Explaining the Increase in Coronary Heart Disease Mortality in Beijing Between 1984 and 1999

Critchley, Julia; Liu, Jing; Zhao, Dong; Wang, Wei; Capewell, Simon

doi:10.1161/01.cir.0000140668.91896.ae

Cited by 274 publications

(228 citation statements)

References 51 publications

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“…In the APCSC, individuals from Asia and those with diabetes experienced a relatively greater rate of haemorrhagic stroke than those from ANZ and those without diabetes. However, an interpretation of the public health and clinical implications of this finding must take into consideration the evolving epidemiology of CVD in the Asia-Pacific region, with a rapidly increasing predominance of atherothrombotic conditions in many areas [15][16][17][18]. For example, during the 1990s, the incidence rate of haemorrhagic stroke in China declined by an average of 12% per year, while that of ischaemic stroke increased by at least 5% per year in most regions [19].…”

Section: Discussionmentioning

confidence: 99%

Cholesterol, diabetes and major cardiovascular diseases in the Asia-Pacific region

2007

Diabetologia

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Aims/hypothesis The aim of this study was to assess the association between total cholesterol and major cardiovascular diseases among persons with and without diabetes in the Asia-Pacific region. Methods We used data on individual participants in 30 cohort studies from the Asia-Pacific region to compute the hazards ratios and 95% CIs for participants with and without diabetes at baseline, using Cox proportional models. Analyses were stratified by sex and region (Asia vs Australia or New Zealand) and adjusted for age. Repeat measurements of total cholesterol were used to adjust for regression dilution bias. Results The analysis included 333,533 individuals (6.3% with diabetes at baseline) who experienced 6,074 fatal and non-fatal cardiovascular events over a median follow-up period of 4.0 years. Total cholesterol was positively associated with coronary heart disease (CHD) and ischaemic stroke, and negatively with haemorrhagic stroke in a continuous, log-linear fashion, similarly among participants with and without diabetes. Each 1 mmol/l increase above the 'usual' level for total cholesterol was associated with a 41% (95% CI 23-63%) and 42% (95% CI 35-50%) greater risk of CHD among participants with and without diabetes. The corresponding values for ischaemic stroke were 23% (95% CI 0-52%) and 31% (95% CI 20-44%), respectively. These results were broadly consistent for sex, age and region. Conclusions/interpretation Total cholesterol is associated with similarly increased risks of cardiovascular events in people with and without diabetes. While abnormal levels of other lipid fractions are frequently observed in people with diabetes, these data support aggressive lowering of total cholesterol and LDL-cholesterol levels for prevention of cardiovascular events.

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Section: Discussionmentioning

confidence: 99%

Cholesterol, diabetes and major cardiovascular diseases in the Asia-Pacific region

2007

Diabetologia

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“…Furthermore, whereas mortality rates from CVD have been halved in many developed countries since the 1980s (27), they are still rising in most developing counties, including China (28). In Beijing, age-adjusted coronary heart disease mortality rates increased by 50% in men and 27% in women from 1984 to 1999 (29). Our study identified a specific population of individuals who have relatively higher prevalence of CKD and need multiple cardiovascular risk factor interventions and thus has significant meaning for prevention and treatment of CVD in China.…”

Section: Discussionmentioning

confidence: 99%

Cardiovascular Disease in Early Stages of Chronic Kidney Disease in a Chinese Population

Zhang

Zuo²,

Wang³

et al. 2006

Journal of the American Society of Nephrology

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C ardiovascular disease (CVD) is the leading cause of death among patients who are on dialysis. CVD mortality rates are approximately 10 to 30 times higher in patients who are on dialysis than in the general population, despite stratification for gender, race, and the presence of diabetes (1). It was recognized recently that earlier stage of chronic kidney disease (CKD) also is a risk factor for CVD mortality (2-7). In particular, this risk has been noted in patients who already have some form of CVD or in individuals who are at high risk for the development of CVD (2-7). In low-risk populations or community studies, the relationship between the level of kidney function and outcomes has not been as clear (8 -11).The relationship between early stages of CKD and CVD, to the best of our knowledge, has never been tested in a community-based Chinese population, in whom genetic and environmental backgrounds are different from those of Western countries, and the profile of CVD is very different from that of white individuals (12,13). Therefore, we initiated this cross-sectional study among a population older than 40 yr in a metropolis of China to investigate the prevalence and the spectrum of CVD in residents with early-stage CKD and compare them with data of residents without CKD. Materials and Methods PopulationAll residents who were 40 yr or older and were served by a community hospital located in an urban district of Beijing were invited to participate in the study. Residents were contacted by telephone using their data that were available in the hospital and notified of the screening protocol by the local general practitioner from Definition of CVDAll participants were asked, "Have you ever been told by a doctor that you had a heart attack?" and, "Have you ever been told by a doctor that you had a stroke?" Participants with an affirmative answer to either of these questions were deemed as having CVD. Definition of CKDSerum creatinine (Scr) was measured by means of enzymatic method on a Hitachi 7170 autoanalyzer (Hitachi, Tokyo, Japan). In addition, Scr of 57 fresh frozen serum samples (Scr range 0.42 to 16.89 mg/dl) were analyzed in both our laboratory and the Cleveland Clinic Laboratory to ensure that Scr values in this study are equally calibrated with the Modification of Diet in Renal Disease (MDRD) study. A calibration equation was generated from the results (R 2 ϭ 0.998): MDRD Scr (mg/dl) ϭ 1.05 ϫ [Beijing Scr (mg/dl)] Ϫ 0.22.

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“…7,8 Conversely, research shows that the modern Western dietary pattern (saturated and trans-fat, refined grains, sugar, salt, etc) is associated with increases in CVD mortality. 9,10 Nutritional purification refers to optimizing the general health and wellness of patients in certain clinical settings using nutrition as the primary therapeutic modality. It takes many forms and may incorporate several integrative and alternative therapies.…”

Section: Introductionmentioning

confidence: 99%

A nutritional program improved lipid profiles and weight in 28 chiropractic patients: a retrospective case series

Powell¹,

Leonard

2008

Journal of Chiropractic Medicine

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Objective: This study retrospectively examined the effects of a 21-day nutritional intervention program, which included fruit and vegetable consumption, energy restriction, and nutritional supplements, on serum lipid measures in 28 chiropractic patients. Methods: Medical records were reviewed for 28 chiropractic patients who had completed a commercially available 21-day nutritional intervention program between April 2005 and August 2007 and for whom complete serum lipid and weight measures immediately pre-and postintervention were available. The primary outcome was change in serum lipids, and change in body weight was a secondary outcome variable. Results: Significant reductions in total, low-density lipoprotein, very low-density lipoprotein, and high-density lipoprotein cholesterol, and triglycerides were observed. Serum triglycerides decreased from 116.3 ± 54.6 (mean ± SD) to 88.6 ± 40.5 mg/dL (P b .01). Total cholesterol decreased from 223.3 ± 40.7 to 176.2 ± 30.0 mg/dL (P b .0001). Low-density lipoprotein cholesterol decreased from 145.7 ± 36.8 to 110.9 ± 25.3 mg/dL (P b .0001). High-density lipoprotein cholesterol decreased from 54.3 ± 14.6 to 47.6 ± 10.5 mg/dL (P b .001). Weight for patients decreased from 191.2 ± 38.8 to 182.2 ± 36.3 lb (P b .0001). Conclusions: This retrospective case series supports the hypothesis that a nutritional purification intervention program emphasizing fruit and vegetable consumption, energy restriction, and nutritional supplements reduces serum lipids and weight.

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Explaining the Increase in Coronary Heart Disease Mortality in Beijing Between 1984 and 1999

Cited by 274 publications

References 51 publications

Cholesterol, diabetes and major cardiovascular diseases in the Asia-Pacific region

Cholesterol, diabetes and major cardiovascular diseases in the Asia-Pacific region

Cardiovascular Disease in Early Stages of Chronic Kidney Disease in a Chinese Population

A nutritional program improved lipid profiles and weight in 28 chiropractic patients: a retrospective case series

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