ObjectivesThe purpose of this study is to assess the prevalence of overweight/obesity, abdominal obesity and obesity-related risk factors in southern China.MethodsA cross-sectional survey of 15,364 participants aged 15 years and older was conducted from November 2013 to August 2014 in Jiangxi Province, China, using questionnaire forms and physical measurements. The physical measurements included body height, weight, waist circumference (WC), body fat percentage (BFP) and visceral adipose index (VAI). Multivariate logistic regression analysis was performed to evaluate the risk factors for overweight/obesity and abdominal obesity.ResultsThe prevalence of overweight was 25.8% (25.9% in males and 25.7% in females), while that of obesity was 7.9% (8.4% in males and 7.6% in females). The prevalence of abdominal obesity was 10.2% (8.6% in males and 11.3% in females). The prevalence of overweight/obesity was 37.1% in urban residents and 30.2% in rural residents, and this difference was significant (P < 0.001). Urban residents had a significantly higher prevalence of abdominal obesity than rural residents (11.6% vs 8.7%, P < 0.001). Among the participants with an underweight/normal body mass index (BMI), 1.3% still had abdominal obesity, 16.1% had a high BFP and 1.0% had a high VAI. Moreover, among obese participants, 9.7% had a low /normal WC, 0.8% had a normal BFP and 15.9% had a normal VAI. Meanwhile, the partial correlation analysis indicated that the correlation coefficients between VAI and BMI, VAI and WC, and BMI and WC were 0.700, 0.666, and 0.721, respectively. A multivariate logistic regression analysis indicated that being female and having a high BFP and a high VAI were significantly associated with an increased risk of overweight/obesity and abdominal obesity. In addition, living in an urban area and older age correlated with overweight/obesity.ConclusionThis study revealed that obesity and abdominal obesity, which differed by gender and age, are epidemic in southern China. Moreover, there was a very high, significant, positive correlation between WC, BMI and VAI. However, further studies are needed to explore which indicator of body fat could be used as the best marker to indirectly reflect cardiometabolic risk.

BackgroundThis study aimed to describe the prevalence and risk factors of prehypertension and hypertension in Jiangxi Province, China. Individuals with prehypertension frequently progress into hypertension and are at high risk of developing cardiovascular disease and stroke.MethodsA cross-sectional survey of 15,296 participants (15 years or older) was conducted in Jiangxi Province, China, in 2013, using questionnaire forms and physical measurements.ResultsThe prevalence of prehypertension and hypertension was 32.3% (39.2% in men and 27.6% in women) and 29.0% (30.1% in men and 28.2% in women), respectively. The awareness, treatment, and control rates among all hypertensive participants were 64.8%, 27.1%, and 12.6%, respectively. The prevalence of prehypertension in males declined with age, but the prevalence of hypertension increased in different genders. The prevalence of prehypertension and hypertension increased with increasing body mass index (BMI). The prevalence of prehypertension decreased, in parallel to an increase in the prevalence of hypertension, with increasing waist circumference (WC). A combination of WC and BMI was superior to individual indices in identifying hypertension. A multivariate logistic regression analysis indicated that increasing age, high BMI, high visceral adipose index, and high heart rate were risk factors for prehypertension and hypertension. The high body fat percentage was significantly associated with prehypertension. Living in an urban area, male sex, abdominal obesity, and menopause were correlated with hypertension.ConclusionsPrehypertension and hypertension are epidemic in southern China. Further studies are needed to explore an indicator that can represent the visceral fat accurately and has a close relationship with cardiovascular disease.

Background: To date, the best adiposity index that predicts or associates strongly with hypertension remains controversial. Therefore, we aimed to compare the performance of different adiposity indices [BMI (body mass index), WC (waist circumference), WHtR (waist-to-height ratio), ABSI (a body shape index), VAI (visceral adipose index), BFP (body fat percentage)] as associates and potential predictors of risk of hypertension among Chinese population. Methods: A cross-sectional survey was conducted in Jiangxi province, China from 2013 to 2014. A total of 14,573 participants were included in the study. The physical measurements included body height, weight, WC, BFP and VAI. Multivariate logistic regression analysis was performed to assess the associations between different adiposity indices and the prevalence of hypertension. Receiver operating characteristic (ROC) analysis was also performed. Results: All adiposity indices were independently and positively associated with the prevalence of hypertension in a dose response fashion. The area under the curves (AUCs) for WHtR, BFP and VAI were significantly larger than those for other adiposity indices in both males and females (all P < 0.01). For males, no statistically significant difference was found in AUCs among WHtR and BFP (0.653 vs. 0.647, P = 0.4774). The AUC of WHtR was significantly higher than VAI (0.653 vs. 0.636, P < 0.01). For females, the AUCs demonstrated that WHtR was significantly more powerful than BFP and VAI (both P < 0.05) for predicting hypertension [WHtR, 0.689 (0.677-0.702); BFP, 0.677 (0.664-0.690); VAI, 0.668 (0.655-0.680)]. Whereas no significant differences were found in AUCs for hypertension among BFP and VAI in both sexes (all P > 0.1). The AUCs for hypertension associated with each adiposity index declined with age in both males and females. For subjects aged < 65 years, WHtR still had the largest AUC. However, for participants aged ≥65 years, BMI had the largest AUC. Conclusion: The findings indicated that WHtR was the best for predicting hypertension, followed by BFP and VAI, especially in younger population.

Uncertainty remains regarding the association between resting heart rate (RHR) with hypertension and stroke because of limited and inconsistent data. We assessed the association between RHR, hypertension, and stroke. In this cross-sectional study, 14 677 participants from the China Hypertension Survey study were analyzed. The history of stroke was conducted by questionnaires. RHR was measured by the standardized electronic monitors. Multivariate logistic regression analyses were performed to evaluate the association between RHR, hypertension, and stroke. Moreover, a generalized additive model (GAM) and smooth curve fitting (penalized spline method) were conducted to assess the association between RHR and stroke in different status of hypertension. Overall, each 10 beats per minute (bpm) increase in RHR was associated with an 18% increased prevalence of stroke (P = 0.017). Subjects with RHR > 80 bpm were associated with a higher prevalence of stroke (OR = 1.47; 95% CI, 1.08-2.01) compared with those with RHR ≤ 80 bpm. Similarly, hypertensives had a higher prevalence of stroke than normotensives (OR = 3.76; 95% CI, 2.39-5.92).Hypertensives with RHR > 80 bpm had the highest prevalence of stroke compared with their counterparts (OR = 5.47; 95% CI, 3.13-9.56). The fully adjusted smooth curve fitting presented a linear association between RHR and stroke among participants with hypertension, but almost horizontal association among participants without hypertension. In conclusion, elevated RHR and hypertension were independently and jointly associated with the increased prevalence of stroke. These findings suggested that elevated RHR was associated with increased prevalence of stroke especially among hypertensives.

Accumulating evidence has reported that prolonged periods of sedentary time have been recognized as a risk factor for cardiocerebrovascular disease. However, whether high levels of sedentary behavior are associated with an increased risk of cardiocerebrovascular disease in different regions remains unclear.The aim of this study was to evaluate the association between sedentary behavior and the risk of myocardial infarction (MI) and stroke in Jiangxi Province of China.A cross-sectional survey was conducted among 15,364 participants in Jiangxi Province of China from November 2013 to August 2014, using standardized questionnaire forms and physical measurements. Self-reported sedentary behavior in daily life and a history of MI and stroke were conducted by answering the questionnaire. The participants were examined for weight, height, waist circumference (WC), body fat percentage (BFP), visceral fat index (VAI), basal metabolic rate (BMR), and blood pressure (BP). Multivariate logistic regression analysis was performed to evaluate the association between sedentary behavior and the risk of MI and stroke after adjustment for sociodemographic characteristics, lifestyle factors, and disease-related risk factors.Of the 15,364 eligible participants, 13,710 participants (5604 men and 8106 women, aged 15–97 years) completed the questionnaire. Subjects who had longer sedentary behavior were significantly associated with an increased risk of MI and stroke [odds ratio (OR) = 1.22, 95% confidence interval (95% CI): 1.168–1.281, P < .001; OR = 1.59, 95% CI: 1.50–1.67, P < .001]. After stratification by the categorical variable of sedentary behavior, individuals with a longer time of sedentary behavior (≥8 hours) were also related to a higher risk of MI and stroke than those in the sedentary behavior (<4 hours) group (OR = 176.62, 95% CI: 43.33–719.90, P < .001; OR = 478.52, 95% CI: 118.50–1932.36, P < .001). However, there were no significant differences between individuals in the short time of sedentary behavior (<4 hours) group and the middle time (4–8 hours) group (p > 0.05).Excessive time spent in sedentary behavior was associated with a higher risk of MI and stroke. The results provide robust evidence to support the guideline recommendations regarding reduction of sedentary behavior in daily life.

Background:Accumulating evidence has reported that physical activity (PA) is effective in reducing stroke and mortality. However, whether PA levels are associated with stroke in middle-aged and elderly people in Jiangxi Province of China remains unclear. In the present study, we evaluated the association between PA and the risk of stroke in Jiangxi Province of China.Methods:A cross-sectional survey was conducted in Jiangxi Province of China from November 2013 to August 2014, using standardized questionnaire forms and physical measurements. Self-reported PA was assessed using the international PA questionnaire. A history of stroke was self-reported by answering the questionnaire. Multivariate logistic regression analysis was performed to evaluate the association between PA levels and the risk of stroke after adjustment for sociodemographic characteristics, lifestyle factors, and disease-related risk factors.Results:A total of 10,398 participants (4240 men and 6158 women, aged 45 to 97 years) completed the International Physical Activity Questionnaire (IPAQ). Compared with low-intensity PA, vigorous PA was associated with graded reduction in the risk of stroke (odds ratio [OR] of 0.763, 95% confidence interval [CI] 0.717–0.812, P < .001 for trend). However, there were no significant differences between individuals in the low-intensity PA and moderate-intensity PA group (P > 0.05).Conclusions:Compared with low PA, vigorous PA, but not moderate PA, was associated with a lower risk of stroke in middle aged and elderly people in southern China, specifically among men. These findings suggested that increasing PA is beneficial.

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Background Association between age at menarche (AAM) and hypertension remains a controversial topic, and data in China were sparse. Therefore, we aimed to investigate the association between AAM and hypertension in Chinese female population. Methods In this cross-sectional study, 5,102 females aged ≥15 years were enrolled. Self-reported AAM was assessed by the questionnaire. Multiple linear regression analysis was used to evaluate the association between systolic blood pressure (SBP), diastolic blood pressure (DBP), and AAM. Logistic regression analysis was performed to evaluate the association between hypertension and AAM. Generalized additive model (GAM) and smooth curve fitting (penalized spline method) were conducted to explore the exact shape of curve between them. Results The overall mean of AAM was 15.5 years. Each additional year of AAM was associated with a 15% higher risk of hypertension (odds ratio (OR) = 1.15, 95% confidence interval (CI): 1.11–1.19). Among females with hypertension, there was a significant positive association between AAM and SBP (β = 0.88, 95% CI: 0.29–1.46) and DBP (β = 0.80, 95% CI: 0.47–1.13). A significantly higher risk of hypertension was found in younger subjects (15–44 y: OR = 1.37, 95% CI: 1.21–1.55; P for interaction = 0.009) compared with those aged between 62 and 97 y.Conclusions AAM was positively associated with hypertension and blood pressure, especially among females in early adulthood from southern China.