Very first, we excluded times clinically determined to have blood pressure level from the standard mainly because participants was in fact prone to alter the slimming down habits shortly after perceiving chance
Just after draining their bladders, the participants seated privately for more than five minutes. Its blood pressure level is counted playing with a calibrated mercury sphygmomanometer because of the an experienced wellness nursing assistant following a standardized procedure. The players put its correct arm for the an effective cuff airbag, counted at least 1 minute between recordings. I laid out blood circulation pressure patients that a suggest out of SBP ? 140 mmHg, a hateful out of DBP ? ninety mmHg, otherwise delivering antihypertensive medication according to the guidance to own blocking and you can treating blood circulation pressure within the China (2010) 23 . Diabetes and you will myocardial infarction was laid out according to mind-report out of medical diagnosis from the a health care provider in public hospitals above the condition top. The participants ought to provide the fresh certification out-of diabetes otherwise myocardial infarction. Investigators have to guarantee new person’s medical diagnosis regarding proof and you may inquiry the questions ‘Keeps a health care provider previously offered you the medical diagnosis of diabetes?
Provides a doctor previously provided you the prognosis out of myocardial infarction? Procedures have fun with try discussed based on the participants’ self-statement, in which investigators need certainly to inquire the players the following questions: ‘Are you getting anti-blood pressure pills? Do you make use of the dental treatments, injection away from insulin, Chinese antique medication, otherwise homemade remedies to ease diabetes? According to the assistance to the reduction and you will treatments for bloodstream lipids when you look at the Chinese people (2006), players exactly who came across one or more of adopting the standards: (1) TC ? 6. We as well as noticed other fat reduction covariates, such as for instance total weight reduction times, time, grain, red meat, good fresh fruit, create, saturated greasy acid, polyunsaturated greasy acidic, cereal fibre, Na, K, and cholesterol levels consumption, since surrogates to manage potential weight-loss confounding.
Analytical investigation
The newest cumulative mediocre consumption from calcium supplements, magnesium, and phosphorus are computed to minimize within-people adaptation which means get an educated imagine of enough time-identity intake. Person-numerous years of go after-right up for every new member were determined while the interval involving the day away from doing of your own standard survey plus the avoid regarding follow-up (the latest day of your last see or even the see from coronary arrest diagnosis), any type of showed up first. Brand new frequency price are determined from the dividing what amount of times from the person-numerous years of follow-upwards. This new multivariate Cox proportional threats habits were utilized to help you guess new possibility rates (HR) and you will 95% believe menstruation (95% CI) of creating coronary arrest predicated on dieting calcium, magnesium, and you can phosphorus intake with the lower quartile just like the source category. Regarding Cox proportional danger habits, brand new p having trend is done from the modeling this new average of the fresh new groups laid out of the for every quartile since the an ongoing 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 blackfling 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.