Long-term use of low-dose aspirin and the risk of Helicobacter pylori infection and the effect of Helicobacter pylori eradication treatment: A Prospective Case-Control Analysis

Long-term use of low-dose aspirin and the risk of Helicobacter pylori infection and the effect of Helicobacter pylori eradication treatment: A Prospective Case-Control Analysis | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Long-term use of low-dose aspirin and the risk of Helicobacter pylori infection and the effect of Helicobacter pylori eradication treatment: A Prospective Case-Control Analysis Shixiong Liu, Yang Shengyi, Qiao Yuqin, Liu Shixiong This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-4300031/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Objective To investigate the relationship between long-term use of low-dose aspirin and Helicobacter pylori (HP) infection and its effect on eradication and recurrence of HP. Methods From March 2019 to December 2020, 3256 patients with cardiovascular and cerebrovascular diseases who were treated in the Affiliated Hospital of Gansu University of Chinese Medicine, Zhangye Second People's Hospital of Gansu Province, Tianshui Hospital of Integrated Traditional Chinese and Western Medicine of Gansu Province, and the First Hospital of Lanzhou University were selected as the study objects. The patients ranged in age from 34 to 93(51.9±9.1) years, including 2147 (65.9%) males and 1109 (34.1%) females. According to the results of C14-urea breath test (C14-UBT), 1733 cases of HP infection and 1523 cases of HP non-infection were divided into two groups. Logistic regression analysis，both univariate and multivariate, was used to investigate the relationship between aspirin use and HP infection. Parallel to this, a prospective case-control analysis was performed, and 859 patients with hypertension combined with HP were selected as the study objects. The patients ranged in age from 43 to 71(50.3±8.4) years, with 568 males (66.1%) and 291 females (33.9%). According to the medication situation, the subjects were divided into aspirin group (432 cases, in addition to taking antihypertensive drugs combined with low-dose aspirin treatment), non-aspirin group (427 cases, only taking conventional antihypertensive drugs), in addition, patients with current HP infection but no hypertension and other acute and chronic diseases were selected as the control group (418 cases). To compare the efficacy, safety and recurrence of HP after 1 year and 3 years of bismuth-containing quadruple therapy. Results The overall infection rate of HP was 53.3% (1733/3256). The results of univariate analysis showed that the infection rate of female was higher than that of male [56.4% (625/1109) vs. 51.6% (1108/2147). χ²=6.628, P=0.010], the age of the HP infected group was higher than that of the uninfected group (52.1±9.2 vs. 50.4±8.9, t=3.166, P=0.002), and the body mass index of the HP infected group was higher than that of the uninfected group (24.59±3.11 vs. 24.36±3.01). t=2.135, P=0.033), LDL cholesterol (2.36±0.61 vs. 2.29±0.57, t=3.174, P=0.002) and fasting blood glucose (5.35±0.53 vs. 5.22±0.52, t=2.519, P=0.024) were higher than those in uninfected group. The infection rate of patients who took low-dose aspirin for a long time was higher than that of those who did not take aspirin [56.6% (674/1191) vs. 51.3% (1059/2065), χ²=8.548, P=0.003]. Multivariate Logistic regression analysis showed that the older the age, the higher the risk of H.pylori infection (OR=1.041, 95%CI: 1.008-1.086, P=0.003), and the risk of infection in females was higher than that in males (OR=1.332, 95%CI: 1.098-1.627, P=0.004), higher fasting blood glucose increased the risk of infection (OR=1.528, 95%CI: 1.337-2.189, P<0.001), higher LDL cholesterol increased the risk of infection (OR=1.103, 95%CI: 1.034-1.392, P=0.007), long-term aspirin increased the risk of infection (OR=1.526, 95%CI: 1.231-2.015, P<0.001), after controlling for age, sex, and body mass index, long-term aspirin use still increased the risk of infection (OR=1.433, 95%CI: 1.196-1.947, P<0.001). The overall eradication rates were 87.6% (1077/1229), 87.8% (367/418), 88.5% (361/408) and 86.6% (349/403) in the treatment group, observation group and control group, respectively. According to intention analysis, the overall eradication rate was 84.3% (1077/1277), 84.9% (367/432), 84.5% (361/427) and 83.5% (349/418), respectively, and the comparison was not statistically significant (P< 0.05). The overall 1-year recurrence rate was 1.3% (14/1046), and the recurrence rates of the three groups were 1.10% (4/359), 1.70% (6/352) and 1.20% (4/335), respectively, with no statistical significance (P<0.05). The overall recurrence rate at 3 years was 3.1% (32/1046), and the recurrence rate in the three groups was 5.30% (19/359), 1.90% (7/352) and 1.70% (6/335), respectively. The recurrence rate in the treatment group was higher than that in the observation group and control group (χ² =6.118 and 5.507, P= 0.01 and 0.015, respectively). The main adverse reactions in the first month of eradication treatment were constipation and mild nausea, and there was no statistical significance between the three groups (P>0.05). Conclusion Long-term use of low-dose aspirin increases the risk of HP infection and the recurrence rate in 3 years after eradication. It is suggested that HP should be tested and eradicated regularly in long-term users. Figures Figure 1 Figure 2 Introduction In recent years, studies have shown that Helicobacter pylori (HP) infection is associated with the development of cardiovascular and cerebrovascular diseases [1] . Aspirin, the main drug used for the prevention of cardiovascular and cerebrovascular diseases, can cause gastrointestinal mucosal damage and increase the risk of gastrointestinal bleeding [2] . It remains unclear whether long-term use of low-dose aspirin increases the risk of HP infection or whether it affects the eradication and recurrence of HP. This study retrospectively analysed the correlation between HP infection and long-term use of low-dose aspirin and compared the effect of long-term use of low-dose aspirin on the eradication and recurrence of HP through a prospective case-control study. Subjects and methods I. Subjects Using retrospective analysis, 3256 patients with cardiovascular diseases (CVDs) who were treated at the Affiliated Hospital of Gansu University of Chinese Medicine, the Second People's Hospital of Zhangye City in Gansu, the Tianshui Hospital of Integrated Traditional Chinese and Western Medicine in Gansu, and the First Hospital of Lanzhou University between March 2019 and December 2020 were included in this study. There were 2,147 males (65.9%) and 1,109 females (34.1%) aged 34-93 (51.9±9.1) years. The inclusion criteria were as follows: (1) patients that had been evaluated using the C 14 -urea breath test (C 14 -UBT); (2) patients that had lived in an urban area for a long time; and (3) patients that had been clearly diagnosed with various cardiovascular and cerebrovascular diseases for at least 1 year and had been given or not given the relevant treatments; (4) patients that had been regularly taking low-dose enteric-coated aspirin tablets (daily dose = 100 mg) orally for at least 1 year. According to the C 14 -UBT results, the subjects were divided into an HP infection group (+) with 1733 patients and an HP noninfection group (-) with 1523 patients. The exclusion criteria were as follows: (1) those who had incomplete disease history data; (2) those who had diabetes, severe liver and kidney dysfunction, a history of malignant tumours, or a history of abdominal surgery; (3) those who had used various types of antimicrobials, H 2 -receptor antagonists or proton pump inhibitors in the last 2 months and those who had been taking other non-steroidal anti-inflammatory drugs (NSAIDs) for a long time; and (4) those who were pregnant or lactating. Using a prospective case-control study, a total of 859 patients with cardiovascular and cerebrovascular diseases combined with HP infection who were treatment-compliant were selected as the research subjects. There were 568 males (66.1%) and 291 females (33.9%) aged 43-71 (50.3±8.4) years. According to medication status, the patients were divided into the following groups: (1) the aspirin group, 432 patients who were treated with aspirin in addition to the routine use of antihypertensive drugs; (2) the aspirin-free group, 427 patients who only used antihypertensive drugs routinely; and (3) the control group, 418 patients with HP infection but without various acute or chronic diseases during the same period. The exclusion criteria were as follows: (1) alcohol or tobacco addiction; (2) blood pressure ≥140/90 mm Hg; and (3) ≥3 risk factors, target organ damage, clinical complications and comorbidities such as diabetes, and other acute and chronic diseases. This study was approved by the Ethics Committee of the First Hospital of Lanzhou University and followed the Declaration of Helsinki . Informed consent was not obtained for this cross-sectional study, but the personal information of the study subjects was kept confidential. Informed consent was obtained from all patients for the case-control study. II. Methods 1. The following clinical data were collected: (1) Inclusion baseline information: age, sex, body mass index (BMI), smoking and drinking history, and past medical history. (2) Laboratory tests and indicators: routine blood test, fasting blood glucose (FBG), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), triacylglycerol (TG), uric acid (UA), homocysteine (Hcy) and C 14 -UBT. Abdominal ultrasound, cardiac colour Doppler ultrasound, arterial ultrasound of the neck and extremities, and brain computed tomography (CT)/magnetic resonance imaging (MRI). (3) Cardiovascular and cerebrovascular diseases; CVDs include various types of coronary heart disease, valvular disease, myocardial disease, and arrhythmia; cerebrovascular diseases include cerebral infarction, cerebral arteriosclerosis, transient ischaemic attack, and intracranial carotid plaque; and peripheral artery disease includes disease of the upper and lower extremity arteries, celiac artery, and extracranial carotid artery. (4) Medication status: doses and time courses of proton pump inhibitors, antibiotics and aspirin. 2. Diagnosis, eradication and efficacy evaluation of HP infection: (1) Diagnostic criterion: C 14 -UBT count/min>100 dpm/mmol. When the C 14 -UBT count was close to 100 dpm/mmol, the test was performed again after 2 weeks. (2) The eradication regimen was as follows: esomeprazole magnesium enteric-coated tablets (20 mg, 2 times/d, taken before breakfast and dinner; AstraZeneca Plc, product batch number: 1603178); bismuth potassium citrate/potassium citrate/clarithromycin/tinidazole tablets (bismuth potassium citrate tablets: 220 mg, 2 times/d, taken on an empty stomach half an hour before breakfast and dinner; tinidazole tablets: 0.5 g, 2 times/d, after breakfast and dinner; clarithromycin tablets: 0.25 g, 2 times/d, after breakfast and dinner (Livzon Pharmaceutical Group, product batch number: 160903)), with a treatment course of 2 weeks. (3) Evaluation of efficacy: The efficacy evaluation was performed 1 month after the end of eradication treatment and 1 year after successful eradication according to the original method, and the diagnostic criteria were the same. The eradication rate was calculated separately (regimen-based analysis = the number of successful eradication cases/the number of enrolled patients receiving treatment × 100%, and intention-based analysis = the number of successful eradication cases/the number of patients who completed the eradication treatment × 100%). Recurrence rate = number of patients experiencing recurrence /(number of patients with successful eradication – number of patients lost to follow-up) × 100%. 3. Antihypertensive treatment and safety evaluation: (1) Antihypertensive treatment: After conducting risk stratification assessments of cardiovascular risk factors, subclinical target organ damage and clinical diseases, the original antihypertensive regimen determined based on patient lifestyle was remained the same and was continually administered to the patients. (2) The subjects were urged to take the medication regularly and record adverse reactions, and liver and kidney function indicators were reviewed. 3. Statistical methods Data analysis was performed using SPSS 22.0 software. Measurement data conforming to normal distribution are expressed as , and comparisons between the two groups were made using a t test or one-way analysis of variance (ANOVA); measurement data not conforming to normal distribution are expressed as median (quartiles) [ M ( Q 1 , Q 3 )], and the Mann-Whitney U test was used. Categorical variables were expressed as the case number or percentage, and the χ2 test and Fisher's exact probability test were used. Variables with statistical significance (or close to statistical significance) according to univariate analysis were included in the multivariate logistic regression model, and the risk factors for HP infection were determined using a regression analysis. A two-sided P <0.05 indicated a statistically significant difference. Results 1. Comparison of HP infection and clinical status in the patient cohort The overall HP infection rate was 53.3% (1733/3256), and the infection rate in females was greater than that in males [56.4% (625/1109) vs. 51.6% (1108/2147), χ²=6.628, P = 0.010]. There were 1191 patients who used small doses of aspirin for a prolonged period of time, accounting for 36.6% (1191/3256) of the patients examined in this study. The HP infection rate of patients who used aspirin was greater than that of patients who did not use aspirin [56.6% (674/1191) vs. 51.3% (1059/2065), χ²=8.548, P=0.003], while the differences in infection rate between the groups that used aspirin for 1-2 years, ≥2-<5 years, and ≥5 years were not statistically significant [54% (95/176) vs. 57% (211/370) vs 57.1% (238/417), χ²=0.533, P=0.758]. In addition, the univariate analysis showed that age, sex, LDL-C, and FBG were significantly associated with HP infection (Table 1). 2. Multivariate logistic regression analysis of the factors associated with HP infection HP infection was used as the dependent variable, and age, sex, LDL-C, FBG, and long-term use of low-dose aspirin were included in multivariate logistic regression analysis as independent variables. Results showed that the risk of HP infection increases with age (odds ratio (OR)=1.041, 95% confidence interval (CI): 1.008-1.086, P= 0.003); women have a greater risk of infection than men ( OR =1.332, 95% CI : 1.098-1.627, P =0.004); long-term use of aspirin can increase the risk of infection ( OR = 1.526, 95% CI : 1.231-2.015, P <0.001); the risk of infection increases with increased FBG (OR=1.528, 95% CI: 1.337-2.189; P<0.001); the risk of infection increases with increased LDL-C levels (OR=1.103, 95% CI: 1.034-1.392, P=0.007). After controlling for age, sex, BMI and other factors, long-term use of aspirin was still found to increase the risk of infection (OR=1.433, 95% CI: 1.196-1.947, P<0.001). 3. HP eradication and recurrence after 1 year and 3 years Comparisons showed that the age, blood pressure, BMI, FBG and TC, LDL-C, HDL-C, TG, and UA levels among the aspirin group, the nonaspirin group, and the control group were not significantly different (Table 2). The regimen-based analysis showed that the overall eradication rate was 87.6% (1077/1229), and the eradication rates among the aspirin group, the nonaspirin group and the control group were 87.8% (367/418), 88.5% (361/408), and 86.6% (349/403), respectively, and were not statistically significantly different (x 2 =0.667, p=0.607). The intention-based analysis showed that the overall eradication rate was 84.3% (1077/1277), and the eradication rates among the three groups were 84.9% (367/432), 84.5% (361/427), and 83.5% (349/418) respectively, and were not statistically significantly different (x 2 =0.364, p=0.843)(Fig.1). A total of 31 patients were lost to the 3-year follow-up, and the loss rate was 2.90% (31/1077). The overall 1-year recurrence rate was 1.3% (14/1046); the recurrence rates of the 3 groups were 1.10% (4/359), 1.70% (6/352), and 1.20% (4/335), respectively; and the recurrence rates among the groups were not statistically significant (x 2 =0.547, p=0.761). The 3-year overall recurrence rate was 3.1% (32/1046), and the recurrence rates of the 3 groups were 5.30% (19/359), 1.90% (7/352), and 1.70% (6/335), respectively; the difference was not statistically significant (x 2 =9.214, p=0.01). The recurrence rate in the aspirin group was significantly greater than that in the nonaspirin group and the control group (x 2 = 6.118 and 5.507, respectively, p = 0.01 and 0.015). There was no significant difference between the nonaspirin group and the control group (x 2 =0.036, p=0.537)(Fig.2). 4. Safety evaluation There were no abnormal changes in indicators such as liver or kidney function after 1 or 3 years of eradication treatment. The main adverse reactions that occurred within 1 month of the eradication treatment/follow-up were constipation, mild nausea, abdominal distension, dry mouth, bad breath, headache, and fatigue, and the differences in adverse reactions among the three groups were not statistically significant (all P>0.05, Table 4). Discussion Low-dose aspirin is widely used to prevent various cardiovascular and cerebrovascular events [ 3 ] . The long-term use of aspirin can cause gastrointestinal mucosal damage and increase the incidence of gastrointestinal haemorrhage, with a marked age-dependence (i.e., higher mortality in the elderly) [ 2 , 4 ] . Ageing is strongly associated with an increased risk of HP infection [ 2 ] , but it is not clear whether the increased risk of HP infection is associated with the use of aspirin. In this study, the univariate analysis showed that the HP infection rate in long-term low-dose aspirin users was greater than that in nonusers, and the multivariate regression analysis also showed that long-term use of low-dose aspirin was associated with an increased risk of HP infection. The risk of infection remained high and statistically significant when controlling for factors, such as age and sex [ 5 ] . The possible cause is related to the effect of the salicylates produced by the hydrolysis of aspirin on factors of the gastric environment, such as the pH, and these changes favour the passage of HP across the mucus barrier and subsequent colonization. In the middle-age and elderly populations, HP infection is an important risk factor for aspirin-associated peptic ulcers [ 6 ] , and combined HP infection increases risks of bleeding and perforation in aspirin users [ 7 ] . Currently, the combination of aspirin use and HP infection is considered to have an enhanced effect on gastric mucosal damage [ 8 – 9 ] . The damage caused by aspirin to the gastric mucosa is mainly due to cyclooxygenase-1 (COX-1) inhibition and prostaglandin depletion, leading to a reduced defence-repair capacity of the gastric mucus-mucosal barrier and mucosal ischaemia [ 10 ] . Moreover, HP can secrete a variety of pathogenic factors that trigger immune and inflammatory responses [ 11 – 12 ] and aggravate gastric mucosal injury. Yoshida [ 13 ] reported that HP tends to evade the immune response in the stomach, which is disrupted by aspirin, and can colonize and multiply in the gastric mucosa for a prolonged period of time. HP infects the gastric mucosa and induces the accumulation of neutrophils, which is an important process that exacerbates the damaging effect of aspirin on the gastric mucosa [ 14 ] . The 2022 US Preventive Services Task Force (USPSTF) recommendation statement emphasized that for people ≥ 60 years old, the bleeding risk of aspirin could offset the benefit of CVD prevention [ 15 ] . Therefore, elderly individuals that use aspirin should be carefully monitored for HP infection and treated with an eradication treatment protocol if HP infection is present to reduce the risk of ulcer bleeding and recurrence [ 16 – 17 ] . This study also showed that there was no significant difference in the infection rate between the groups treated with aspirin over different periods of time, which was consistent with the results reported in the literature [ 18 ] . It is also unclear whether long-term use of low-dose aspirin affects the eradication of HP. This study used the 2-week bismuth-containing quadruple therapy for HP eradication, and the effects were basically consistent with those of the 10-day classic quadruple regimen commonly used in China [ 19 ] . The difference in the eradication rate between the aspirin and nonaspirin groups was not statistically significant. A previous study confirmed [ 5 ] that the aspirin use and course of treatment did not affect the HP eradication rate. Therefore, long-term use of low-dose aspirin did not affect the efficacy of bismuth-containing quadruple therapy for HP eradication, and patients did not experience serious adverse reactions during treatment. The recurrence rate of HP varies greatly in different regions and among different populations. A study focusing on people 18–65 years old in 18 hospitals in 15 provinces in China showed that the annual reinfection rate after the first HP eradication in China was 1.5%/year [ 20 ] . It remains unclear whether patients who use low-dose aspirin for a long time are more likely to experience recurrence. This study showed that the overall recurrence rate after HP eradication was 1.3%; the comparison of the recurrence rates among the three groups was not statistically significant. The overall 3-year recurrence rate was 3.1%, while that of the aspirin group was 5.30%, which was higher than that of the nonaspirin group and the control group. In summary, we believe that long-term use of low-dose aspirin can increase the risk of HP infection and the 3-year recurrence rate after eradication but cannot affect the efficacy of bismuth-containing quadruple therapy for HP eradication. Moreover, patients do not experience severe adverse events during the eradication treatment regardless of aspirin use. This study provides evidence for the possible correlation between aspirin use and HP infection. However, there are certain limitations. This study was a retrospective study and could not determine the sequence of aspirin use and HP infection. In view of the significant efficacy of aspirin in the prevention and treatment of cardiovascular and cerebrovascular diseases, how to use aspirin rationally to maximise its efficacy and reduce adverse reactions has become an important research topic. This study provides a reference for clinical decision-making and the treatment of HP. Declarations Ethics approval and consent to participate The study was approved by the Ethics Committee of the First Hospital of Lanzhou University (No. LDYYLL2022-02),Signed written informed consents were obtained from the patients and/or guardians. Consent for publication Not applicable. Availability of data and materials The datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request. Competing interests The authors declare that they have no competing interests. Funding This work was supported by Hospital fund of The First Hospital of Lanzhou University (ldyyyyn2021-43); Science and technology Project of Gansu Province (Key Research and Development Program, 21YF5FA120);Gansu Province Health Industry Research Project (GSWSKY2020-12) Author Contributions Statement The manuscript is entitled " Sex differences in Helicobacter pylori infection and recurrence rate among 81,754 Chinese adults: A cross-sectional study" by by ZhouYun, ZhaoLi,ZhangXiaodong,Yang Shengyi ,CaoYibo,Qiao Yuqin,Liu Shixiong. 1.The frist author's name is Zhou Yun, She directly involved in the design and implementation of the research; Collect and analyze data, write articles, and obtain research funding. 2 .Author Zhao Li, Zhang Xiaodong, Shengyi Yang, They provided research work support, data collection. 3.The author's name is Cao Yibo,Qiao Yuqin, Bai Lumucao,They directly participated in and conducted the research; Collect and analyze data. 4. 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Tables Table 1 Comparison of the HP infection status and the clinical conditions of the 3256 patients Item HP (+) (1733 cases) HP (-) (1523cases) t/Z/χ² Value P value Age [years] 52.1±9.2 50.4±8.9 3.166 0.002 Female [case (%)] 794(45.8) 631(41.4) 6.628 0.01 BMI (kg/m 2 ) 24.59±3.11 24.36±3.01 2.135 0.033 Long-term smoking [cases (%)] 144(8.3) 128(8.4) 0.01 0.922 Fatty liver [cases (%)] 71(4.1) 52(3.4) 1.039 0.308 Essential hypertension [cases (%)] 1389(80.2) 1207(79.3) 0.405 0.541 Heart disease [cases (%)] 204(11.8) 193(12.7) 0.614 0.453 Cerebrovascular diseases [cases (%)] 81(4.7) 72(4.7) 0.005 0.943 Peripheral artery disease [cases (%)] 57(3.3) 48(3.2) 0.049 0.843 Others [example (%)] 46(2.7) 41(2.8) 0.004 0.947 TG (mmol/L) 1.93±1.17 1.92±1.21 0.204 0.838 TC (mmol/L) 5.06±0.94 5.07±0.91 0.416 0.677 HDL-C (mmol/L) 1.47±0.35 1.44±0.34 0.343 0.641 LDL-C (mmol/L) 2.36±0.61 2.29±0.57 3.174 0.002 UA (µmol/L) 361.21±90.41 359.87±92.77 1.083 0.293 FBG (mmol/L) 5.35±0.53 5.22±0.52 2.519 0.024 Hcy (µmol/L) 19.33±5.56 20.17±4.79 0.328 0.531 Long-term use of aspirin [cases (%)] 674(38.9) 517(33.9) 8.548 0.003 1-2 years [case(%)] 103(15.3) 92(17.8) 1.35 0.269 ≥2-<5 years [case(%)] 245(36.4) 181(35.0) 0.229 0.669 ≥5 years [case(%)] 326(48.4) 244(47.2) 1.161 0.726 Statins [case (%)] 698(40.3) 621(40.8) 0.083 0.775 Endothelin B-receptor blockers [case (%)] 303(17.5) 259(17) 0.13 0.745 Angiotensin-converting enzyme inhibitors (ACEI) or angiotensin-receptor blockers (ARB) [case (%)] 836(48.2) 754(49.5) 0.521 0.482 Aldosterone receptor antagonists [case (%)] 539(31.1) 482(31.6) 0.112 0.762 Thiazide diuretics [case (%)] 219(12.6) 182(11.9) 0.354 0.552 Clopidogrel [case (%)] 175(10.1) 138(9.1) 1.003 0.341 Table 2 General characteristics and clinical biochemical indices of the patients selected for HP eradication Groups Number of cases Age (years) Systolic blood pressure Diastolic pressure BMI FBG TC LDL-C HDL-C TG UA (mm Hg) (mm Hg) (kg/m 2 ) (mmol/L) (mmol/L) (mmol/L) (mmol/L) (mmol/L) (umol/L) Case group Aspirin group 432 53.8±8.3 127.4±8.4 70.4±7.4 25.6±3.8 5.5±1.1 5.2±0.9 2.5±0.6 1.2±0.8 1.9±1.0 233.8±42.4 Nonaspirin group 427 54.1±9.5 126.2±6.2 71.1±6.8 24.9±4.1 5.7±1.3 4.9±1.1 2.4±0.5 1.3±0.3 1.8±1.7 240.2±36.1 Control group 418 53.9±8.6 128.7±7.1 71.6±7.8 25.5±4.8 5.5±1.1 5.1±1.4 2.5±0.1 1.3±0.6 1.9±0.9 237.6±40.6 F 1.551 1.351 1.338 1.061 0.384 1.326 1.176 1.432 0.216 1.368 P 0.186 0.305 0.329 0.277 0.641 0.311 0.329 0.264 0.783 0.314 Table 3 HP eradication and recurrence after 1 and 3 years Number of included cases Number of patients who complete the HP eradication treatment Number of successfully erradicted patients Eradication rate (%) Number of patients lost to follow-up Lost to follow-up rate Number of patients re-examined Number of recurrences in 1 year Number of recurrences in 3 years Recurrence rate (%) (Case) (Case) (Case) Regimen-based analysis Intention-based analysis (Case) (Casee) (Case) (Case) 1 year 3 years Aspirin group 432 418 367 87.8 84.9 8 0.021798365 359 4 19 1.1 5.3 Nonaspirin group 427 408 361 88.5 84.5 9 0.024930748 352 6 7 1.7 1.9 Control group 418 403 349 86.6 83.5 14 0.040114613 335 4 6 1.2 1.7 χ² value 0.667 0.364 0.547 9.214 P value 0.607 0.834 0.761 0.01 Table 4 Comparison of adverse reactions that occurred during eradication treatment [case (%)] Groups Number of cases Constipation Abdominal distension Dry mouth Nausea Bad breath Headache Fatigue Aspirin group 432 23(5.3) 15(3.5) 12(2.8) 8(1.8) 12(2.8) 6(1.4) 8(1.9) Nonaspirin group 427 21(4.9) 17(4.9) 14(3.3) 6(1.4) 12(2.8) 7(1.6) 6(1.4) Control group 418 25(5.9) 14(5.9) 12(2.9) 5(1.2) 9(2.2) 5(1.12) 8(1.9) χ² value 0.475 0.275 0.21 0.653 0.46 0.301 0.387 P value 0.789 0.872 0.9 0.721 0.795 0.86 0.824 Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-4300031","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":297802728,"identity":"e1259502-8cdd-4753-ba81-57c05744873b","order_by":0,"name":"Shixiong Liu","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAAoklEQVRIiWNgGAWjYBACPgYG9h8JFRJy8kRrYQNiiQ9nLIwNG0jRIjmzrSKR4QDRWvjPGBjzzpNIYGxgfvjoBlFaJNISknm3SeSxM7AZG+cQp4X5wGGglmLGBh42aeK08B9sbOadI5HYcIBoLQzJhxlnNpCkRSItjeHDMQljw2Zi/cLPf8aMIaGmTk6evfnhY6K0IAAzacpHwSgYBaNgFOADAF4pKGGnuEs7AAAAAElFTkSuQmCC","orcid":"https://orcid.org/0009-0004-2418-9343","institution":"Lanzhou University First Affiliated Hospital: Lanzhou University First Hospital","correspondingAuthor":true,"submittingAuthor":false,"prefix":"","firstName":"Shixiong","middleName":"","lastName":"Liu","suffix":""},{"id":297802729,"identity":"7db696cd-d361-4930-9190-709c19858431","order_by":1,"name":"Yang Shengyi","email":"","orcid":"","institution":"Tianshui Hospital of Traditional Chinese Medicine: Tianshui Affiliated Hospital of Gansu University of Chinese Medicine","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Yang","middleName":"","lastName":"Shengyi","suffix":""},{"id":297802730,"identity":"5f947bd0-dd71-4a78-9abf-3088b992ad6f","order_by":2,"name":"Qiao Yuqin","email":"","orcid":"","institution":"Lanzhou University First Clinical Medical College: Lanzhou University First Hospital","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Qiao","middleName":"","lastName":"Yuqin","suffix":""},{"id":297802731,"identity":"b496ca87-68a2-4b3f-b86c-bb4c529bd12b","order_by":3,"name":"Liu Shixiong","email":"","orcid":"","institution":"Lanzhou University First Clinical Medical College: Lanzhou University First Hospital","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Liu","middleName":"","lastName":"Shixiong","suffix":""}],"badges":[],"createdAt":"2024-04-21 08:56:14","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-4300031/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-4300031/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":56196566,"identity":"7e1d6b8c-2907-415a-8d37-a1da39929895","added_by":"auto","created_at":"2024-05-09 18:11:26","extension":"png","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":51233,"visible":true,"origin":"","legend":"\u003cp\u003eThe eradication rates of the aspirin group, nonaspirin group and control group ，There was no statistical significance by PP and ITT analysis( χ² =0.667 ,P=0.607 and χ² =0.364 ,P=0.834, respectively). PP:Per-Protocol analysis，ITT:Intention-to-treat analysis.\u003c/p\u003e","description":"","filename":"1.png","url":"https://assets-eu.researchsquare.com/files/rs-4300031/v1/0d82f95f64e94edf5f17e3cf.png"},{"id":56196541,"identity":"79bc6dd7-f927-49c7-80c2-96f56eb9fb61","added_by":"auto","created_at":"2024-05-09 18:11:20","extension":"png","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":43145,"visible":true,"origin":"","legend":"\u003cp\u003eThe recurrence rate of the aspirin group, nonaspirin group and control group in 1-year and 3-year. There was no statistical significance 1-year( χ² =0.547 ,P=0.761). The 3-year recurrence rate was significantly higher in the aspirin group(χ² =9.214 ,P=0.010)\u003c/p\u003e","description":"","filename":"2.png","url":"https://assets-eu.researchsquare.com/files/rs-4300031/v1/09dd420262c2b69ba2a757f6.png"},{"id":56855563,"identity":"08db57be-a54e-4129-bdf1-f9f16578f63e","added_by":"auto","created_at":"2024-05-21 10:00:36","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":704601,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-4300031/v1/a54b052b-2146-45c1-a16b-fb9aeec8216f.pdf"}],"financialInterests":"","formattedTitle":"Long-term use of low-dose aspirin and the risk of Helicobacter pylori infection and the effect of Helicobacter pylori eradication treatment: A Prospective Case-Control Analysis","fulltext":[{"header":"Introduction","content":"\u003cp\u003eIn recent years, studies have shown that \u003cem\u003eHelicobacter pylori\u003c/em\u003e (HP) infection is associated with the development of cardiovascular and cerebrovascular diseases \u003csup\u003e[1]\u003c/sup\u003e. Aspirin, the main drug used for the prevention of cardiovascular and cerebrovascular diseases, can cause gastrointestinal mucosal damage and increase the risk of gastrointestinal bleeding \u003csup\u003e[2]\u003c/sup\u003e. It remains unclear whether long-term use of low-dose aspirin increases the risk of HP infection or whether it affects the eradication and recurrence of HP. This study retrospectively analysed the correlation between HP infection and long-term use of low-dose aspirin and compared the effect of long-term use of low-dose aspirin on the eradication and recurrence of HP through a prospective case-control study.\u003c/p\u003e"},{"header":"Subjects and methods","content":"\u003cp\u003e\u003cstrong\u003eI. Subjects\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;Using retrospective analysis, 3256 patients with cardiovascular diseases (CVDs) who were treated at the Affiliated Hospital of Gansu University of Chinese Medicine, the Second People\u0026apos;s Hospital of Zhangye City in Gansu, the Tianshui Hospital of Integrated Traditional Chinese and Western Medicine in Gansu, and the First Hospital of Lanzhou University between March 2019 and December 2020 were included in this study. There were 2,147 males (65.9%) and 1,109 females (34.1%) aged 34-93 (51.9\u0026plusmn;9.1) years.\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;The inclusion criteria were as follows: (1) patients that had been evaluated using the C\u003csup\u003e14\u003c/sup\u003e-urea breath test\u003csup\u003e\u0026nbsp;\u003c/sup\u003e(C\u003csup\u003e14\u003c/sup\u003e-UBT); (2) patients that had lived in an urban area for a long time; and (3) patients that had been clearly diagnosed with various cardiovascular and cerebrovascular diseases for at least 1 year and had been given or not given the relevant treatments; (4) patients that had been regularly taking low-dose enteric-coated aspirin tablets (daily dose = 100 mg) orally for at least 1 year. According to the C\u003csup\u003e14\u003c/sup\u003e-UBT results, the subjects were divided into an HP infection group (+) with 1733 patients and an HP noninfection group (-) with 1523 patients. The exclusion criteria were as follows: (1) those who had incomplete disease history data; (2) those who had diabetes, severe liver and kidney dysfunction, a history of malignant tumours, or a history of abdominal surgery; (3) those who had used various types of antimicrobials, H\u003csub\u003e2\u003c/sub\u003e-receptor antagonists or proton pump inhibitors in the last 2 months and those who had been taking other non-steroidal anti-inflammatory drugs (NSAIDs) for a long time; and (4) those who were pregnant or lactating.\u003c/p\u003e\n\u003cp\u003eUsing a prospective case-control study, a total of 859 patients with cardiovascular and cerebrovascular diseases combined with HP infection who were treatment-compliant were selected as the research subjects. There were 568 males (66.1%) and 291 females (33.9%) aged 43-71 (50.3\u0026plusmn;8.4) years. According to medication status, the patients were divided into the following groups: (1) the aspirin group, 432 patients who were treated with aspirin in addition to the routine use of antihypertensive drugs; (2) the aspirin-free group, 427 patients who only used antihypertensive drugs routinely; and (3) the control group, 418 patients with HP infection but without various acute or chronic diseases during the same period. The exclusion criteria were as follows: (1) alcohol or tobacco addiction; (2) blood pressure \u0026ge;140/90 mm Hg; and (3) \u0026ge;3 risk factors, target organ damage, clinical complications and comorbidities such as diabetes, and other acute and chronic diseases.\u003c/p\u003e\n\u003cp\u003eThis study was approved by the Ethics Committee of the First Hospital of Lanzhou University and followed the \u003cem\u003eDeclaration of Helsinki\u003c/em\u003e. Informed consent was not obtained for this cross-sectional study, but the personal information of the study subjects was kept confidential. Informed consent was obtained from all patients for the case-control study.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eII. Methods\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;1. The following clinical data were collected: (1) Inclusion baseline information: age, sex, body mass index (BMI), smoking and drinking history, and past medical history. (2) Laboratory tests and indicators: routine blood test, fasting blood glucose (FBG), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), triacylglycerol (TG), uric acid (UA), homocysteine (Hcy) and C\u003csup\u003e14\u003c/sup\u003e-UBT. Abdominal ultrasound, cardiac colour Doppler ultrasound, arterial ultrasound of the neck and extremities, and brain computed tomography (CT)/magnetic resonance imaging (MRI). (3) Cardiovascular and cerebrovascular diseases; CVDs include various types of coronary heart disease, valvular disease, myocardial disease, and\u0026nbsp;arrhythmia; cerebrovascular diseases include cerebral infarction, cerebral arteriosclerosis, transient ischaemic attack, and intracranial carotid plaque; and peripheral artery disease includes disease of the upper and lower extremity arteries, celiac artery, and extracranial carotid artery. (4) Medication status: doses and time courses of proton pump inhibitors, antibiotics and aspirin.\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;2. Diagnosis, eradication and efficacy evaluation of HP infection:\u003c/p\u003e\n\u003cp\u003e(1) Diagnostic criterion: C\u003csup\u003e14\u003c/sup\u003e-UBT count/min\u0026gt;100 dpm/mmol. When the C\u003csup\u003e14\u003c/sup\u003e-UBT count was close to 100 dpm/mmol, the test was performed again after 2 weeks. (2) The eradication regimen was as follows: esomeprazole magnesium enteric-coated tablets (20 mg, 2 times/d, taken before breakfast and dinner; AstraZeneca Plc, product batch number: 1603178); bismuth potassium citrate/potassium citrate/clarithromycin/tinidazole tablets (bismuth potassium citrate tablets: 220 mg, 2 times/d, taken on an empty stomach half an hour before breakfast and dinner; tinidazole tablets: 0.5 g, 2 times/d, after breakfast and dinner; clarithromycin tablets: 0.25 g, 2 times/d, after breakfast and dinner (Livzon Pharmaceutical Group, product batch number: 160903)), with a treatment course of 2 weeks. (3) Evaluation of efficacy: The efficacy evaluation was performed 1 month after the end of eradication treatment and 1 year after successful eradication according to the original method, and the diagnostic criteria were the same. The eradication rate was calculated separately (regimen-based analysis = the number of successful eradication cases/the number of enrolled patients receiving treatment \u0026times; 100%, and intention-based analysis = the number of successful eradication cases/the number of patients who completed the eradication treatment \u0026times; 100%). Recurrence rate = number of patients experiencing recurrence /(number of patients with successful eradication \u0026ndash; number of patients lost to follow-up) \u0026times; 100%.\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;3. Antihypertensive treatment and safety evaluation:\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;(1) Antihypertensive treatment: After conducting risk stratification assessments of cardiovascular risk factors, subclinical target organ damage and clinical diseases, the original antihypertensive regimen determined based on patient lifestyle was remained the same and was continually administered to the patients. (2) The subjects were urged to take the medication regularly and record adverse reactions, and liver and kidney function indicators were reviewed.\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;\u003cstrong\u003e3. Statistical methods\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;Data analysis was performed using SPSS 22.0 software. Measurement data conforming to normal distribution are expressed as\u0026nbsp;, and comparisons between the two groups were made using a \u003cem\u003et\u003c/em\u003e test or one-way analysis of variance (ANOVA); measurement data not conforming to normal distribution are expressed as median (quartiles) [\u003cem\u003eM\u003c/em\u003e (\u003cem\u003eQ\u003c/em\u003e\u003csub\u003e1\u003c/sub\u003e, \u003cem\u003eQ\u003c/em\u003e\u003csub\u003e3\u003c/sub\u003e)], and the Mann-Whitney \u003cem\u003eU\u003c/em\u003e test was used. Categorical variables were expressed as the case number or percentage, and the \u0026chi;2 test and Fisher\u0026apos;s exact probability test were used. Variables with statistical significance (or close to statistical significance) according to univariate analysis were included in the multivariate logistic regression model, and the risk factors for HP infection were determined using a regression analysis. A two-sided \u003cem\u003eP\u003c/em\u003e \u0026lt;0.05 indicated a statistically significant difference.\u003c/p\u003e"},{"header":"Results","content":"\u003cp\u003e\u003cstrong\u003e1. Comparison of HP infection and clinical status in the patient cohort\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe overall HP infection rate was 53.3% (1733/3256), and the infection rate in females was greater than that in males [56.4% (625/1109) vs. 51.6% (1108/2147), \u0026chi;\u0026sup2;=6.628, \u003cem\u003eP\u003c/em\u003e = 0.010].\u003c/p\u003e\n\u003cp\u003eThere were 1191 patients who used small doses of aspirin for a prolonged period of time, accounting for 36.6% (1191/3256) of the patients examined in this study. The HP infection rate of patients who used aspirin was greater than that of patients who did not use aspirin [56.6% (674/1191) vs. 51.3% (1059/2065), \u0026chi;\u0026sup2;=8.548, P=0.003], while the differences in infection rate between the groups that used aspirin for 1-2 years, \u0026ge;2-\u0026lt;5 years, and \u0026ge;5 years were not statistically significant [54% (95/176) vs. 57% (211/370) vs 57.1% (238/417), \u0026chi;\u0026sup2;=0.533, P=0.758]. In addition, the univariate analysis showed that age, sex, LDL-C, and FBG were significantly associated with HP infection (Table 1).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e2. Multivariate logistic regression analysis of the factors associated with HP infection\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eHP infection was used as the dependent variable, and age, sex, LDL-C, FBG, and long-term use of low-dose aspirin were included in multivariate logistic regression analysis as independent variables. Results showed that the risk of HP infection increases with age (odds ratio (OR)=1.041, 95% confidence interval (CI): 1.008-1.086, \u003cem\u003eP=\u003c/em\u003e 0.003); women have a greater risk of infection than men (\u003cem\u003eOR\u003c/em\u003e =1.332, 95% \u003cem\u003eCI\u003c/em\u003e: 1.098-1.627, \u003cem\u003eP\u003c/em\u003e =0.004); long-term use of aspirin can increase the risk of infection (\u003cem\u003eOR\u003c/em\u003e = 1.526, 95% \u003cem\u003eCI\u003c/em\u003e: 1.231-2.015, \u003cem\u003eP\u003c/em\u003e \u0026lt;0.001); the risk of infection increases with increased FBG (OR=1.528, 95% CI: 1.337-2.189; P\u0026lt;0.001); the risk of infection increases with increased LDL-C levels (OR=1.103, 95% CI: 1.034-1.392, P=0.007). After controlling for age, sex, BMI and other factors, long-term use of aspirin was still found to increase the risk of infection (OR=1.433, 95% CI: 1.196-1.947, P\u0026lt;0.001).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e3. HP eradication and recurrence after 1 year and 3 years\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eComparisons showed that the age, blood pressure, BMI, FBG and TC, LDL-C, HDL-C, TG, and UA levels among the aspirin group, the nonaspirin group, and the control group were not significantly different (Table 2).\u003c/p\u003e\n\u003cp\u003eThe regimen-based analysis showed that the overall eradication rate was 87.6% (1077/1229), and the eradication rates among the aspirin group, the nonaspirin group and the control group were 87.8% (367/418), 88.5% (361/408), and 86.6% (349/403), respectively, and were not statistically significantly different (x\u003csup\u003e2\u003c/sup\u003e =0.667, p=0.607). The intention-based analysis showed that the overall eradication rate was 84.3% (1077/1277), and the eradication rates among the three groups were 84.9% (367/432), 84.5% (361/427), and 83.5% (349/418) respectively, and were not statistically significantly different (x\u003csup\u003e2\u003c/sup\u003e =0.364, p=0.843)(Fig.1).\u003c/p\u003e\n\u003cp\u003eA total of 31 patients were lost to the 3-year follow-up, and the loss rate was 2.90% (31/1077). The overall 1-year recurrence rate was 1.3% (14/1046); the recurrence rates of the 3 groups were 1.10% (4/359), 1.70% (6/352), and 1.20% (4/335), respectively; and the recurrence rates among the groups were not statistically significant (x\u003csup\u003e2\u003c/sup\u003e =0.547, p=0.761).\u003c/p\u003e\n\u003cp\u003eThe 3-year overall recurrence rate was 3.1% (32/1046), and the recurrence rates of the 3 groups were 5.30% (19/359), 1.90% (7/352), and 1.70% (6/335), respectively; the difference was not statistically significant (x\u003csup\u003e2\u003c/sup\u003e =9.214, p=0.01). The recurrence rate in the aspirin group was significantly greater than that in the nonaspirin group and the control group (x\u003csup\u003e2\u003c/sup\u003e = 6.118 and 5.507, respectively, p = 0.01 and 0.015). There was no significant difference between the nonaspirin group and the control group (x\u003csup\u003e2\u003c/sup\u003e =0.036, p=0.537)(Fig.2).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e4. Safety evaluation\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThere were no abnormal changes in indicators such as liver or kidney function after 1 or 3 years of eradication treatment. The main adverse reactions that occurred within 1 month of the eradication treatment/follow-up were constipation, mild nausea, abdominal distension, dry mouth, bad breath, headache, and fatigue, and the differences in adverse reactions among the three groups were not statistically significant (all P\u0026gt;0.05, Table 4).\u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eLow-dose aspirin is widely used to prevent various cardiovascular and cerebrovascular events \u003csup\u003e[\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e]\u003c/sup\u003e. The long-term use of aspirin can cause gastrointestinal mucosal damage and increase the incidence of gastrointestinal haemorrhage, with a marked age-dependence (i.e., higher mortality in the elderly) \u003csup\u003e[\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e, \u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e]\u003c/sup\u003e. Ageing is strongly associated with an increased risk of HP infection \u003csup\u003e[\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e]\u003c/sup\u003e, but it is not clear whether the increased risk of HP infection is associated with the use of aspirin. In this study, the univariate analysis showed that the HP infection rate in long-term low-dose aspirin users was greater than that in nonusers, and the multivariate regression analysis also showed that long-term use of low-dose aspirin was associated with an increased risk of HP infection. The risk of infection remained high and statistically significant when controlling for factors, such as age and sex \u003csup\u003e[\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e]\u003c/sup\u003e. The possible cause is related to the effect of the salicylates produced by the hydrolysis of aspirin on factors of the gastric environment, such as the pH, and these changes favour the passage of HP across the mucus barrier and subsequent colonization.\u003c/p\u003e \u003cp\u003eIn the middle-age and elderly populations, HP infection is an important risk factor for aspirin-associated peptic ulcers \u003csup\u003e[\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e]\u003c/sup\u003e, and combined HP infection increases risks of bleeding and perforation in aspirin users \u003csup\u003e[\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e]\u003c/sup\u003e. Currently, the combination of aspirin use and HP infection is considered to have an enhanced effect on gastric mucosal damage \u003csup\u003e[\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e]\u003c/sup\u003e. The damage caused by aspirin to the gastric mucosa is mainly due to cyclooxygenase-1 (COX-1) inhibition and prostaglandin depletion, leading to a reduced defence-repair capacity of the gastric mucus-mucosal barrier and mucosal ischaemia \u003csup\u003e[\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e]\u003c/sup\u003e. Moreover, HP can secrete a variety of pathogenic factors that trigger immune and inflammatory responses \u003csup\u003e[\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e]\u003c/sup\u003e and aggravate gastric mucosal injury. Yoshida \u003csup\u003e[\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e]\u003c/sup\u003e reported that HP tends to evade the immune response in the stomach, which is disrupted by aspirin, and can colonize and multiply in the gastric mucosa for a prolonged period of time. HP infects the gastric mucosa and induces the accumulation of neutrophils, which is an important process that exacerbates the damaging effect of aspirin on the gastric mucosa \u003csup\u003e[\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e]\u003c/sup\u003e. The 2022 US Preventive Services Task Force (USPSTF) recommendation statement emphasized that for people\u0026thinsp;\u0026ge;\u0026thinsp;60 years old, the bleeding risk of aspirin could offset the benefit of CVD prevention \u003csup\u003e[\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e]\u003c/sup\u003e. Therefore, elderly individuals that use aspirin should be carefully monitored for HP infection and treated with an eradication treatment protocol if HP infection is present to reduce the risk of ulcer bleeding and recurrence \u003csup\u003e[\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e]\u003c/sup\u003e.\u003c/p\u003e \u003cp\u003eThis study also showed that there was no significant difference in the infection rate between the groups treated with aspirin over different periods of time, which was consistent with the results reported in the literature \u003csup\u003e[\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e]\u003c/sup\u003e. It is also unclear whether long-term use of low-dose aspirin affects the eradication of HP. This study used the 2-week bismuth-containing quadruple therapy for HP eradication, and the effects were basically consistent with those of the 10-day classic quadruple regimen commonly used in China \u003csup\u003e[\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e]\u003c/sup\u003e. The difference in the eradication rate between the aspirin and nonaspirin groups was not statistically significant. A previous study confirmed \u003csup\u003e[\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e]\u003c/sup\u003e that the aspirin use and course of treatment did not affect the HP eradication rate. Therefore, long-term use of low-dose aspirin did not affect the efficacy of bismuth-containing quadruple therapy for HP eradication, and patients did not experience serious adverse reactions during treatment.\u003c/p\u003e \u003cp\u003eThe recurrence rate of HP varies greatly in different regions and among different populations. A study focusing on people 18\u0026ndash;65 years old in 18 hospitals in 15 provinces in China showed that the annual reinfection rate after the first HP eradication in China was 1.5%/year \u003csup\u003e[\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e]\u003c/sup\u003e. It remains unclear whether patients who use low-dose aspirin for a long time are more likely to experience recurrence. This study showed that the overall recurrence rate after HP eradication was 1.3%; the comparison of the recurrence rates among the three groups was not statistically significant. The overall 3-year recurrence rate was 3.1%, while that of the aspirin group was 5.30%, which was higher than that of the nonaspirin group and the control group.\u003c/p\u003e \u003cp\u003eIn summary, we believe that long-term use of low-dose aspirin can increase the risk of HP infection and the 3-year recurrence rate after eradication but cannot affect the efficacy of bismuth-containing quadruple therapy for HP eradication. Moreover, patients do not experience severe adverse events during the eradication treatment regardless of aspirin use.\u003c/p\u003e \u003cp\u003eThis study provides evidence for the possible correlation between aspirin use and HP infection. However, there are certain limitations. This study was a retrospective study and could not determine the sequence of aspirin use and HP infection. In view of the significant efficacy of aspirin in the prevention and treatment of cardiovascular and cerebrovascular diseases, how to use aspirin rationally to maximise its efficacy and reduce adverse reactions has become an important research topic. This study provides a reference for clinical decision-making and the treatment of HP.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eEthics approval and consent to participate\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe study was approved by the Ethics Committee of the First Hospital of Lanzhou University (No. LDYYLL2022-02),Signed written informed consents were obtained from the patients and/or guardians.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent for publication\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAvailability of data and materials\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting interests\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors declare that they have no competing interests.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis work was supported by\u0026nbsp;Hospital fund of\u0026nbsp;The First Hospital of Lanzhou University (ldyyyyn2021-43);\u0026nbsp;Science and technology Project of Gansu Province (Key Research and Development Program, 21YF5FA120);Gansu Province Health Industry Research Project (GSWSKY2020-12)\u003cstrong\u003e\u003c/strong\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthor Contributions Statement\u003c/strong\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe manuscript is entitled \u0026quot; Sex differences in Helicobacter pylori infection and recurrence rate among 81,754 Chinese adults: A cross-sectional study\u0026quot; by by\u0026nbsp;ZhouYun,\u0026nbsp;ZhaoLi,ZhangXiaodong,Yang Shengyi ,CaoYibo,Qiao Yuqin,Liu Shixiong.\u003c/p\u003e\n\u003cp\u003e1.The frist author\u0026apos;s name is Zhou Yun, She directly involved in the design and implementation of the research; Collect and analyze data, write articles, and obtain research funding.\u003c/p\u003e\n\u003cp\u003e2 .Author Zhao Li, Zhang Xiaodong, Shengyi Yang, They provided research work support, data collection.\u003c/p\u003e\n\u003cp\u003e3.The author\u0026apos;s name is Cao Yibo,Qiao Yuqin, Bai Lumucao,They directly participated in and conducted the research; Collect and analyze data.\u003c/p\u003e\n\u003cp\u003e4. Corresponding author\u0026apos;s name is Liu Shixiong, He directly involved in the design and implementation of the research; Collect and analyze data, write articles, and obtain research funding; Support and guide experiments.\u003c/p\u003e\n\u003cp\u003eAll authors reviewed the manuscript.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n \u003cli\u003e\u003cspan\u003eJu L, Hao C. Research progress of \u003cem\u003eHelicobacter pylori\u003c/em\u003e infection and cardiovascular disease[J]. Chin J Intern Med. 2022;61(1):121\u0026ndash;5. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.3760/cma.j.cn112138-20210105-00015\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e\n \u003cli\u003e\u003cspan\u003eThorat MA, Cuzick J. Prophylactic use of aspirin: systematic review of harms and approaches to mitigation in the general population[J]. 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J Dig Dis. 2010;11(5):313\u0026ndash;8. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1111/j.1751-2980.2010.00457.x\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e\n \u003cli\u003e\u003cspan\u003eXie Y, Song C, Cheng H, et al. Long-term follow-up of \u003cem\u003eHelicobacter pylori\u003c/em\u003e reinfection and its risk factors after initial eradication: a large-scale multicentre, prospective open cohort, observational study[J]. Emerg Microbes Infect. 2020;9(1):548\u0026ndash;57. \u003cspan\u003eDOI. 10.1080/22221751.2020.1737579.\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e\n\u003c/ol\u003e"},{"header":"Tables","content":"\u003ctable style=\"width: 102%;border: none;border-collapse:collapse;\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"5\" style=\"width:100.0%;border:none;border-bottom: solid black 1.0pt;padding:0in 5.4pt 0in 5.4pt;height:24.75pt;\"\u003e\n \u003cp style='margin:0in;text-align:justify;font-size:14px;font-family:\"Times New Roman\",serif;vertical-align:middle;'\u003e\u003cspan style=\"color:black;\"\u003e\u0026nbsp;Table 1 Comparison of the HP infection status and the clinical conditions of the \u003cstrong\u003e3256\u003c/strong\u003e patients\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width:42.52%;border:none;border-bottom:solid black 1.0pt;padding:0in 5.4pt 0in 5.4pt;height:23.95pt;\"\u003e\n \u003cp style='margin:0in;text-align:justify;font-size:14px;font-family:\"Times New Roman\",serif;vertical-align:middle;'\u003e\u003cspan style=\"color:black;\"\u003e\u0026nbsp;Item\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:22.98%;border:none;border-bottom:solid black 1.0pt;padding:0in 5.4pt 0in 5.4pt;height:23.95pt;\"\u003e\n \u003cp style='margin:0in;text-align:justify;font-size:14px;font-family:\"Times New Roman\",serif;vertical-align:middle;'\u003e\u003cspan style=\"color:black;\"\u003eHP (+)\u003c/span\u003e\u003c/p\u003e\n \u003cp style='margin:0in;text-align:justify;font-size:14px;font-family:\"Times New Roman\",serif;vertical-align:middle;'\u003e\u003cspan style=\"color:black;\"\u003e\u0026nbsp;(1733 cases)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:14.94%;border:none;border-bottom:solid black 1.0pt;padding:0in 5.4pt 0in 5.4pt;height:23.95pt;\"\u003e\n \u003cp style='margin:0in;text-align:justify;font-size:14px;font-family:\"Times New Roman\",serif;vertical-align:middle;'\u003e\u003cspan style=\"color:black;\"\u003eHP (-) (1523cases)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:10.46%;border:none;border-bottom:solid black 1.0pt;padding:0in 5.4pt 0in 5.4pt;height:23.95pt;\"\u003e\n \u003cp style='margin:0in;text-align:justify;font-size:14px;font-family:\"Times New Roman\",serif;vertical-align:middle;'\u003e\u003cspan style=\"color:black;\"\u003e\u0026nbsp;t/Z/\u0026chi;\u0026sup2; Value\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:9.04%;border:none;border-bottom:solid black 1.0pt;padding:0in 5.4pt 0in 5.4pt;height:23.95pt;\"\u003e\n \u003cp style='margin:0in;text-align:justify;font-size:14px;font-family:\"Times New Roman\",serif;vertical-align:middle;'\u003e\u003cspan style=\"color:black;\"\u003e\u0026nbsp;P value\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width:42.52%;padding:0in 5.4pt 0in 5.4pt;height:23.2pt;\"\u003e\n \u003cp style='margin:0in;text-align:justify;font-size:14px;font-family:\"Times New Roman\",serif;vertical-align:middle;'\u003e\u003cspan style=\"color:black;\"\u003e\u0026nbsp;Age [years]\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:22.98%;padding:0in 5.4pt 0in 5.4pt;height:23.2pt;\"\u003e\n \u003cp style='margin:0in;text-align:justify;font-size:14px;font-family:\"Times New Roman\",serif;vertical-align:middle;'\u003e\u003cspan style=\"color:black;\"\u003e52.1\u0026plusmn;9.2\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:14.94%;padding:0in 5.4pt 0in 5.4pt;height:23.2pt;\"\u003e\n \u003cp style='margin:0in;text-align:justify;font-size:14px;font-family:\"Times New Roman\",serif;vertical-align:middle;'\u003e\u003cspan style=\"color:black;\"\u003e50.4\u0026plusmn;8.9\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:10.46%;padding:0in 5.4pt 0in 5.4pt;height:23.2pt;\"\u003e\n \u003cp style='margin:0in;text-align:justify;font-size:14px;font-family:\"Times New Roman\",serif;vertical-align:middle;'\u003e\u003cspan style=\"color:black;\"\u003e3.166\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:9.04%;padding:0in 5.4pt 0in 5.4pt;height:23.2pt;\"\u003e\n \u003cp style='margin:0in;text-align:justify;font-size:14px;font-family:\"Times New Roman\",serif;vertical-align:middle;'\u003e\u003cspan style=\"color:black;\"\u003e0.002\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width:42.52%;background:yellow;padding:0in 5.4pt 0in 5.4pt;height:23.2pt;\"\u003e\n \u003cp style='margin:0in;text-align:justify;font-size:14px;font-family:\"Times New Roman\",serif;vertical-align:middle;'\u003e\u003cspan style=\"color:black;\"\u003e\u0026nbsp;Female [case (%)]\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:22.98%;background:yellow;padding:0in 5.4pt 0in 5.4pt;height:23.2pt;\"\u003e\n \u003cp style='margin:0in;text-align:justify;font-size:14px;font-family:\"Times New Roman\",serif;vertical-align:middle;'\u003e\u003cspan style=\"color:black;\"\u003e794(45.8)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:14.94%;background:yellow;padding:0in 5.4pt 0in 5.4pt;height:23.2pt;\"\u003e\n \u003cp style='margin:0in;text-align:justify;font-size:14px;font-family:\"Times New Roman\",serif;vertical-align:middle;'\u003e\u003cspan style=\"color:black;\"\u003e631(41.4)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:10.46%;background:yellow;padding:0in 5.4pt 0in 5.4pt;height:23.2pt;\"\u003e\n \u003cp style='margin:0in;text-align:justify;font-size:14px;font-family:\"Times New Roman\",serif;vertical-align:middle;'\u003e\u003cspan style=\"color:black;\"\u003e6.628\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:9.04%;background:yellow;padding:0in 5.4pt 0in 5.4pt;height:23.2pt;\"\u003e\n \u003cp style='margin:0in;text-align:justify;font-size:14px;font-family:\"Times New Roman\",serif;vertical-align:middle;'\u003e\u003cspan style=\"color:black;\"\u003e0.01\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width:42.52%;padding:0in 5.4pt 0in 5.4pt;height:23.2pt;\"\u003e\n \u003cp style='margin:0in;text-align:justify;font-size:14px;font-family:\"Times New Roman\",serif;vertical-align:middle;'\u003e\u003cspan style=\"color:black;\"\u003eBMI (kg/m\u003csup\u003e2\u003c/sup\u003e)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 22.98%;background: yellow;padding: 0in 5.4pt;height: 23.2pt;vertical-align: bottom;\"\u003e\n \u003cp style='margin:0in;text-align:justify;font-size:14px;font-family:\"Times New Roman\",serif;vertical-align:bottom;'\u003e\u003cspan style=\"color:black;\"\u003e24.59\u0026plusmn;3.11\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 14.94%;background: yellow;padding: 0in 5.4pt;height: 23.2pt;vertical-align: bottom;\"\u003e\n \u003cp style='margin:0in;text-align:justify;font-size:14px;font-family:\"Times New Roman\",serif;vertical-align:bottom;'\u003e\u003cspan style=\"color:black;\"\u003e24.36\u0026plusmn;3.01\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10.46%;background: yellow;padding: 0in 5.4pt;height: 23.2pt;vertical-align: bottom;\"\u003e\n \u003cp style='margin:0in;text-align:justify;font-size:14px;font-family:\"Times New Roman\",serif;vertical-align:bottom;'\u003e\u003cspan style=\"color:black;\"\u003e2.135\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9.04%;background: yellow;padding: 0in 5.4pt;height: 23.2pt;vertical-align: bottom;\"\u003e\n \u003cp style='margin:0in;text-align:justify;font-size:14px;font-family:\"Times New Roman\",serif;vertical-align:bottom;'\u003e\u003cspan style=\"color:black;\"\u003e0.033\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width:42.52%;background:yellow;padding:0in 5.4pt 0in 5.4pt;height:23.2pt;\"\u003e\n \u003cp style='margin:0in;text-align:justify;font-size:14px;font-family:\"Times New Roman\",serif;vertical-align:middle;'\u003e\u003cspan style=\"color:black;\"\u003e\u0026nbsp;Long-term smoking [cases (%)]\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:22.98%;background:yellow;padding:0in 5.4pt 0in 5.4pt;height:23.2pt;\"\u003e\n \u003cp style='margin:0in;text-align:justify;font-size:14px;font-family:\"Times New Roman\",serif;vertical-align:middle;'\u003e\u003cspan style=\"color:black;\"\u003e144(8.3)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:14.94%;background:yellow;padding:0in 5.4pt 0in 5.4pt;height:23.2pt;\"\u003e\n \u003cp style='margin:0in;text-align:justify;font-size:14px;font-family:\"Times New Roman\",serif;vertical-align:middle;'\u003e\u003cspan style=\"color:black;\"\u003e128(8.4)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:10.46%;background:yellow;padding:0in 5.4pt 0in 5.4pt;height:23.2pt;\"\u003e\n \u003cp style='margin:0in;text-align:justify;font-size:14px;font-family:\"Times New Roman\",serif;vertical-align:middle;'\u003e\u003cspan style=\"color:black;\"\u003e0.01\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:9.04%;background:yellow;padding:0in 5.4pt 0in 5.4pt;height:23.2pt;\"\u003e\n \u003cp style='margin:0in;text-align:justify;font-size:14px;font-family:\"Times New Roman\",serif;vertical-align:middle;'\u003e\u003cspan style=\"color:black;\"\u003e0.922\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width:42.52%;background:yellow;padding:0in 5.4pt 0in 5.4pt;height:23.2pt;\"\u003e\n \u003cp style='margin:0in;text-align:justify;font-size:14px;font-family:\"Times New Roman\",serif;vertical-align:middle;'\u003e\u003cspan style=\"color:black;\"\u003e\u0026nbsp;Fatty liver [cases (%)]\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:22.98%;background:yellow;padding:0in 5.4pt 0in 5.4pt;height:23.2pt;\"\u003e\n \u003cp style='margin:0in;text-align:justify;font-size:14px;font-family:\"Times New Roman\",serif;vertical-align:middle;'\u003e\u003cspan style=\"color:black;\"\u003e71(4.1)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:14.94%;background:yellow;padding:0in 5.4pt 0in 5.4pt;height:23.2pt;\"\u003e\n \u003cp style='margin:0in;text-align:justify;font-size:14px;font-family:\"Times New Roman\",serif;vertical-align:middle;'\u003e\u003cspan style=\"color:black;\"\u003e52(3.4)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:10.46%;background:yellow;padding:0in 5.4pt 0in 5.4pt;height:23.2pt;\"\u003e\n \u003cp style='margin:0in;text-align:justify;font-size:14px;font-family:\"Times New Roman\",serif;vertical-align:middle;'\u003e\u003cspan style=\"color:black;\"\u003e1.039\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:9.04%;background:yellow;padding:0in 5.4pt 0in 5.4pt;height:23.2pt;\"\u003e\n \u003cp style='margin:0in;text-align:justify;font-size:14px;font-family:\"Times New Roman\",serif;vertical-align:middle;'\u003e\u003cspan style=\"color:black;\"\u003e0.308\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width:42.52%;padding:0in 5.4pt 0in 5.4pt;height:23.2pt;\"\u003e\n \u003cp style='margin:0in;text-align:justify;font-size:14px;font-family:\"Times New Roman\",serif;vertical-align:middle;'\u003e\u003cspan style=\"color:black;\"\u003e\u0026nbsp;Essential hypertension [cases (%)]\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:22.98%;padding:0in 5.4pt 0in 5.4pt;height:23.2pt;\"\u003e\n \u003cp style='margin:0in;text-align:justify;font-size:14px;font-family:\"Times New Roman\",serif;vertical-align:middle;'\u003e\u003cspan style=\"color:black;\"\u003e1389(80.2)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:14.94%;padding:0in 5.4pt 0in 5.4pt;height:23.2pt;\"\u003e\n \u003cp style='margin:0in;text-align:justify;font-size:14px;font-family:\"Times New Roman\",serif;vertical-align:middle;'\u003e\u003cspan style=\"color:black;\"\u003e1207(79.3)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:10.46%;padding:0in 5.4pt 0in 5.4pt;height:23.2pt;\"\u003e\n \u003cp style='margin:0in;text-align:justify;font-size:14px;font-family:\"Times New Roman\",serif;vertical-align:middle;'\u003e\u003cspan style=\"color:black;\"\u003e0.405\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:9.04%;padding:0in 5.4pt 0in 5.4pt;height:23.2pt;\"\u003e\n \u003cp style='margin:0in;text-align:justify;font-size:14px;font-family:\"Times New Roman\",serif;vertical-align:middle;'\u003e\u003cspan style=\"color:black;\"\u003e0.541\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width:42.52%;padding:0in 5.4pt 0in 5.4pt;height:23.2pt;\"\u003e\n \u003cp style='margin:0in;text-align:justify;font-size:14px;font-family:\"Times New Roman\",serif;vertical-align:middle;'\u003e\u003cspan style=\"color:black;\"\u003e\u0026nbsp;Heart disease [cases (%)]\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:22.98%;padding:0in 5.4pt 0in 5.4pt;height:23.2pt;\"\u003e\n \u003cp style='margin:0in;text-align:justify;font-size:14px;font-family:\"Times New Roman\",serif;vertical-align:middle;'\u003e\u003cspan style=\"color:black;\"\u003e204(11.8)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:14.94%;padding:0in 5.4pt 0in 5.4pt;height:23.2pt;\"\u003e\n \u003cp style='margin:0in;text-align:justify;font-size:14px;font-family:\"Times New Roman\",serif;vertical-align:middle;'\u003e\u003cspan style=\"color:black;\"\u003e193(12.7)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:10.46%;padding:0in 5.4pt 0in 5.4pt;height:23.2pt;\"\u003e\n \u003cp style='margin:0in;text-align:justify;font-size:14px;font-family:\"Times New Roman\",serif;vertical-align:middle;'\u003e\u003cspan style=\"color:black;\"\u003e0.614\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:9.04%;padding:0in 5.4pt 0in 5.4pt;height:23.2pt;\"\u003e\n \u003cp style='margin:0in;text-align:justify;font-size:14px;font-family:\"Times New Roman\",serif;vertical-align:middle;'\u003e\u003cspan style=\"color:black;\"\u003e0.453\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width:42.52%;padding:0in 5.4pt 0in 5.4pt;height:23.2pt;\"\u003e\n \u003cp style='margin:0in;text-align:justify;font-size:14px;font-family:\"Times New Roman\",serif;vertical-align:middle;'\u003e\u003cspan style=\"color:black;\"\u003e\u0026nbsp;Cerebrovascular diseases [cases (%)]\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:22.98%;padding:0in 5.4pt 0in 5.4pt;height:23.2pt;\"\u003e\n \u003cp style='margin:0in;text-align:justify;font-size:14px;font-family:\"Times New Roman\",serif;vertical-align:middle;'\u003e\u003cspan style=\"color:black;\"\u003e81(4.7)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:14.94%;padding:0in 5.4pt 0in 5.4pt;height:23.2pt;\"\u003e\n \u003cp style='margin:0in;text-align:justify;font-size:14px;font-family:\"Times New Roman\",serif;vertical-align:middle;'\u003e\u003cspan style=\"color:black;\"\u003e72(4.7)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:10.46%;padding:0in 5.4pt 0in 5.4pt;height:23.2pt;\"\u003e\n \u003cp style='margin:0in;text-align:justify;font-size:14px;font-family:\"Times New Roman\",serif;vertical-align:middle;'\u003e\u003cspan style=\"color:black;\"\u003e0.005\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:9.04%;padding:0in 5.4pt 0in 5.4pt;height:23.2pt;\"\u003e\n \u003cp style='margin:0in;text-align:justify;font-size:14px;font-family:\"Times New Roman\",serif;vertical-align:middle;'\u003e\u003cspan style=\"color:black;\"\u003e0.943\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width:42.52%;padding:0in 5.4pt 0in 5.4pt;height:23.2pt;\"\u003e\n \u003cp style='margin:0in;text-align:justify;font-size:14px;font-family:\"Times New Roman\",serif;vertical-align:middle;'\u003e\u003cspan style=\"color:black;\"\u003e\u0026nbsp;Peripheral artery disease [cases (%)]\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:22.98%;padding:0in 5.4pt 0in 5.4pt;height:23.2pt;\"\u003e\n \u003cp style='margin:0in;text-align:justify;font-size:14px;font-family:\"Times New Roman\",serif;vertical-align:middle;'\u003e\u003cspan style=\"color:black;\"\u003e57(3.3)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:14.94%;padding:0in 5.4pt 0in 5.4pt;height:23.2pt;\"\u003e\n \u003cp style='margin:0in;text-align:justify;font-size:14px;font-family:\"Times New Roman\",serif;vertical-align:middle;'\u003e\u003cspan style=\"color:black;\"\u003e48(3.2)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:10.46%;padding:0in 5.4pt 0in 5.4pt;height:23.2pt;\"\u003e\n \u003cp style='margin:0in;text-align:justify;font-size:14px;font-family:\"Times New Roman\",serif;vertical-align:middle;'\u003e\u003cspan style=\"color:black;\"\u003e0.049\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:9.04%;padding:0in 5.4pt 0in 5.4pt;height:23.2pt;\"\u003e\n \u003cp style='margin:0in;text-align:justify;font-size:14px;font-family:\"Times New Roman\",serif;vertical-align:middle;'\u003e\u003cspan style=\"color:black;\"\u003e0.843\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width:42.52%;padding:0in 5.4pt 0in 5.4pt;height:23.2pt;\"\u003e\n \u003cp style='margin:0in;text-align:justify;font-size:14px;font-family:\"Times New Roman\",serif;vertical-align:middle;'\u003e\u003cspan style=\"color:black;\"\u003e\u0026nbsp;Others [example (%)]\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:22.98%;padding:0in 5.4pt 0in 5.4pt;height:23.2pt;\"\u003e\n \u003cp style='margin:0in;text-align:justify;font-size:14px;font-family:\"Times New Roman\",serif;vertical-align:middle;'\u003e\u003cspan style=\"color:black;\"\u003e46(2.7)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:14.94%;padding:0in 5.4pt 0in 5.4pt;height:23.2pt;\"\u003e\n \u003cp style='margin:0in;text-align:justify;font-size:14px;font-family:\"Times New Roman\",serif;vertical-align:middle;'\u003e\u003cspan style=\"color:black;\"\u003e41(2.8)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:10.46%;padding:0in 5.4pt 0in 5.4pt;height:23.2pt;\"\u003e\n \u003cp style='margin:0in;text-align:justify;font-size:14px;font-family:\"Times New Roman\",serif;vertical-align:middle;'\u003e\u003cspan style=\"color:black;\"\u003e0.004\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:9.04%;padding:0in 5.4pt 0in 5.4pt;height:23.2pt;\"\u003e\n \u003cp style='margin:0in;text-align:justify;font-size:14px;font-family:\"Times New Roman\",serif;vertical-align:middle;'\u003e\u003cspan style=\"color:black;\"\u003e0.947\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width:42.52%;padding:0in 5.4pt 0in 5.4pt;height:23.2pt;\"\u003e\n \u003cp style='margin:0in;text-align:justify;font-size:14px;font-family:\"Times New Roman\",serif;vertical-align:middle;'\u003e\u003cspan style=\"color:black;\"\u003e\u0026nbsp;TG (mmol/L)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 22.98%;background: yellow;padding: 0in 5.4pt;height: 23.2pt;vertical-align: bottom;\"\u003e\n \u003cp style='margin:0in;text-align:justify;font-size:14px;font-family:\"Times New Roman\",serif;vertical-align:bottom;'\u003e\u003cspan style=\"color:black;\"\u003e1.93\u0026plusmn;1.17\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 14.94%;background: yellow;padding: 0in 5.4pt;height: 23.2pt;vertical-align: bottom;\"\u003e\n \u003cp style='margin:0in;text-align:justify;font-size:14px;font-family:\"Times New Roman\",serif;vertical-align:bottom;'\u003e\u003cspan style=\"color:black;\"\u003e1.92\u0026plusmn;1.21\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10.46%;background: yellow;padding: 0in 5.4pt;height: 23.2pt;vertical-align: bottom;\"\u003e\n \u003cp style='margin:0in;text-align:justify;font-size:14px;font-family:\"Times New Roman\",serif;vertical-align:bottom;'\u003e\u003cspan style=\"color:black;\"\u003e0.204\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9.04%;background: yellow;padding: 0in 5.4pt;height: 23.2pt;vertical-align: bottom;\"\u003e\n \u003cp style='margin:0in;text-align:justify;font-size:14px;font-family:\"Times New Roman\",serif;vertical-align:bottom;'\u003e\u003cspan style=\"color:black;\"\u003e0.838\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width:42.52%;padding:0in 5.4pt 0in 5.4pt;height:23.2pt;\"\u003e\n \u003cp style='margin:0in;text-align:justify;font-size:14px;font-family:\"Times New Roman\",serif;vertical-align:middle;'\u003e\u003cspan style=\"color:black;\"\u003e\u0026nbsp;TC (mmol/L)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 22.98%;background: yellow;padding: 0in 5.4pt;height: 23.2pt;vertical-align: bottom;\"\u003e\n \u003cp style='margin:0in;text-align:justify;font-size:14px;font-family:\"Times New Roman\",serif;vertical-align:bottom;'\u003e\u003cspan style=\"color:black;\"\u003e5.06\u0026plusmn;0.94\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 14.94%;background: yellow;padding: 0in 5.4pt;height: 23.2pt;vertical-align: bottom;\"\u003e\n \u003cp style='margin:0in;text-align:justify;font-size:14px;font-family:\"Times New Roman\",serif;vertical-align:bottom;'\u003e\u003cspan style=\"color:black;\"\u003e5.07\u0026plusmn;0.91\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10.46%;background: yellow;padding: 0in 5.4pt;height: 23.2pt;vertical-align: bottom;\"\u003e\n \u003cp style='margin:0in;text-align:justify;font-size:14px;font-family:\"Times New Roman\",serif;vertical-align:bottom;'\u003e\u003cspan style=\"color:black;\"\u003e0.416\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9.04%;background: yellow;padding: 0in 5.4pt;height: 23.2pt;vertical-align: bottom;\"\u003e\n \u003cp style='margin:0in;text-align:justify;font-size:14px;font-family:\"Times New Roman\",serif;vertical-align:bottom;'\u003e\u003cspan style=\"color:black;\"\u003e0.677\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width:42.52%;padding:0in 5.4pt 0in 5.4pt;height:23.2pt;\"\u003e\n \u003cp style='margin:0in;text-align:justify;font-size:14px;font-family:\"Times New Roman\",serif;vertical-align:middle;'\u003e\u003cspan style=\"color:black;\"\u003e\u0026nbsp;HDL-C (mmol/L)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 22.98%;background: yellow;padding: 0in 5.4pt;height: 23.2pt;vertical-align: bottom;\"\u003e\n \u003cp style='margin:0in;text-align:justify;font-size:14px;font-family:\"Times New Roman\",serif;vertical-align:bottom;'\u003e\u003cspan style=\"color:black;\"\u003e1.47\u0026plusmn;0.35\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 14.94%;background: yellow;padding: 0in 5.4pt;height: 23.2pt;vertical-align: bottom;\"\u003e\n \u003cp style='margin:0in;text-align:justify;font-size:14px;font-family:\"Times New Roman\",serif;vertical-align:bottom;'\u003e\u003cspan style=\"color:black;\"\u003e1.44\u0026plusmn;0.34\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10.46%;background: yellow;padding: 0in 5.4pt;height: 23.2pt;vertical-align: bottom;\"\u003e\n \u003cp style='margin:0in;text-align:justify;font-size:14px;font-family:\"Times New Roman\",serif;vertical-align:bottom;'\u003e\u003cspan style=\"color:black;\"\u003e0.343\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9.04%;background: yellow;padding: 0in 5.4pt;height: 23.2pt;vertical-align: bottom;\"\u003e\n \u003cp style='margin:0in;text-align:justify;font-size:14px;font-family:\"Times New Roman\",serif;vertical-align:bottom;'\u003e\u003cspan style=\"color:black;\"\u003e0.641\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width:42.52%;padding:0in 5.4pt 0in 5.4pt;height:23.2pt;\"\u003e\n \u003cp style='margin:0in;text-align:justify;font-size:14px;font-family:\"Times New Roman\",serif;vertical-align:middle;'\u003e\u003cspan style=\"color:black;\"\u003e\u0026nbsp;LDL-C (mmol/L)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 22.98%;background: yellow;padding: 0in 5.4pt;height: 23.2pt;vertical-align: bottom;\"\u003e\n \u003cp style='margin:0in;text-align:justify;font-size:14px;font-family:\"Times New Roman\",serif;vertical-align:bottom;'\u003e\u003cspan style=\"color:black;\"\u003e2.36\u0026plusmn;0.61\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 14.94%;background: yellow;padding: 0in 5.4pt;height: 23.2pt;vertical-align: bottom;\"\u003e\n \u003cp style='margin:0in;text-align:justify;font-size:14px;font-family:\"Times New Roman\",serif;vertical-align:bottom;'\u003e\u003cspan style=\"color:black;\"\u003e2.29\u0026plusmn;0.57\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10.46%;background: yellow;padding: 0in 5.4pt;height: 23.2pt;vertical-align: bottom;\"\u003e\n \u003cp style='margin:0in;text-align:justify;font-size:14px;font-family:\"Times New Roman\",serif;vertical-align:bottom;'\u003e\u003cspan style=\"color:black;\"\u003e3.174\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9.04%;background: yellow;padding: 0in 5.4pt;height: 23.2pt;vertical-align: bottom;\"\u003e\n \u003cp style='margin:0in;text-align:justify;font-size:14px;font-family:\"Times New Roman\",serif;vertical-align:bottom;'\u003e\u003cspan style=\"color:black;\"\u003e0.002\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width:42.52%;padding:0in 5.4pt 0in 5.4pt;height:23.2pt;\"\u003e\n \u003cp style='margin:0in;text-align:justify;font-size:14px;font-family:\"Times New Roman\",serif;vertical-align:middle;'\u003e\u003cspan style=\"color:black;\"\u003e\u0026nbsp;UA (\u0026micro;mol/L)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:22.98%;background:yellow;padding:0in 5.4pt 0in 5.4pt;height:23.2pt;\"\u003e\n \u003cp style='margin:0in;text-align:justify;font-size:14px;font-family:\"Times New Roman\",serif;vertical-align:middle;'\u003e\u003cspan style=\"color:black;\"\u003e361.21\u0026plusmn;90.41\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:14.94%;background:yellow;padding:0in 5.4pt 0in 5.4pt;height:23.2pt;\"\u003e\n \u003cp style='margin:0in;text-align:justify;font-size:14px;font-family:\"Times New Roman\",serif;vertical-align:middle;'\u003e\u003cspan style=\"color:black;\"\u003e359.87\u0026plusmn;92.77\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:10.46%;background:yellow;padding:0in 5.4pt 0in 5.4pt;height:23.2pt;\"\u003e\n \u003cp style='margin:0in;text-align:justify;font-size:14px;font-family:\"Times New Roman\",serif;vertical-align:middle;'\u003e\u003cspan style=\"color:black;\"\u003e1.083\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:9.04%;background:yellow;padding:0in 5.4pt 0in 5.4pt;height:23.2pt;\"\u003e\n \u003cp style='margin:0in;text-align:justify;font-size:14px;font-family:\"Times New Roman\",serif;vertical-align:middle;'\u003e\u003cspan style=\"color:black;\"\u003e0.293\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width:42.52%;padding:0in 5.4pt 0in 5.4pt;height:23.2pt;\"\u003e\n \u003cp style='margin:0in;text-align:justify;font-size:14px;font-family:\"Times New Roman\",serif;vertical-align:middle;'\u003e\u003cspan style=\"color:black;\"\u003e\u0026nbsp;FBG (mmol/L)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 22.98%;background: yellow;padding: 0in 5.4pt;height: 23.2pt;vertical-align: bottom;\"\u003e\n \u003cp style='margin:0in;text-align:justify;font-size:14px;font-family:\"Times New Roman\",serif;vertical-align:bottom;'\u003e\u003cspan style=\"color:black;\"\u003e5.35\u0026plusmn;0.53\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 14.94%;background: yellow;padding: 0in 5.4pt;height: 23.2pt;vertical-align: bottom;\"\u003e\n \u003cp style='margin:0in;text-align:justify;font-size:14px;font-family:\"Times New Roman\",serif;vertical-align:bottom;'\u003e\u003cspan style=\"color:black;\"\u003e5.22\u0026plusmn;0.52\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10.46%;background: yellow;padding: 0in 5.4pt;height: 23.2pt;vertical-align: bottom;\"\u003e\n \u003cp style='margin:0in;text-align:justify;font-size:14px;font-family:\"Times New Roman\",serif;vertical-align:bottom;'\u003e\u003cspan style=\"color:black;\"\u003e2.519\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9.04%;background: yellow;padding: 0in 5.4pt;height: 23.2pt;vertical-align: bottom;\"\u003e\n \u003cp style='margin:0in;text-align:justify;font-size:14px;font-family:\"Times New Roman\",serif;vertical-align:bottom;'\u003e\u003cspan style=\"color:black;\"\u003e0.024\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width:42.52%;padding:0in 5.4pt 0in 5.4pt;height:23.2pt;\"\u003e\n \u003cp style='margin:0in;text-align:justify;font-size:14px;font-family:\"Times New Roman\",serif;vertical-align:middle;'\u003e\u003cspan style=\"color:black;\"\u003e\u0026nbsp;Hcy (\u0026micro;mol/L)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 22.98%;background: yellow;padding: 0in 5.4pt;height: 23.2pt;vertical-align: bottom;\"\u003e\n \u003cp style='margin:0in;text-align:justify;font-size:14px;font-family:\"Times New Roman\",serif;vertical-align:bottom;'\u003e\u003cspan style=\"color:black;\"\u003e19.33\u0026plusmn;5.56\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 14.94%;background: yellow;padding: 0in 5.4pt;height: 23.2pt;vertical-align: bottom;\"\u003e\n \u003cp style='margin:0in;text-align:justify;font-size:14px;font-family:\"Times New Roman\",serif;vertical-align:bottom;'\u003e\u003cspan style=\"color:black;\"\u003e20.17\u0026plusmn;4.79\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10.46%;background: yellow;padding: 0in 5.4pt;height: 23.2pt;vertical-align: bottom;\"\u003e\n \u003cp style='margin:0in;text-align:justify;font-size:14px;font-family:\"Times New Roman\",serif;vertical-align:bottom;'\u003e\u003cspan style=\"color:black;\"\u003e0.328\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9.04%;background: yellow;padding: 0in 5.4pt;height: 23.2pt;vertical-align: bottom;\"\u003e\n \u003cp style='margin:0in;text-align:justify;font-size:14px;font-family:\"Times New Roman\",serif;vertical-align:bottom;'\u003e\u003cspan style=\"color:black;\"\u003e0.531\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width:42.52%;padding:0in 5.4pt 0in 5.4pt;height:23.2pt;\"\u003e\n \u003cp style='margin:0in;text-align:justify;font-size:14px;font-family:\"Times New Roman\",serif;vertical-align:middle;'\u003e\u003cspan style=\"color:black;\"\u003e\u0026nbsp;Long-term use of aspirin [cases (%)]\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:22.98%;background:yellow;padding:0in 5.4pt 0in 5.4pt;height:23.2pt;\"\u003e\n \u003cp style='margin:0in;text-align:justify;font-size:14px;font-family:\"Times New Roman\",serif;vertical-align:middle;'\u003e\u003cspan style=\"color:black;\"\u003e674(38.9)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:14.94%;background:yellow;padding:0in 5.4pt 0in 5.4pt;height:23.2pt;\"\u003e\n \u003cp style='margin:0in;text-align:justify;font-size:14px;font-family:\"Times New Roman\",serif;vertical-align:middle;'\u003e\u003cspan style=\"color:black;\"\u003e517(33.9)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:10.46%;background:yellow;padding:0in 5.4pt 0in 5.4pt;height:23.2pt;\"\u003e\n \u003cp style='margin:0in;text-align:justify;font-size:14px;font-family:\"Times New Roman\",serif;vertical-align:middle;'\u003e\u003cspan style=\"color:black;\"\u003e8.548\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:9.04%;background:yellow;padding:0in 5.4pt 0in 5.4pt;height:23.2pt;\"\u003e\n \u003cp style='margin:0in;text-align:justify;font-size:14px;font-family:\"Times New Roman\",serif;vertical-align:middle;'\u003e\u003cspan style=\"color:black;\"\u003e0.003\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width:42.52%;padding:0in 5.4pt 0in 5.4pt;height:23.2pt;\"\u003e\n \u003cp style='margin:0in;text-align:justify;font-size:14px;font-family:\"Times New Roman\",serif;vertical-align:middle;'\u003e\u003cspan style=\"color:black;\"\u003e1-2 years [case(%)]\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:22.98%;background:yellow;padding:0in 5.4pt 0in 5.4pt;height:23.2pt;\"\u003e\n \u003cp style='margin:0in;text-align:justify;font-size:14px;font-family:\"Times New Roman\",serif;vertical-align:middle;'\u003e\u003cspan style=\"color:black;\"\u003e103(15.3)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:14.94%;background:yellow;padding:0in 5.4pt 0in 5.4pt;height:23.2pt;\"\u003e\n \u003cp style='margin:0in;text-align:justify;font-size:14px;font-family:\"Times New Roman\",serif;vertical-align:middle;'\u003e\u003cspan style=\"color:black;\"\u003e92(17.8)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:10.46%;background:yellow;padding:0in 5.4pt 0in 5.4pt;height:23.2pt;\"\u003e\n \u003cp style='margin:0in;text-align:justify;font-size:14px;font-family:\"Times New Roman\",serif;vertical-align:middle;'\u003e\u003cspan style=\"color:black;\"\u003e1.35\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:9.04%;background:yellow;padding:0in 5.4pt 0in 5.4pt;height:23.2pt;\"\u003e\n \u003cp style='margin:0in;text-align:justify;font-size:14px;font-family:\"Times New Roman\",serif;vertical-align:middle;'\u003e\u003cspan style=\"color:black;\"\u003e0.269\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width:42.52%;padding:0in 5.4pt 0in 5.4pt;height:23.2pt;\"\u003e\n \u003cp style='margin:0in;text-align:justify;font-size:14px;font-family:\"Times New Roman\",serif;vertical-align:middle;'\u003e\u003cspan style=\"color:black;\"\u003e\u0026ge;2-\u0026lt;5 years [case(%)]\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:22.98%;background:yellow;padding:0in 5.4pt 0in 5.4pt;height:23.2pt;\"\u003e\n \u003cp style='margin:0in;text-align:justify;font-size:14px;font-family:\"Times New Roman\",serif;vertical-align:middle;'\u003e\u003cspan style=\"color:black;\"\u003e245(36.4)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:14.94%;background:yellow;padding:0in 5.4pt 0in 5.4pt;height:23.2pt;\"\u003e\n \u003cp style='margin:0in;text-align:justify;font-size:14px;font-family:\"Times New Roman\",serif;vertical-align:middle;'\u003e\u003cspan style=\"color:black;\"\u003e181(35.0)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:10.46%;background:yellow;padding:0in 5.4pt 0in 5.4pt;height:23.2pt;\"\u003e\n \u003cp style='margin:0in;text-align:justify;font-size:14px;font-family:\"Times New Roman\",serif;vertical-align:middle;'\u003e\u003cspan style=\"color:black;\"\u003e0.229\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:9.04%;background:yellow;padding:0in 5.4pt 0in 5.4pt;height:23.2pt;\"\u003e\n \u003cp style='margin:0in;text-align:justify;font-size:14px;font-family:\"Times New Roman\",serif;vertical-align:middle;'\u003e\u003cspan style=\"color:black;\"\u003e0.669\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width:42.52%;padding:0in 5.4pt 0in 5.4pt;height:23.2pt;\"\u003e\n \u003cp style='margin:0in;text-align:justify;font-size:14px;font-family:\"Times New Roman\",serif;vertical-align:middle;'\u003e\u003cspan style=\"color:black;\"\u003e\u0026ge;5 years [case(%)]\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:22.98%;background:yellow;padding:0in 5.4pt 0in 5.4pt;height:23.2pt;\"\u003e\n \u003cp style='margin:0in;text-align:justify;font-size:14px;font-family:\"Times New Roman\",serif;vertical-align:middle;'\u003e\u003cspan style=\"color:black;\"\u003e326(48.4)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:14.94%;background:yellow;padding:0in 5.4pt 0in 5.4pt;height:23.2pt;\"\u003e\n \u003cp style='margin:0in;text-align:justify;font-size:14px;font-family:\"Times New Roman\",serif;vertical-align:middle;'\u003e\u003cspan style=\"color:black;\"\u003e244(47.2)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:10.46%;background:yellow;padding:0in 5.4pt 0in 5.4pt;height:23.2pt;\"\u003e\n \u003cp style='margin:0in;text-align:justify;font-size:14px;font-family:\"Times New Roman\",serif;vertical-align:middle;'\u003e\u003cspan style=\"color:black;\"\u003e1.161\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:9.04%;background:yellow;padding:0in 5.4pt 0in 5.4pt;height:23.2pt;\"\u003e\n \u003cp style='margin:0in;text-align:justify;font-size:14px;font-family:\"Times New Roman\",serif;vertical-align:middle;'\u003e\u003cspan style=\"color:black;\"\u003e0.726\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width:42.52%;padding:0in 5.4pt 0in 5.4pt;height:23.2pt;\"\u003e\n \u003cp style='margin:0in;text-align:justify;font-size:14px;font-family:\"Times New Roman\",serif;vertical-align:middle;'\u003e\u003cspan style=\"color:black;\"\u003e\u0026nbsp;Statins [case (%)]\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:22.98%;background:yellow;padding:0in 5.4pt 0in 5.4pt;height:23.2pt;\"\u003e\n \u003cp style='margin:0in;text-align:justify;font-size:14px;font-family:\"Times New Roman\",serif;vertical-align:middle;'\u003e\u003cspan style=\"color:black;\"\u003e698(40.3)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:14.94%;background:yellow;padding:0in 5.4pt 0in 5.4pt;height:23.2pt;\"\u003e\n \u003cp style='margin:0in;text-align:justify;font-size:14px;font-family:\"Times New Roman\",serif;vertical-align:middle;'\u003e\u003cspan style=\"color:black;\"\u003e621(40.8)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:10.46%;background:yellow;padding:0in 5.4pt 0in 5.4pt;height:23.2pt;\"\u003e\n \u003cp style='margin:0in;text-align:justify;font-size:14px;font-family:\"Times New Roman\",serif;vertical-align:middle;'\u003e\u003cspan style=\"color:black;\"\u003e0.083\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:9.04%;background:yellow;padding:0in 5.4pt 0in 5.4pt;height:23.2pt;\"\u003e\n \u003cp style='margin:0in;text-align:justify;font-size:14px;font-family:\"Times New Roman\",serif;vertical-align:middle;'\u003e\u003cspan style=\"color:black;\"\u003e0.775\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width:42.52%;padding:0in 5.4pt 0in 5.4pt;height:23.2pt;\"\u003e\n \u003cp style='margin:0in;text-align:justify;font-size:14px;font-family:\"Times New Roman\",serif;vertical-align:middle;'\u003e\u003cspan style=\"color:black;\"\u003e\u0026nbsp;Endothelin B-receptor blockers [case (%)]\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:22.98%;background:yellow;padding:0in 5.4pt 0in 5.4pt;height:23.2pt;\"\u003e\n \u003cp style='margin:0in;text-align:justify;font-size:14px;font-family:\"Times New Roman\",serif;vertical-align:middle;'\u003e\u003cspan style=\"color:black;\"\u003e303(17.5)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:14.94%;background:yellow;padding:0in 5.4pt 0in 5.4pt;height:23.2pt;\"\u003e\n \u003cp style='margin:0in;text-align:justify;font-size:14px;font-family:\"Times New Roman\",serif;vertical-align:middle;'\u003e\u003cspan style=\"color:black;\"\u003e259(17)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:10.46%;background:yellow;padding:0in 5.4pt 0in 5.4pt;height:23.2pt;\"\u003e\n \u003cp style='margin:0in;text-align:justify;font-size:14px;font-family:\"Times New Roman\",serif;vertical-align:middle;'\u003e\u003cspan style=\"color:black;\"\u003e0.13\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:9.04%;background:yellow;padding:0in 5.4pt 0in 5.4pt;height:23.2pt;\"\u003e\n \u003cp style='margin:0in;text-align:justify;font-size:14px;font-family:\"Times New Roman\",serif;vertical-align:middle;'\u003e\u003cspan style=\"color:black;\"\u003e0.745\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width:42.52%;padding:0in 5.4pt 0in 5.4pt;height:23.2pt;\"\u003e\n \u003cp style='margin:0in;text-align:justify;font-size:14px;font-family:\"Times New Roman\",serif;vertical-align:middle;'\u003e\u003cspan style=\"color:black;\"\u003e\u0026nbsp;Angiotensin-converting enzyme inhibitors (ACEI) or angiotensin-receptor blockers (ARB) [case (%)]\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:22.98%;background:yellow;padding:0in 5.4pt 0in 5.4pt;height:23.2pt;\"\u003e\n \u003cp style='margin:0in;text-align:justify;font-size:14px;font-family:\"Times New Roman\",serif;vertical-align:middle;'\u003e\u003cspan style=\"color:black;\"\u003e836(48.2)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:14.94%;background:yellow;padding:0in 5.4pt 0in 5.4pt;height:23.2pt;\"\u003e\n \u003cp style='margin:0in;text-align:justify;font-size:14px;font-family:\"Times New Roman\",serif;vertical-align:middle;'\u003e\u003cspan style=\"color:black;\"\u003e754(49.5)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:10.46%;background:yellow;padding:0in 5.4pt 0in 5.4pt;height:23.2pt;\"\u003e\n \u003cp style='margin:0in;text-align:justify;font-size:14px;font-family:\"Times New Roman\",serif;vertical-align:middle;'\u003e\u003cspan style=\"color:black;\"\u003e0.521\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:9.04%;background:yellow;padding:0in 5.4pt 0in 5.4pt;height:23.2pt;\"\u003e\n \u003cp style='margin:0in;text-align:justify;font-size:14px;font-family:\"Times New Roman\",serif;vertical-align:middle;'\u003e\u003cspan style=\"color:black;\"\u003e0.482\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width:42.52%;padding:0in 5.4pt 0in 5.4pt;height:23.2pt;\"\u003e\n \u003cp style='margin:0in;text-align:justify;font-size:14px;font-family:\"Times New Roman\",serif;vertical-align:middle;'\u003e\u003cspan style=\"color:black;\"\u003e\u0026nbsp;Aldosterone receptor antagonists [case (%)]\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:22.98%;background:yellow;padding:0in 5.4pt 0in 5.4pt;height:23.2pt;\"\u003e\n \u003cp style='margin:0in;text-align:justify;font-size:14px;font-family:\"Times New Roman\",serif;vertical-align:middle;'\u003e\u003cspan style=\"color:black;\"\u003e539(31.1)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:14.94%;background:yellow;padding:0in 5.4pt 0in 5.4pt;height:23.2pt;\"\u003e\n \u003cp style='margin:0in;text-align:justify;font-size:14px;font-family:\"Times New Roman\",serif;vertical-align:middle;'\u003e\u003cspan style=\"color:black;\"\u003e482(31.6)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:10.46%;background:yellow;padding:0in 5.4pt 0in 5.4pt;height:23.2pt;\"\u003e\n \u003cp style='margin:0in;text-align:justify;font-size:14px;font-family:\"Times New Roman\",serif;vertical-align:middle;'\u003e\u003cstrong\u003e\u003cspan style=\"color:black;\"\u003e0.112\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:9.04%;background:yellow;padding:0in 5.4pt 0in 5.4pt;height:23.2pt;\"\u003e\n \u003cp style='margin:0in;text-align:justify;font-size:14px;font-family:\"Times New Roman\",serif;vertical-align:middle;'\u003e\u003cspan style=\"color:black;\"\u003e0.762\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width:42.52%;padding:0in 5.4pt 0in 5.4pt;height:23.2pt;\"\u003e\n \u003cp style='margin:0in;text-align:justify;font-size:14px;font-family:\"Times New Roman\",serif;vertical-align:middle;'\u003e\u003cspan style=\"color:black;\"\u003e\u0026nbsp;Thiazide diuretics [case (%)]\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:22.98%;padding:0in 5.4pt 0in 5.4pt;height:23.2pt;\"\u003e\n \u003cp style='margin:0in;text-align:justify;font-size:14px;font-family:\"Times New Roman\",serif;vertical-align:middle;'\u003e\u003cspan style=\"color:black;\"\u003e219(12.6)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:14.94%;padding:0in 5.4pt 0in 5.4pt;height:23.2pt;\"\u003e\n \u003cp style='margin:0in;text-align:justify;font-size:14px;font-family:\"Times New Roman\",serif;vertical-align:middle;'\u003e\u003cspan style=\"color:black;\"\u003e182(11.9)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:10.46%;background:yellow;padding:0in 5.4pt 0in 5.4pt;height:23.2pt;\"\u003e\n \u003cp style='margin:0in;text-align:justify;font-size:14px;font-family:\"Times New Roman\",serif;vertical-align:middle;'\u003e\u003cspan style=\"color:black;\"\u003e0.354\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:9.04%;background:yellow;padding:0in 5.4pt 0in 5.4pt;height:23.2pt;\"\u003e\n \u003cp style='margin:0in;text-align:justify;font-size:14px;font-family:\"Times New Roman\",serif;vertical-align:middle;'\u003e\u003cspan style=\"color:black;\"\u003e0.552\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width:42.52%;border:none;border-bottom:solid black 1.0pt;padding:0in 5.4pt 0in 5.4pt;height:23.95pt;\"\u003e\n \u003cp style='margin:0in;text-align:justify;font-size:14px;font-family:\"Times New Roman\",serif;vertical-align:middle;'\u003e\u003cspan style=\"color:black;\"\u003e\u0026nbsp;Clopidogrel [case (%)]\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:22.98%;border:none;border-bottom:solid black 1.0pt;padding:0in 5.4pt 0in 5.4pt;height:23.95pt;\"\u003e\n \u003cp style='margin:0in;text-align:justify;font-size:14px;font-family:\"Times New Roman\",serif;vertical-align:middle;'\u003e\u003cspan style=\"color:black;\"\u003e175(10.1)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:14.94%;border:none;border-bottom:solid black 1.0pt;padding:0in 5.4pt 0in 5.4pt;height:23.95pt;\"\u003e\n \u003cp style='margin:0in;text-align:justify;font-size:14px;font-family:\"Times New Roman\",serif;vertical-align:middle;'\u003e\u003cspan style=\"color:black;\"\u003e138(9.1)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:10.46%;border:none;border-bottom:solid black 1.0pt;background:yellow;padding:0in 5.4pt 0in 5.4pt;height:23.95pt;\"\u003e\n \u003cp style='margin:0in;text-align:justify;font-size:14px;font-family:\"Times New Roman\",serif;vertical-align:middle;'\u003e\u003cspan style=\"color:black;\"\u003e1.003\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:9.04%;border:none;border-bottom:solid black 1.0pt;background:yellow;padding:0in 5.4pt 0in 5.4pt;height:23.95pt;\"\u003e\n \u003cp style='margin:0in;text-align:justify;font-size:14px;font-family:\"Times New Roman\",serif;vertical-align:middle;'\u003e\u003cspan style=\"color:black;\"\u003e0.341\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003cbr\u003e\u003c/p\u003e\n\u003ctable border=\"0\" cellspacing=\"0\" cellpadding=\"0\" align=\"left\" width=\"102%\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd width=\"100%\" colspan=\"13\"\u003e\n \u003cp\u003e\u0026nbsp;Table 2 General characteristics and clinical biochemical indices of the patients selected for HP eradication\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"17.02127659574468%\" colspan=\"2\" rowspan=\"2\"\u003e\n \u003cp\u003e\u0026nbsp;Groups\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.382978723404255%\" rowspan=\"2\"\u003e\n \u003cp\u003e\u0026nbsp;Number of cases\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.382978723404255%\" rowspan=\"2\"\u003e\n \u003cp\u003e\u0026nbsp;Age (years)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.446808510638298%\"\u003e\n \u003cp\u003e\u0026nbsp;Systolic blood pressure\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.382978723404255%\"\u003e\n \u003cp\u003e\u0026nbsp;Diastolic pressure\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.51063829787234%\"\u003e\n \u003cp\u003e\u0026nbsp;BMI\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.446808510638298%\"\u003e\n \u003cp\u003e\u0026nbsp;FBG\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.446808510638298%\"\u003e\n \u003cp\u003e\u0026nbsp;TC\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.446808510638298%\"\u003e\n \u003cp\u003e\u0026nbsp;LDL-C\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.446808510638298%\"\u003e\n \u003cp\u003e\u0026nbsp;HDL-C\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.446808510638298%\"\u003e\n \u003cp\u003e\u0026nbsp;TG\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.638297872340425%\"\u003e\n \u003cp\u003e\u0026nbsp;UA\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"10.606060606060606%\"\u003e\n \u003cp\u003e\u0026nbsp;(mm Hg)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.090909090909092%\"\u003e\n \u003cp\u003e\u0026nbsp;(mm Hg)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.121212121212121%\"\u003e\n \u003cp\u003e(kg/m\u003csup\u003e2\u003c/sup\u003e)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.606060606060606%\"\u003e\n \u003cp\u003e\u0026nbsp;(mmol/L)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.606060606060606%\"\u003e\n \u003cp\u003e\u0026nbsp;(mmol/L)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.606060606060606%\"\u003e\n \u003cp\u003e\u0026nbsp;(mmol/L)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.606060606060606%\"\u003e\n \u003cp\u003e\u0026nbsp;(mmol/L)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.606060606060606%\"\u003e\n \u003cp\u003e\u0026nbsp;(mmol/L)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.151515151515152%\"\u003e\n \u003cp\u003e\u0026nbsp;(umol/L)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"5.376344086021505%\"\u003e\n \u003cp\u003e\u0026nbsp;Case group\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.75268817204301%\"\u003e\n \u003cp\u003e\u0026nbsp;Aspirin group\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.451612903225806%\"\u003e\n \u003cp\u003e432\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.451612903225806%\" valign=\"top\"\u003e\n \u003cp\u003e53.8\u0026plusmn;8.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.526881720430108%\" valign=\"top\"\u003e\n \u003cp\u003e127.4\u0026plusmn;8.4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.451612903225806%\" valign=\"top\"\u003e\n \u003cp\u003e70.4\u0026plusmn;7.4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.602150537634408%\" valign=\"top\"\u003e\n \u003cp\u003e25.6\u0026plusmn;3.8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.526881720430108%\" valign=\"top\"\u003e\n \u003cp\u003e5.5\u0026plusmn;1.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.526881720430108%\" valign=\"top\"\u003e\n \u003cp\u003e5.2\u0026plusmn;0.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.526881720430108%\" valign=\"top\"\u003e\n \u003cp\u003e2.5\u0026plusmn;0.6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.526881720430108%\" valign=\"top\"\u003e\n \u003cp\u003e1.2\u0026plusmn;0.8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.526881720430108%\" valign=\"top\"\u003e\n \u003cp\u003e1.9\u0026plusmn;1.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.75268817204301%\" valign=\"top\"\u003e\n \u003cp\u003e233.8\u0026plusmn;42.4\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"5.376344086021505%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.75268817204301%\"\u003e\n \u003cp\u003e\u0026nbsp;Nonaspirin group\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.451612903225806%\"\u003e\n \u003cp\u003e427\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.451612903225806%\" valign=\"top\"\u003e\n \u003cp\u003e54.1\u0026plusmn;9.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.526881720430108%\" valign=\"top\"\u003e\n \u003cp\u003e126.2\u0026plusmn;6.2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.451612903225806%\" valign=\"top\"\u003e\n \u003cp\u003e71.1\u0026plusmn;6.8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.602150537634408%\" valign=\"top\"\u003e\n \u003cp\u003e24.9\u0026plusmn;4.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.526881720430108%\" valign=\"top\"\u003e\n \u003cp\u003e5.7\u0026plusmn;1.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.526881720430108%\" valign=\"top\"\u003e\n \u003cp\u003e4.9\u0026plusmn;1.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.526881720430108%\" valign=\"top\"\u003e\n \u003cp\u003e2.4\u0026plusmn;0.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.526881720430108%\" valign=\"top\"\u003e\n \u003cp\u003e1.3\u0026plusmn;0.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.526881720430108%\" valign=\"top\"\u003e\n \u003cp\u003e1.8\u0026plusmn;1.7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.75268817204301%\" valign=\"top\"\u003e\n \u003cp\u003e240.2\u0026plusmn;36.1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"5.376344086021505%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.75268817204301%\"\u003e\n \u003cp\u003e\u0026nbsp;Control group\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.451612903225806%\"\u003e\n \u003cp\u003e418\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.451612903225806%\" valign=\"top\"\u003e\n \u003cp\u003e53.9\u0026plusmn;8.6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.526881720430108%\" valign=\"top\"\u003e\n \u003cp\u003e128.7\u0026plusmn;7.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.451612903225806%\" valign=\"top\"\u003e\n \u003cp\u003e71.6\u0026plusmn;7.8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.602150537634408%\" valign=\"top\"\u003e\n \u003cp\u003e25.5\u0026plusmn;4.8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.526881720430108%\" valign=\"top\"\u003e\n \u003cp\u003e5.5\u0026plusmn;1.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.526881720430108%\" valign=\"top\"\u003e\n \u003cp\u003e5.1\u0026plusmn;1.4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.526881720430108%\" valign=\"top\"\u003e\n \u003cp\u003e2.5\u0026plusmn;0.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.526881720430108%\" valign=\"top\"\u003e\n \u003cp\u003e1.3\u0026plusmn;0.6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.526881720430108%\" valign=\"top\"\u003e\n \u003cp\u003e1.9\u0026plusmn;0.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.75268817204301%\" valign=\"top\"\u003e\n \u003cp\u003e237.6\u0026plusmn;40.6\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"5.376344086021505%\"\u003e\n \u003cp\u003e\u0026nbsp;F\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.75268817204301%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.451612903225806%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.451612903225806%\"\u003e\n \u003cp\u003e1.551\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.526881720430108%\"\u003e\n \u003cp\u003e1.351\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.451612903225806%\"\u003e\n \u003cp\u003e1.338\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.602150537634408%\"\u003e\n \u003cp\u003e1.061\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.526881720430108%\"\u003e\n \u003cp\u003e0.384\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.526881720430108%\"\u003e\n \u003cp\u003e1.326\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.526881720430108%\"\u003e\n \u003cp\u003e1.176\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.526881720430108%\"\u003e\n \u003cp\u003e1.432\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.526881720430108%\"\u003e\n \u003cp\u003e0.216\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.75268817204301%\"\u003e\n \u003cp\u003e1.368\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"5.376344086021505%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003cem\u003eP\u003c/em\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.75268817204301%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.451612903225806%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.451612903225806%\"\u003e\n \u003cp\u003e0.186\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.526881720430108%\"\u003e\n \u003cp\u003e0.305\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.451612903225806%\"\u003e\n \u003cp\u003e0.329\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.602150537634408%\"\u003e\n \u003cp\u003e0.277\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.526881720430108%\"\u003e\n \u003cp\u003e0.641\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.526881720430108%\"\u003e\n \u003cp\u003e0.311\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.526881720430108%\"\u003e\n \u003cp\u003e0.329\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.526881720430108%\"\u003e\n \u003cp\u003e0.264\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.526881720430108%\"\u003e\n \u003cp\u003e0.783\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.75268817204301%\"\u003e\n \u003cp\u003e0.314\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003ctable border=\"0\" cellspacing=\"0\" cellpadding=\"0\" width=\"96%\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd width=\"100%\" colspan=\"13\"\u003e\n \u003cp\u003e\u0026nbsp;Table 3 HP eradication and recurrence after 1 and 3 years\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"5.2631578947368425%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.368421052631579%\"\u003e\n \u003cp\u003e\u0026nbsp;Number of included cases\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.526315789473685%\"\u003e\n \u003cp\u003e\u0026nbsp;Number of patients who complete the HP eradication treatment\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.421052631578947%\"\u003e\n \u003cp\u003e\u0026nbsp;Number of successfully erradicted patients\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20%\" colspan=\"2\"\u003e\n \u003cp\u003e\u0026nbsp;Eradication rate (%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.421052631578947%\"\u003e\n \u003cp\u003e\u0026nbsp;Number of patients lost to follow-up\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.315789473684211%\"\u003e\n \u003cp\u003e\u0026nbsp;Lost to follow-up rate\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.421052631578947%\"\u003e\n \u003cp\u003e\u0026nbsp;Number of patients re-examined\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.421052631578947%\"\u003e\n \u003cp\u003e\u0026nbsp;Number of recurrences in 1 year\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.315789473684211%\"\u003e\n \u003cp\u003e\u0026nbsp;Number of recurrences in 3 years\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.315789473684211%\"\u003e\n \u003cp\u003e\u0026nbsp;Recurrence rate (%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.2105263157894735%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"5.319148936170213%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.446808510638298%\"\u003e\n \u003cp\u003e\u0026nbsp;(Case)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.638297872340425%\"\u003e\n \u003cp\u003e\u0026nbsp;(Case)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.51063829787234%\"\u003e\n \u003cp\u003e\u0026nbsp;(Case)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.574468085106384%\"\u003e\n \u003cp\u003e\u0026nbsp;Regimen-based analysis\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.574468085106384%\"\u003e\n \u003cp\u003e\u0026nbsp;Intention-based analysis\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.51063829787234%\"\u003e\n \u003cp\u003e\u0026nbsp;(Case)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.382978723404255%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.51063829787234%\"\u003e\n \u003cp\u003e\u0026nbsp;(Casee)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.51063829787234%\"\u003e\n \u003cp\u003e\u0026nbsp;(Case)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.382978723404255%\"\u003e\n \u003cp\u003e\u0026nbsp;(Case)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.382978723404255%\"\u003e\n \u003cp\u003e1 year\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.25531914893617%\"\u003e\n \u003cp\u003e3 years\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"5.319148936170213%\"\u003e\n \u003cp\u003e\u0026nbsp;Aspirin group\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.446808510638298%\"\u003e\n \u003cp\u003e432\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.638297872340425%\"\u003e\n \u003cp\u003e418\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.51063829787234%\"\u003e\n \u003cp\u003e367\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.574468085106384%\"\u003e\n \u003cp\u003e87.8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.574468085106384%\"\u003e\n \u003cp\u003e84.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.51063829787234%\"\u003e\n \u003cp\u003e8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.382978723404255%\"\u003e\n \u003cp\u003e0.021798365\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.51063829787234%\"\u003e\n \u003cp\u003e359\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.51063829787234%\"\u003e\n \u003cp\u003e4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.382978723404255%\"\u003e\n \u003cp\u003e19\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.382978723404255%\"\u003e\n \u003cp\u003e1.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.25531914893617%\"\u003e\n \u003cp\u003e5.3\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"5.319148936170213%\"\u003e\n \u003cp\u003e\u0026nbsp;Nonaspirin group\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.446808510638298%\"\u003e\n \u003cp\u003e427\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.638297872340425%\"\u003e\n \u003cp\u003e408\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.51063829787234%\"\u003e\n \u003cp\u003e361\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.574468085106384%\"\u003e\n \u003cp\u003e88.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.574468085106384%\"\u003e\n \u003cp\u003e84.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.51063829787234%\"\u003e\n \u003cp\u003e9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.382978723404255%\"\u003e\n \u003cp\u003e0.024930748\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.51063829787234%\"\u003e\n \u003cp\u003e352\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.51063829787234%\"\u003e\n \u003cp\u003e6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.382978723404255%\"\u003e\n \u003cp\u003e7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.382978723404255%\"\u003e\n \u003cp\u003e1.7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.25531914893617%\"\u003e\n \u003cp\u003e1.9\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"5.319148936170213%\"\u003e\n \u003cp\u003e\u0026nbsp;Control group\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.446808510638298%\"\u003e\n \u003cp\u003e418\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.638297872340425%\"\u003e\n \u003cp\u003e403\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.51063829787234%\"\u003e\n \u003cp\u003e349\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.574468085106384%\"\u003e\n \u003cp\u003e86.6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.574468085106384%\"\u003e\n \u003cp\u003e83.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.51063829787234%\"\u003e\n \u003cp\u003e14\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.382978723404255%\"\u003e\n \u003cp\u003e0.040114613\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.51063829787234%\"\u003e\n \u003cp\u003e335\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.51063829787234%\"\u003e\n \u003cp\u003e4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.382978723404255%\"\u003e\n \u003cp\u003e6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.382978723404255%\"\u003e\n \u003cp\u003e1.2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.25531914893617%\"\u003e\n \u003cp\u003e1.7\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"5.319148936170213%\"\u003e\n \u003cp\u003e\u0026nbsp;\u0026chi;\u0026sup2; value\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.446808510638298%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.638297872340425%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.51063829787234%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.574468085106384%\"\u003e\n \u003cp\u003e0.667\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.574468085106384%\"\u003e\n \u003cp\u003e0.364\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.51063829787234%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.382978723404255%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.51063829787234%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.51063829787234%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.382978723404255%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.382978723404255%\"\u003e\n \u003cp\u003e0.547\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.25531914893617%\"\u003e\n \u003cp\u003e9.214\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"5.319148936170213%\"\u003e\n \u003cp\u003e\u0026nbsp;P value\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.446808510638298%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.638297872340425%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.51063829787234%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.574468085106384%\"\u003e\n \u003cp\u003e0.607\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.574468085106384%\"\u003e\n \u003cp\u003e0.834\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.51063829787234%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.382978723404255%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.51063829787234%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.51063829787234%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.382978723404255%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.382978723404255%\"\u003e\n \u003cp\u003e0.761\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.25531914893617%\"\u003e\n \u003cp\u003e0.01\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003ctable border=\"0\" cellspacing=\"0\" cellpadding=\"0\" width=\"97%\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd width=\"100%\" colspan=\"9\" style=\"width: 39.3492%;\"\u003e\n \u003cp\u003eTable 4 Comparison of adverse reactions that occurred during eradication treatment [case (%)]\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"12.5%\"\u003e\n \u003cp\u003e\u0026nbsp;Groups\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.583333333333334%\" style=\"width: 6.3459%;\"\u003e\n \u003cp\u003e\u0026nbsp;Number of cases\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.375%\" style=\"width: 5.4663%;\"\u003e\n \u003cp\u003e\u0026nbsp;Constipation\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.666666666666668%\" style=\"width: 7.2884%;\"\u003e\n \u003cp\u003e\u0026nbsp;Abdominal distension\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.458333333333334%\" style=\"width: 4.9636%;\"\u003e\n \u003cp\u003e\u0026nbsp;Dry mouth\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.291666666666667%\" style=\"width: 3.33%;\"\u003e\n \u003cp\u003e\u0026nbsp;Nausea\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.416666666666666%\" style=\"width: 4.5867%;\"\u003e\n \u003cp\u003e\u0026nbsp;Bad breath\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.375%\" style=\"width: 4.2725%;\"\u003e\n \u003cp\u003e\u0026nbsp;Headache\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.333333333333334%\" style=\"width: 3.3929%;\"\u003e\n \u003cp\u003e\u0026nbsp;Fatigue\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"9.473684210526315%\" style=\"width: 4.7752%;\"\u003e\n \u003cp\u003e\u0026nbsp;Aspirin group\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.736842105263158%\" style=\"width: 6.3459%;\"\u003e\n \u003cp\u003e432\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.473684210526315%\" style=\"width: 5.4663%;\"\u003e\n \u003cp\u003e23(5.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.842105263157894%\" style=\"width: 7.2884%;\"\u003e\n \u003cp\u003e15(3.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.578947368421053%\" style=\"width: 4.9636%;\"\u003e\n \u003cp\u003e12(2.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.368421052631579%\" style=\"width: 3.33%;\"\u003e\n \u003cp\u003e8(1.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.526315789473685%\" style=\"width: 4.5867%;\"\u003e\n \u003cp\u003e12(2.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.473684210526315%\" style=\"width: 4.2725%;\"\u003e\n \u003cp\u003e6(1.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.421052631578947%\" style=\"width: 3.3929%;\"\u003e\n \u003cp\u003e8(1.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"9.473684210526315%\" style=\"width: 4.7752%;\"\u003e\n \u003cp\u003e\u0026nbsp;Nonaspirin group\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.736842105263158%\" style=\"width: 6.3459%;\"\u003e\n \u003cp\u003e427\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.473684210526315%\" style=\"width: 5.4663%;\"\u003e\n \u003cp\u003e21(4.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.842105263157894%\" style=\"width: 7.2884%;\"\u003e\n \u003cp\u003e17(4.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.578947368421053%\" style=\"width: 4.9636%;\"\u003e\n \u003cp\u003e14(3.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.368421052631579%\" style=\"width: 3.33%;\"\u003e\n \u003cp\u003e6(1.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.526315789473685%\" style=\"width: 4.5867%;\"\u003e\n \u003cp\u003e12(2.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.473684210526315%\" style=\"width: 4.2725%;\"\u003e\n \u003cp\u003e7(1.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.421052631578947%\" style=\"width: 3.3929%;\"\u003e\n \u003cp\u003e6(1.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"9.473684210526315%\" style=\"width: 4.7752%;\"\u003e\n \u003cp\u003e\u0026nbsp;Control group\u003c/p\u003e\n \u003c/td\u003e\n 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width=\"8.333333333333334%\" style=\"width: 3.3929%;\"\u003e\n \u003cp\u003e0.387\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"27.083333333333332%\" colspan=\"2\" style=\"width: 11.9379%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003cem\u003eP\u003c/em\u003e value\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.375%\" style=\"width: 5.4663%;\"\u003e\n \u003cp\u003e0.789\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.666666666666668%\" style=\"width: 7.2884%;\"\u003e\n \u003cp\u003e0.872\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.458333333333334%\" style=\"width: 4.9636%;\"\u003e\n \u003cp\u003e0.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.291666666666667%\" style=\"width: 3.33%;\"\u003e\n \u003cp\u003e0.721\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.416666666666666%\" style=\"width: 4.5867%;\"\u003e\n \u003cp\u003e0.795\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.375%\" style=\"width: 4.2725%;\"\u003e\n \u003cp\u003e0.86\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.333333333333334%\" style=\"width: 3.3929%;\"\u003e\n \u003cp\u003e0.824\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"","lastPublishedDoi":"10.21203/rs.3.rs-4300031/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-4300031/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003eObjective\u003c/strong\u003e To investigate the relationship between long-term use of low-dose aspirin and Helicobacter pylori (HP) infection and its effect on eradication and recurrence of HP.\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMethods\u003c/strong\u003e From March 2019 to December 2020, 3256 patients with cardiovascular and cerebrovascular diseases who were treated in the Affiliated Hospital of Gansu University of Chinese Medicine, Zhangye Second People's Hospital of Gansu Province, Tianshui Hospital of Integrated Traditional Chinese and Western Medicine of Gansu Province, and the First Hospital of Lanzhou University were selected as the study objects. The patients ranged in age from 34 to 93(51.9±9.1) years, including 2147 (65.9%) males and 1109 (34.1%) females. According to the results of C14-urea breath test (C14-UBT), 1733 cases of HP infection and 1523 cases of HP non-infection were divided into two groups. Logistic regression analysis，both univariate and multivariate, was used to investigate the relationship between aspirin use and HP infection. Parallel to this, a prospective case-control analysis was performed, and 859 patients with hypertension combined with HP were selected as the study objects. The patients ranged in age from 43 to 71(50.3±8.4) years, with 568 males (66.1%) and 291 females (33.9%). According to the medication situation, the subjects were divided into aspirin group (432 cases, in addition to taking antihypertensive drugs combined with low-dose aspirin treatment), non-aspirin group (427 cases, only taking conventional antihypertensive drugs), in addition, patients with current HP infection but no hypertension and other acute and chronic diseases were selected as the control group (418 cases). To compare the efficacy, safety and recurrence of HP after 1 year and 3 years of bismuth-containing quadruple therapy.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eResults\u003c/strong\u003e The overall infection rate of HP was 53.3% (1733/3256). The results of univariate analysis showed that the infection rate of female was higher than that of male [56.4% (625/1109) vs. 51.6% (1108/2147). χ²=6.628, P=0.010], the age of the HP infected group was higher than that of the uninfected group (52.1±9.2 vs. 50.4±8.9, t=3.166, P=0.002), and the body mass index of the HP infected group was higher than that of the uninfected group (24.59±3.11 vs. 24.36±3.01). t=2.135, P=0.033), LDL cholesterol (2.36±0.61 vs. 2.29±0.57, t=3.174, P=0.002) and fasting blood glucose (5.35±0.53 vs. 5.22±0.52, t=2.519, P=0.024) were higher than those in uninfected group. The infection rate of patients who took low-dose aspirin for a long time was higher than that of those who did not take aspirin [56.6% (674/1191) vs. 51.3% (1059/2065), χ²=8.548, P=0.003]. Multivariate Logistic regression analysis showed that the older the age, the higher the risk of H.pylori infection (OR=1.041, 95%CI: 1.008-1.086, P=0.003), and the risk of infection in females was higher than that in males (OR=1.332, 95%CI: 1.098-1.627, P=0.004), higher fasting blood glucose increased the risk of infection (OR=1.528, 95%CI: 1.337-2.189, P\u0026lt;0.001), higher LDL cholesterol increased the risk of infection (OR=1.103, 95%CI: 1.034-1.392, P=0.007), long-term aspirin increased the risk of infection (OR=1.526, 95%CI: 1.231-2.015, P\u0026lt;0.001), after controlling for age, sex, and body mass index, long-term aspirin use still increased the risk of infection (OR=1.433, 95%CI: 1.196-1.947, P\u0026lt;0.001). The overall eradication rates were 87.6% (1077/1229), 87.8% (367/418), 88.5% (361/408) and 86.6% (349/403) in the treatment group, observation group and control group, respectively. According to intention analysis, the overall eradication rate was 84.3% (1077/1277), 84.9% (367/432), 84.5% (361/427) and 83.5% (349/418), respectively, and the comparison was not statistically significant (P\u0026lt; 0.05). The overall 1-year recurrence rate was 1.3% (14/1046), and the recurrence rates of the three groups were 1.10% (4/359), 1.70% (6/352) and 1.20% (4/335), respectively, with no statistical significance (P\u0026lt;0.05). The overall recurrence rate at 3 years was 3.1% (32/1046), and the recurrence rate in the three groups was 5.30% (19/359), 1.90% (7/352) and 1.70% (6/335), respectively. The recurrence rate in the treatment group was higher than that in the observation group and control group (χ² =6.118 and 5.507, P= 0.01 and 0.015, respectively). The main adverse reactions in the first month of eradication treatment were constipation and mild nausea, and there was no statistical significance between the three groups (P\u0026gt;0.05).\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConclusion\u003c/strong\u003e Long-term use of low-dose aspirin increases the risk of HP infection and the recurrence rate in 3 years after eradication. It is suggested that HP should be tested and eradicated regularly in long-term users.\u003c/p\u003e","manuscriptTitle":"Long-term use of low-dose aspirin and the risk of Helicobacter pylori infection and the effect of Helicobacter pylori eradication treatment: A Prospective Case-Control Analysis","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2024-05-09 18:09:40","doi":"10.21203/rs.3.rs-4300031/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"304b95d3-632b-434d-8ea1-cbd6482b58b9","owner":[],"postedDate":"May 9th, 2024","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2024-05-21T09:52:29+00:00","versionOfRecord":[],"versionCreatedAt":"2024-05-09 18:09:40","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-4300031","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-4300031","identity":"rs-4300031","version":["v1"]},"buildId":"WrCJVZZCHTDjtuVLN7oU0","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}