Ideal cardiovascular health metrics and its association with 20-year cardiovascular morbidity and mortality in a Chinese population

Zhou, Long; Zhao, Liancheng; Wu, Yong; Wu, Yangfeng; Gao, Xing; Liu, Ying; Mai, Jinzhuang; Nie, Zhiqiang; Ou, Yanqiu; Guo, Min; Liu, Xiaoqing

doi:10.1136/jech-2017-210396

Cited by 40 publications

(28 citation statements)

References 24 publications

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“…[5] Systematic reviews suggested that ideal CVH metrics were associated with a reduced risk of cardiovascular events and mortality. [6][7][8] However, the prevalence of ideal CVH metrics was extremely low in middle-aged and elderly people in many countries, including China. [9][10][11][12][13] In addition, the gender differences in CVH metrics have been previously reported in studies from Europe, whereby ideal CVH metrics were more common in women than in men.…”

Section: Introductionmentioning

confidence: 99%

Gender Disparities in Cardiovascular Health Metrics among Rural-Dwelling Older Adults in China: a population-based study

Han

Jiang

et al. 2020

Preprint

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Background: Cardiovascular health (CVH) metrics among Chinese older adults are poorly understood. We investigated gender disparities in CVH metrics and their management among rural-dwelling older adults in China.Methods: This community-based study included 5026 participants (age ≥65 years; 57.2% women) in the baseline survey of a multimodal intervention study in rural China. Data were collected through face-to-face interviews, clinical examinations, and laboratory tests in March-September 2018. We defined six CVH metrics (three behavioral factors—smoking, body mass index, and physical activity; three biological factors—blood pressure, total cholesterol, and blood glucose) following the modified American Heart Association’s recommendations. We performed descriptive analysis separately for men and women.Results: Of all participants, only 0.8% achieved ideal levels in all six CVH metrics. Men were more likely than women to have ideal levels in all CVH metrics but smoking. Women had higher prevalence of ideal global CVH metrics (9.7% in women vs. 7.8% in men) and behavioral CVH metrics (18.3% vs. 9.5%) (p<0.001), whereas men had higher prevalence of ideal biological CVH metrics (5.4% in men vs. 3.5% in women, p<0.001). The prevalence of ideal global and behavioral CVH metrics increased with age in both women and men (p for trend<0.001). Women were more likely to be aware of their hypertension and diabetes, and to receive antihypertensive treatment, while men were more likely to achieve the goal of high cholesterol treatment (p<0.05).Conclusions: The CVH metrics among older adults living in the rural communities in China are characterized by an extremely low proportion of optimal global CVH metrics and distinct gender differences, alongside poor management of major biological risk factors.Trial registration: ChiCTR1800017758.

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Section: Introductionmentioning

confidence: 99%

Gender Disparities in Cardiovascular Health Metrics among Rural-Dwelling Older Adults in China: a population-based study

Han

Jiang

et al. 2020

Preprint

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“…135,136 Nevertheless, cardiovascular benefits of the favorable CVH metrics applied to all sex and agespecific populations. 6,84,113,137 In addition, the ideal CVH status was less than 30% in all sex and age subgroups, which further emphasized the urgent need for primordial prevention of CVD risk factors in the whole population. For geographical variations, it seems that Asians had better CVH status compared to those from Europe and North America, whereas we cannot draw a conclusion due to the limited studies in each subgroup.…”

Section: Discussionmentioning

confidence: 99%

“…A total of 27 studies 12,27,29,30,35,36,42,63,69,84,85,91,105,113,[143][144][145][146][147][148][149][150][151][152][153][154][155] were included in our study and Table 3.3 listed the results of associations between number of ideal metrics and CVD related outcomes. In all studies, persons with higher numbers of ideal CVH metrics had a lower risk of overall CVD mortality, 27,30,35,84,113,143,144,146 incidence, 12,29,69,113,143,150 and prevalence 151 than did those with fewer ideal CVH metrics. Compared with persons in the lowest ideal metrics categories, persons in the highest categories had 42% to 90%, 59% to 89%, and 66% reduction in the risk of CVD mortality, incidence, and prevalence, respectively.…”

Section: Study Characteristicsmentioning

confidence: 99%

“…Several studies have explored the association between ideal CVH metrics number and IHD mortality, 30 IHD prevalence, 152 CHD incidence, 84,85,105,113 stroke incidence, 36,42,84,85,105,113,143 and stroke prevalence 148 and they all demonstrated an inverse association. Participants in the highest categories had 70%, 78% and 42%-73% reduced risk of IHD mortality, IHD prevalence, and CHD incidence compared with those in the lowest categories.…”

Section: Number Of Ideal Cvh Metrics and Cvd Riskmentioning

confidence: 99%

“…30 The strong associations between Life's Simple 7 and incidence of CHD, another term of IHD, are noticed in several cohort studies in Europe 84 and China. 113 The associations between Life's Simple 7 and IHD risk were still not well examined in the general Australian adults.…”

Section: The Cvh Status and Ihd Prevalence In The Overall Australian mentioning

confidence: 99%

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Cardiovascular health status and its associations with cardiovascular disease and ischemic heart disease prevalence in Australian adults

Yang

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BackgroundCardiovascular disease (CVD) and ischemic heart disease (IHD) are two major health burdens. It has been suggested that the improvement of modifiable lifestyle factors could substantially reduce the CVD and IHD risk. To define and monitor the cardiovascular health (CVH) status in the general population, the American Heart Association has outlined seven modifiable lifestyle-related factors [smoking, body mass index (BMI), physical activity, dietary pattern, total cholesterol (TC), blood pressure (BP), and fasting plasma glucose (FPG)] and they were also called Life's Simple 7. A number of studies have measured the CVH status and explored its association with CVD/IHD risk.However, very few studies have used Life's Simple 7 in Australian adults. MethodsFirstly, we conducted two systematic reviews to estimate the CVH status and explore the association between the CVH status and CVD/IHD related events in adults worldwide. We searched PubMed, Embase, and the Cochrane Central Register of Controlled Trials and relevant articles published between 2010 and 2018.Secondly, we used the core sample of the 2011-2012 Australian Health Survey and included 7499 adults (≥ 18 years) with available TC and FPG tests. We estimated the proportions of ideal status for the seven CVH metrics and the prevalence of overall poor (having 0-2 ideal CVH metrics) and ideal (having 5-7 ideal CVH metrics) CVH status in the overall Australians and sex/age subpopulations. In addition, we explored the associations between the ideal status of individual metrics, using Poisson regression analysis and population attributable fractions, and overall CVH status, using logistic regression analysis, on the CVD and IHD prevalence in the overall Australians and sex/age subpopulations. ResultsThe first systematic review indicated that FPG has the highest proportion of ideal status (69.1%) whereas the dietary pattern has the lowest (12.1%) for adults worldwide. 32.2% and 19.6% of adults have overall poor and ideal CVH status. Compared to males and older adults (≥ 60 years), females and younger adults (< 60 years) have lower proportions of the overall poor CVH status and higher proportions of ideal status for most CVH metrics and the overall ideal CVH status. The CVH status has improved over study time and there may exist regional variations in CVH status. The second systematic review suggested that a higher number of ideal CVH metrics was associated with a IV Publications included in this thesis 1. Peng Y, Cao S, Yao Z, Wang Z. Prevalence of the cardiovascular health status in adults: a systematic review and meta-analysis. Nutrition, Metabolism and Cardiovascular Diseases 2018; VIII

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Lifelong smoking status, weight gain, and subsequent risk of major adverse cardiovascular events: Long‐term follow‐up of a middle‐aged Chinese population

Liang

Liu

et al. 2022

Obesity

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Objective The aim of this study was to explore the association of lifelong smoking status with risk of major adverse cardiovascular events (MACE) accounting for weight change in a Chinese cohort. Methods The cohort of the People’s Republic of China‐United States of America (PRC‐USA) Collaborative Study of Cardiovascular and Cardiopulmonary Epidemiology was established in 1983 to 1984, resurveyed during 1987 to 1988 and 1993 to 1994, and followed up to 2005. A total of 5,849 participants who survived in 1993 to 1994 were classified into never smokers, long‐term quitters, short‐term quitters, short‐term relapsers and new smokers, long‐term relapsers and new smokers, and persistent smokers according to the information on lifelong smoking status collected in all three surveys. The associations of lifelong smoking status with MACE in the subsequent 10 years were explored with Cox proportional hazards models. Results During a median follow‐up of 10.2 years, 694 participants had MACE. Compared with persistent smokers, the multivariable‐adjusted hazard ratio of developing MACE was 0.83 (95% CI: 0.61‐1.12) for short‐term quitters, 0.75 (95% CI: 0.54‐1.02) for long‐term quitters, and 0.68 (95% CI: 0.54‐0.85) for never smokers (ptrend = 0.001). In comparison, the hazard ratio was 1.03 (95% CI: 0.77‐1.35) for long‐term relapsers and new smokers and 0.78 (95% CI: 0.46‐1.22) for short‐term relapsers and new smokers (ptrend = 0.018). These associations were not significantly altered by further adjusting for weight change in the past 10 years. Conclusions Lifelong smoking status is significantly associated with risk of MACE. As time duration increased, health benefit to quitters would become close to that of never smokers, and harms to relapsers and new smokers would become close to that of persistent smokers.

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Ideal cardiovascular health metrics and its association with 20-year cardiovascular morbidity and mortality in a Chinese population

Abstract: The number of ideal CVH metrics was inversely associated with the risk of cardiovascular morbidity and mortality in this Chinese general population.

Cited by 40 publications

References 24 publications

Gender Disparities in Cardiovascular Health Metrics among Rural-Dwelling Older Adults in China: a population-based study

Gender Disparities in Cardiovascular Health Metrics among Rural-Dwelling Older Adults in China: a population-based study

Cardiovascular health status and its associations with cardiovascular disease and ischemic heart disease prevalence in Australian adults

Lifelong smoking status, weight gain, and subsequent risk of major adverse cardiovascular events: Long‐term follow‐up of a middle‐aged Chinese population

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