIF":1.8,"publicationDate":"2024-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11341526/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142057281","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}