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Ideal cardiovascular health metrics and its association with 20-year cardiovascular morbidity and mortality in a Chinese population
  1. Long Zhou1,
  2. Liancheng Zhao1,
  3. Yong Wu2,
  4. Yangfeng Wu3,
  5. Xiangmin Gao2,
  6. Ying Li1,
  7. Jinzhuang Mai2,
  8. Zhiqiang Nie2,
  9. Yanqiu Ou2,
  10. Min Guo1,
  11. Xiaoqing Liu2
  1. 1Division of Prevention and Community Health, National Center for Cardiovascular Disease, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
  2. 2Department of Epidemiology, Guangdong Cardiovascular Institute, Guangdong Provincial Key Laboratory of South China Structural Heart Disease, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
  3. 3Peking University Clinical Research Institute, Beijing, China
  1. Correspondence to Professor Liancheng Zhao, Division of Prevention and Community Health, National Center for Cardiovascular Disease, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China; zhaolch{at}163.com and Professor Xiaoqing Liu, Department of Epidemiology Guangdong Cardiovascular Institute, Guangdong Provincial Key Laboratory of South China Structural Heart Disease, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China ; drxqliu{at}21cn.com

Abstract

Background The American Heart Association (AHA) developed a simplified assessment tool based on seven ideal cardiovascular health (CVH) metrics, but the relationship between the AHA defined ideal CVH metrics and cardiovascular risk in Chinese population has not been well estimated.

Methods The baseline survey were conducted among 938 Chinese men and women from four urban and rural population samples in China, aged 35–59 years in 1983–1984. The cohort was followed up for multiple cardiovascular endpoints up to 2005. Cox proportional hazard models were used to test the associations accounting for multiple covariates. Outcomes were collected in 1987–2005 and data analysed in 2017.

Results During a median of 20.3 years follow-up, 68 non-fatal CVD events and 139 deaths (29 CVD deaths) occurred. The multivariable adjusted HRs and 95% CIs for all CVD in the groups with three and 4–7 ideal CVH metrics were 0.59 (95% CI 0.33 to 1.04) and 0.24 (95% CI 0.12 to 0.47), when the group with 0–2 ideal CVH metrics as the reference. Results also showed that participants with 4–7 ideal CVH metrics had a 54% (95% CI 24% to 72%) lower risk of all-cause mortality in comparison with those with 0–2 ideal metrics.

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

  • cardiovascular disease
  • cohort studies
  • epidemiology of cardiovascular disease

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Footnotes

  • LZ and LZ contributed equally.

  • Contributors LZ, LCZ, YFW and XQL contributed to the study design. YFW, YL, LCZ and XQL critically revised and edited the manuscript for important intellectual content. YL and MG performed laboratory tests and quality control. YW, XMG, JZM, ZQN and YQO took part in the study follow-up. LZ analysed data and wrote the manuscript. LCZ and XQL had full access to all the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis. All authors approved the final version of the manuscript to be published.

  • Funding This study was supported by the United States National Heart, Lung, and Blood Institute (grants NO-1HV12243 and NO-1HV8112); Ministry of Science and Technology of the People’s Republic of China from the 8th to 10th National Five-Year Plan projects (grants 85-915-01-01, 96-906-02-01 and 2001BA703B01).

  • Competing interests None declared.

  • Patient consent Obtained.

  • Ethics approval This study with multiple follow-up was approved by the Cardiovascular Institute and Fuwai Hospital Ethics Committee.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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