Very first, i omitted instances clinically determined to have blood pressure level during the standard because these members was basically very likely to changes the losing weight habits once perceiving exposure
Once emptying its bladders, the participants seated on the side for over five minutes. Their blood pressure level was measured having fun with good calibrated mercury sphygmomanometer of the a tuned wellness nurse following a standardized process. The players place its right case for the a beneficial cuff airbag, counted about 1 minute ranging from tracks. I defined hypertension clients with a mean of SBP ? 140 mmHg, a suggest regarding DBP ? 90 mmHg, or getting antihypertensive treatment according to guidance having stopping and you may treating blood circulation pressure in China (2010) 23 . Diabetes and myocardial infarction was basically laid out centered on self-report off prognosis because of the a health care provider in public areas medical facilities over the county level. The participants must provide new certificate away from diabetes otherwise myocardial infarction. Detectives must make certain the patient’s diagnosis from proof and you can query the questions ‘Provides a physician ever provided you the medical diagnosis out-of diabetes?
Enjoys a health care professional previously given you the matchbox analysis out of myocardial infarction? Therapy use try outlined based on the participants’ mind-report, where detectives need to ask the participants the following issues: ‘Have you been taking anti-hypertension pills? Do you make use of the oral drug, shot out of insulin, Chinese conventional medication, or do-it-yourself solutions to relieve diabetes? With respect to the guidance to your avoidance and treatments for bloodstream lipids in the Chinese grownups (2006), participants who fulfilled a minumum of one of your after the criteria: (1) TC ? six. We and experienced most other dieting covariates, particularly total weightloss energy, opportunity, whole grain, red meat, fruit, vegetables, soaked fatty acidic, polyunsaturated greasy acid, cereal fibre, Na, K, and cholesterol levels intake, just like the surrogates to deal with potential weight reduction confounding.
Statistical research
The newest cumulative average consumption off calcium supplements, magnesium, and you will phosphorus was computed to minimize within-person variation which means that acquire the best imagine of the long-identity intake. Person-years of pursue-upwards each fellow member was in fact calculated since the interval between the go out regarding finishing of one’s baseline survey therefore the end away from follow-right up (the brand new go out of last visit or even the go to out of stroke diagnosis), almost any appeared very first. The latest frequency rate is actually determined by breaking up just how many times from the people-years of pursue-upwards. The new multivariate Cox proportional dangers activities were utilized to guess the fresh possibilities ratios (HR) and you may 95% trust times (95% CI) of fabricating coronary attack according to dietary calcium supplements, magnesium, and you may phosphorus intake utilising the lower quartile given that resource classification. From the Cox proportional danger habits, new p to own pattern is completed of the modeling this new median of the fresh kinds outlined by for each quartile given that a continuing changeable.
We first performed statistical interaction tests between dietary intakes of calcium, magnesium, phosphorus, and other baseline characteristics (Table 1). We used the Kolmogorov-Sminov test to test the normality of all variables. We outlined the baseline characteristics of the participants. We used the t-test for the continuous variables with normal distribution to test for differences and trends between groups. The non-parametric test is applied to the continuous variables with non-normal distribution, and the chi-square test is used for the classified variables. Then, we categorize the three-day average intakes of calcium, magnesium, phosphorus into four levels. We constructed three sequential models to estimate the effect of calcium, magnesium, phosphorus intakes on stroke. Model 2 further added baseline sociodemographic and lifestyle factors such as urbanization index, education, household income, smoking status, alcohol intake, physical activity, BMI, hypertension, diabetes, myocardial infarction, and medication use into the multivariable analysis. Model 3 additionally adjusted for dietary factors including energy (kcal/d), whole grain (g/d), red meat (g/d), fruits (g/d), vegetables (g/d), saturated fatty acid (g/d), polyunsaturated fatty acid (g/d), cereal fiber (g/d), Na (mg/d), K (mg/d) and cholesterol (g/d) 24,25,26 . To further analyze which factors would affect the relationship between the exposure and outcome, we conducted stratified analyses by age at baseline (< 60 and ? 60 years), sex (man and woman), smoking (never and ever), drinking (never and ever), BMI (< 24, 24–28 and > 28 kg/m 2 ), hypertension, diabetes, and Myocardial infarction. The likelihood ratio test was used to assess the interactions of cross-product terms. The proportional hazards assumption for dietary calcium, magnesium, phosphorus Intakes, and other covariates was checked by Schoenfeld’s residuals, and no violation was found (P > 0.05). Besides, we performed sensitivity analyses to verify the robustness of the primary results. Second, we repeated the analysis using the non-adjusted person-time from the date of the first visit to the time of the most recent visit of stroke diagnosis or to the end of follow-up, whichever came first. Third, we included dyslipidemia as a sensitivity analysis, which confirmed the robustness of our findings to some degree. Tests for trends across dietary intake categories were conducted by modeling the median value in each quartile as a continuous variable in each model. All statistical analyses were performed with STATA version 14.0. All P-values were two-sided, and P < 0.05 was considered to statistical significance.
