Use of traditional Chinese medicine in Chinese patients with coronary heart disease / 生物医学与环境科学（英文）

<p><b>OBJECTIVE</b>To study the use of traditional Chinese medicine (TCM) or both TCM and guideline-recommended Western medicine (WM) in Chinese patients with coronary heart disease (CHD).</p><p><b>METHODS</b>A cross-sectional nationwide survey of 2803 CHD outpatients was completed by collecting information, including general demographic data, disease history, and use of drugs (including TCM and WM).</p><p><b>RESULTS</b>Of the 2712 CHD outpatients with complete drug treatment data, only 3.1% received TCM without any WM for CHD, 30.0% received both TCM and WM recommended by current CHD guidelines, and 66.9% received only WM. Patients with a longer history of CHD or with a history of stroke, were more likely to use TCM. However, 90.6% of CHD patients who used TCM also used certain WM. Furthermore, patients who used more types of TCM tended to use much less WM recommended by current guidelines.</p><p><b>CONCLUSION</b>A substantial proportion of Chinese CHD outpatients use both TCM and WM for secondary prevention of CHD. It is important to assess the effect of combined TCM and WM on major clinical outcomes in Chinese CHD patients.</p>

Impact of gender on lipoprotein-associated phospholipase A2 activity and association with known cardiovascularrisk factors / 中华心血管病杂志

<p><b>OBJECTIVE</b>To explore the impact of gender on lipoprotein-associated phospholipase A(2) (Lp-PLA(2)) activity and association with known cardiovascular risk factors.</p><p><b>METHODS</b>Participants in this study were recruited from Beijing sub-cohort from the Chinese Multi-provincial Cohort Study (CMCS) database. A total of 1471 participants with complete laboratory data were included in the study (688 male). Lp-PLA(2) activity was determined by colorimetric assay kit.Lp-PLA(2) activity level and correlation between Lp-PLA(2) activity and known risk factors were compared between men and women.</p><p><b>RESULTS</b>(1) Lp-PLA(2) activity was higher in males than in females [(22.73 ± 8.52) nmol·min(-1)·ml(-1) vs.(20.01 ± 8.06) nmol·min(-1)·ml(-1), P < 0.01].(2) Age, waist circumference, systolic blood pressure, diastolic blood pressure and the prevalence of hypertension were higher in males than in females, while total cholesterol, low-density lipoprotein cholesterol (LDL-C) and high-density lipoprotein cholesterol (HDL-C) were higher in females than in males (P < 0.05 or P < 0.01).(3)Pearson correlation showed that Lp-PLA(2) activity was correlated with lipids ( total cholesterol, LDL-C, HDL-C, and triglyceride), blood pressure (systolic blood pressure and diastolic blood pressure), and adiposity associated parameters (waist circumference and body mass index) in males (all P < 0.01) and was correlated with lipid level (total cholesterol, LDL-C, HDL-C, and triglyceride) and age in females( P < 0.05 or P < 0.01). Correlations with variables associated with obesity or blood pressure in females were much weaker than those in males (in females, r = 0.02-0.08; in males, r = 0.10-0.16).(4)After adjustment for age, waist circumference, systolic blood pressure, glucose, LDL-C, HDL-C, triglyceride and high sensitivity C-reactive protein by multiple logistic regression model, Lp-PLA(2) activity was still significantly higher in males than in females (OR = 1.72, 95% confidence interval = 1.34-2.21, P < 0.01).</p><p><b>CONCLUSIONS</b>Lp-PLA(2) activity and association with known cardiovascular risk factors differed in males and females. The gender difference in Lp-PLA(2) activity still presents after adjustment for known cardiovascular risk factors in this cohort.</p>

Association between glucose level and carotid plaque among 50-79 year olds from the communities / 中华流行病学杂志

Objective To investigate the association between fasting blood glucose levels and the prevalence of carotid plaque in a community-based population of Beijing and to further explore the association between fasting glucose levels concomitant wand other cardiovascular risk factors as well as the prevalence of carotid plaque.Methods This study was a part of the Chinese Multi-provincial Cohort Study conducted in the communities of Beijing University in 2007.All the members aged 50-79 years from the community were recruited,with 1046 of them qualified as without missing data.Case of diabetes was defined if the fasting glucose level was greater than 7.0 mmol/L or on antidiabetic drugs.Results The mean level of fasting glucose was 5.89 mmol/L,and the prevalence of carotid plaque was 56.3％.For the reference on normal levels of fasting glucose,the risk on carotid plaque had an increase along with the increase of fasting glucose levels only under the univariate and multivariate analyses,after adjusting for age.However,the risk on carotid plaque in women was increased when there was an increase on the levels of fasting glucose.Specifically,for the reference on normal levels of fasting glucose,after adjusting for other cardiovascular risk factors,the odds of developing a carotid plaque was more than two folds in diabetic women.When combining the groups of risk factors (normal and abnormal) among the three groups of fasting glucose and assigning the normal level of risk factors concomitant with normal fasting glucose as a reference for both genders,the risk of developing a carotid plaque in diabetic women with abnormal level of risk factors ranked the highest,with statistical significance.When the diabetic patients combined with a decreased levels of HDL but increased levels of LDL,blood pressure,waist circumference,there appeared 2.8- (P=0.014),2.7- (P=0.010),2.4- (P=0.013) and 2.1-times (P=0.031) higher risks of developing carotid plaque than those in the reference group,respectively.Conclusion In this study,the prevalence of carotid plaque driven by increased fasting glucose was different on gender but the difference was only statistically significant in women.There also appeared a joint association of fasting glucose combined with other cardiovascular risk factors on the risk of developing a carotid plaque.

Association between high sensitivity C-reactive protein levels in serum and the 5-year-accumulative-risk of diabetes / 中华流行病学杂志

Objective To analyze the association between hs-CRP(high-sensitivity C-reactive protein) levels in serum and the 5-year-accumulative-risk of diabetes in a general population.Methods Participants were from the cohort of Peking University residential community in the Chinese Multi- provincial Cohort Study(CMCS). Two surveys on cardiovascular risk factors and the measurements of serum hs-CRP levels were conducted in 2002 and 2007, respectively. Individuals with incomplete information and those having infectious diseases at baseline were excluded. A total of 1045 participants aged 45 to 74 years and free of diabetes at baseline were included in this analysis.Results The age-standardized 5-year accumulative incidence rate of diabetes was 8.8% (male:9.8%, female: 8.2% ) and increased significantly with the level of hs-CRP in both women and men (P＜0.01). After adjustment for age, hypertension, low-density liproprotein cholesterol, and high-density liproprotein cholesterol, triglycerides, fasting glucose, smoking status and central obesity,people with hs-CRP≥3 mg/L had a 3.30 times higher risk of developing diabetes in men and 2.58 times for women when compared to those with hs-CRP＜1 mg/L. The areas under the receiver operating characteristic curves of baseline hs-CRP level in predicting the incidence of diabetes were 0.619(95%CI:0.536-0.701 ) in men and 0.667(95%CI:0.585-0.749) in women. Conclusion Serum hs-CRP levels could predict the incidence of diabetes, indicating that inflammation might have great importance in the onset of diabetes.

Association between the risk factors of cardiovascular diseases and Insulin resistance / 中华流行病学杂志

Objective To explore the association between risk factors of cardiovascular diseases (CVD) and insulin resistance in a cross-sectional study.Methods An investigation on risk factors of CVD was carried out using stratified-random sampling method among 1475 participants in Beijing.Homeostasis model assessment index(HOMA) was calculated to assess the insulin resistance in 1359 non-diabetic subjects aged 25-64 years.Insulin resistance was defined as HOMA index (fasting glucose in mmol/L×fasting insulin in mU/L/22.5) in the top quartile of the studied population.Results The degree of correlation between risk factors and natural logarithm of HOMA index in descending order were glucose,body mass index (BMI),triglyceride ( TG ),waist circumstance,high density lipoprotein- cholesterol (HDL-C),uric acid,diastolic blood pressure,systolic blood pressure and total cholesterol(TC) (all P＜0.01 ).After adjusting factors as sex and age,glucose (r=0.49),BMI(r=0.44),TG (r=0.44),waist circumstance (r=0.41),uric acid (r=0.33) and HDL-C (r=-0.32),the systolic blood pressure (r=0.20),diastolic blood pressure (r=0.18) and TC (r=0.16) were independently correlated with HOMA index (P＜0.001).Sex(OR=1.75) ,low HDL-C(OR= 1.80),hyperuricemia(OR=2.11 ),high TG(OR=2.14) and central obesity(OR=2.68)appeared to be independently correlated to insulin resistance in multiple logistic regression analysis.Conclusion The risk factors of CVD as low HDL-C,high TG,central obesity and hyperuricemia were independently correlated to insulin resistance.

Relationship between serum non-high-density lipoprotein cholesterol and incidence of cardiovascular disease / 中华心血管病杂志

<p><b>OBJECTIVE</b>To evaluate the relationship between serum non-HDL-C and incidence of various cardiovascular disease (CVD) in Chinese population aged 35-64 years.</p><p><b>METHODS</b>This prospective study was performed from 1992 to 2004 in 11 provinces of China and the association between baseline non-HDL-C level with the risk of various CVD events was analyzed in 29 937 subjects aged 35-64 years using Cox multivariate proportional hazards regression. CVD events in this study including acute coronary events (ACE), ischemic stroke, hemorrhagic stroke and ischemic cardiovascular disease (ICVD).</p><p><b>RESULTS</b>(1) Adjusted for age, gender, smoking status, diabetes, body mass index and blood pressure, the relative risk of ACE, ischemic stroke and ICVD in groups of non-HDL-C 3.37 - 4.13 mmol/L (130 - 159 mg/dl), 4.14 - 4.91 mmol/L (160 - 189 mg/dl) and ≥ 4.92 mmol/L (190 mg/dl) was 1.24 (0.91 - 1.70), 1.78 (1.25 - 2.53), 2.23 (1.48 - 3.35); 1.34 (1.07 - 1.68), 1.38 (1.04 - 1.83), 1.38 (0.97 - 1.94) and 1.37 (1.12 - 1.63), 1.52 (1.22 - 1.90), 1.70 (1.30 - 2.22), respectively. The risk of hemorrhagic stroke was declined obviously in group > 4.92 mmol/L (190 mg/dl). (2) The correlation between VLDL-C and ACE was the strongest in four CVD events when VLDL-C and LDL-C were joint analyzed, ICVD events ranked the second. The risk for ischemic stroke also borderline increased with increasing VLDL-C and LDL-C (P > 0.05).</p><p><b>CONCLUSION</b>Increased non-HDL-C is associated with increased risk of suffering ACE, ischemic stroke and ICVD and VLDL-C plays a critical role in the development of ICVD events, especially ACS, in middle aged Chinese population.</p>

Real world use of statins for secondary prevention in patients with high risk coronary heart disease in China / 中华心血管病杂志

<p><b>OBJECTIVE</b>To observe the real world statins use for secondary prevention in patients with high risk coronary heart disease (CHD) in China.</p><p><b>METHODS</b>Sixty-four hospitals across 31 provinces of China including 32 secondary hospitals and 32 tertiary hospitals were selected for baseline survey. Fifty consecutive outpatients with established history of acute coronary syndrome were recruited in each hospital. Information of these patients including statins use was collected.</p><p><b>RESULTS</b>A total of 2516 high risk CHD outpatients were involved in present report. Mean age of the patients was (65 ± 10) years and 69.4% patients were male. Fifty-seven point nine percent patients were treated with a statin at the time of interview and recommended low-density lipoprotein-cholesterol (LDL-C) target was achieved in 29.8% patients. Percent of statin use and achieving LDL-C goal was significantly higher in male outpatients than in female outpatients. Outpatients admitted in tertiary hospitals were more likely to have achieved their LDL-C targets than those admitted in secondary hospitals. Statin use was more often for patients in South China than patients in North China. The percentage reaching the optimal LDL-C treatment target was the highest in Central China (38.5%) and the lowest in Northeast China (18.5%). At this interview, 68.2% outpatients were prescribed statins and 24.1% prescribed doses of statins were sub-minimal.</p><p><b>CONCLUSION</b>There was a gap between real world statin use and guideline recommendations for secondary prevention in high risk CHD patients in China.</p>

Association between body mass index and ten-year-accumulative-risk of hypertension / 中华流行病学杂志

Objective To explore the association between body mass index(BMI) and ten-year accumulative risk of hypertension. Methods A prospective study of relationship between blood pressure and other traditional risk factors was carried out in a cohort with 2115 people aged 35-64 years old involved, in 1992 and 2002. The association between baseline BMI level and a ten-year accumulative risk of hypertension was analyzed. Results The ten-year accumulative incidence rate of hypertension was 34.8%, and increased with the elevated baseline BMI level in both genders (P<0.001). Similar changing trends were observed in both age groups of 45-54 year and 55-64 year olds (P<0.05). Multivariable OR (95%CI) of accumulative incident hypertension in the highest BMI tertile(≥128 kg/m2) was 3.569 higher (2.559 to 4.977) when compared to the lowest (<24 kg/m2). The ten-year accumulative risk of hypertension increased 17.5% with elevation of baseline BMI level by 1 kg/m2. The ten-year accumulative incidence rate of hypertension was 22.0% in the subjects with normal BMI and 56.3% in those with obesity, both in 1992 and 2002. Conclusion BMI appeared to be an independent risk factor for hypertension, and the risk of incident hypertension increased with elevated BMI level.

Incidence risk of cardiovascular diseases associated with specific combinations regarding the metabolic syndrome components / 中华流行病学杂志

Objective To investigate the risk of cardiovascular diseases(CVD)incidence related to different combinations of the metabolic syndrome(MS)components.Methods A total of 30 378 subjects aged 35 to 64 years were recruited from 11 provinces in a Chinese Multi-provincial Cohort Study and of Dyslipidemia for Chinese Adults',issued in 2007.CVD incidence rates and relative risks(RR)were estimated by different MS components and by their various combinations.Results (1)According to the new criteria.the prevalence of MS was 11.8% for Chinese middle-age adults.The prevalence was 12.4% in men,significantly higher than that in women(9.0%).(2)Risk of CVD increased in proportion to the number of MS components after adjusting for other risk factors.If only 1 component was present,elevated blood pressure was the only significant predictor of CVD.When 2 components were present.5 of the 10 combinations were associated with significantly higher risk.All combinations with≥3 components(MS)had significant contribution except for those rare traits(＜0.5% of the whole sample).Among the 16 combinations of≥3 components.the feature of"central obesity and elevated blood pressure"was found in all the 7 combinations with the highest risk.Conclusion CVD risk associated with various number and combinations of MS components seemed to be heterogeneous.The clustering of≥3 disorders,especially those with central obesity and elevated blood pressure could significantly predict the future development of CVD.

Predictive value of combined measurements of body mass index and waist circumference for the risk of cardiovascular disease / 中华心血管病杂志

<p><b>OBJECTIVE</b>To evaluate the predictive value of the combined measurements of body mass index (BMI) and waist circumference (WC) for the risk of cardiometabolic diseases (including diabetes, hypertension, and dyslipidemia) and ischemic cardiovascular disease.</p><p><b>METHOD</b>A total of 30,378 Chinese people from 11 provinces were studied in this prospective study conducted from 1992 to 2003. Multivariable logistic and Cox regression were used respectively to determine the predictive value of WC for cardiometabolic diseases and ischemic cardiovascular disease within each BMI categories.</p><p><b>RESULTS</b>(1) The prevalence of obesity were 10% defined by BMI. Among them, 76.4% had abdominal obesity defined by WC. The prevalence of abdominal obesity was 17.5% by WC categories, and 43.4% of them were classified as obesity by BMI. (2) The prevalence rates of cardiometabolic diseases were higher in individuals with elevated WC within each BMI category. (3) Compared with subjects with normal BMI and WC, the risk of ischemic cardiovascular disease increased by 38% (RR = 1.383, 95% CI 1.083 - 1.765) in overweight subjects with elevated WC and by 57% (RR = 1.570, 95% CI 1.226 - 2.010) in obese subjects with elevated WC.</p><p><b>CONCLUSION</b>Combined measurements of BMI and WC provide a better prediction for the risk of cardiometabolic diseases and ischemic cardiovascular disease.</p>

Serum triglyceride is an independent risk factor for acute coronary heart disease events in 35 - 64 years old Chinese-Chinese Multi-provincial Cohort Study / 中华心血管病杂志

<p><b>OBJECTIVE</b>To evaluate the association between serum triglyceride (TG) and the cardiovascular diseases (CVD) risk in Chinese population.</p><p><b>METHODS</b>A total of 30, 378 men and women aged 35 - 64 years old were recruited in the Chinese-Chinese Multi-provincial Cohort Study (CMCS). The serum TG and other CVD risk factors were measured. All subjects were followed up annually or biannually for acute CVD events from 1992 to 2004. A Cox regression model was established to identify the association between TG and risk of CVD events.</p><p><b>RESULTS</b>The accumulative incidence rate of acute coronary heart disease (CHD) events increased from 62.6/100 000 in the low TG groups to 168.4/100 000 in the high TG group divided by the quartile. TG was identified as an independent risk factor for CHD after adjustment for the confounding risk factors by a Cox regression model. Compared subjects with TG < 0.81 mmol/L, CHD risk increased 81% and 59% in subjects with TG 1.15 - 1.59 mmol/L and TG >/= 1.60 mmol/L, respectively (all P < 0.05). There was no significant association between TG level and the risks of hemorrhagic and ischemic stroke events (P > 0.05).</p><p><b>CONCLUSION</b>Serum TG is an independent risk factor for acute CHD events in Chinese population aged 35 - 64.</p>

Association between hypertensive left ventricular hypertrophy and cardiovascular events in adult Beijing residents: a cohort study / 中华心血管病杂志

<p><b>OBJECTIVE</b>To analyze the impact of hypertensive left ventricular hypertrophy (LVH) on cardiovascular events (CVD) in adult Beijing residents.</p><p><b>METHODS</b>CVD risk factor survey was conducted in 7023 Beijing residents aged 25 - 64 by a stratified-random sample design from 1984 to 1993 in three years interval. CVD events were followed up and the association of the hypertensive LVH and risk of CVD and total death was analyzed by multivariable Cox Regression Model. All subjects were followed up to December 2004.</p><p><b>RESULTS</b>There were 211 non hypertensive LVH patients in the cohort and were excluded from the study. (1) There were 2240 hypertensive patients among 6812 subjects on baseline. The total prevalence of LVH was 11.8% (16.1% in male and 7.5% in female). (2) Compared to the group with normal blood pressure and without left ventricular hypertrophy, subjects with hypertensive LVH had significantly higher risk for acute coronary, acute stroke, total CVD and total death rate. The relative risks (RR) were 4.92 (95% CI: 2.3, 10.7), 4.2 (95% CI: 2.6, 7.0), 4.1 (95% CI: 2.6, 6.3) and 3.3 (95% CI: 2.0, 5.3), respectively. (3) Compared to the group with hypertension and without LVH, the group with hypertensive LVH had also significantly higher risk for acute stroke, total CVD and total death rate. The RR were 1.8 (95% CI: 1.1, 2.8), 1.7 (95% CI: 1.2, 2.3) and 1.7 (95% CI: 1.1, 2.7), respectively. (4) The population attribute risks (PAR) of hypertensive LVH to the incidents of acute CHD, acute stroke, total CVD and total death were 13.0%, 11.0%, 10.4% and 7.9%, respectively.</p><p><b>CONCLUSIONS</b>Hypertensive left ventricular hypertrophy was an independent risk factor for long term risk of cardiovascular events and death.</p>

The association between white blood cell count and 10-year cardiovascular risk in a large Chinese cohort aged 35-64 years / 中华心血管病杂志

<p><b>OBJECTIVE</b>To evaluate the association between white blood cell count and the risk of cardiovascular diseases (CVD) in subjects aged 35 - 64 years.</p><p><b>METHODS</b>This prospective study was carried out in 11 provinces from 1992 to 2003. The association of baseline white blood cell count and cardiovascular disease occurrence was analyzed in 30 384 subjects aged 35 - 64 years using Cox multivariate proportional hazards regression.</p><p><b>RESULTS</b>(1) Compared with the group of 4.0 - 4.9 x 10(9)/L, multivariate-adjusted relative risk of ischemic cardiovascular disease (ICVD, including coronary heart disease and ischemic stroke) increased continuously in proportion to increased white blood cell count. (2) White blood cell count had different impact on different types of CVD. Positive association was observed between white blood cell count and the risk of ischemic stroke, but the relationship between white blood cell count and the risk of hemorrhagic stroke was not significant. Compared with the referent group (4.0 - 4.9 x 10(9)/L), the risk of coronary heart disease of the group of white blood count > 9.0 x 10(9)/L increased by 70% (RR = 1.71, P < 0.05) and that of ischemic stroke increased by 80% (RR = 1.85, P < 0.01).</p><p><b>CONCLUSION</b>The risk of ICVD and CVD increases continuously in proportion to increased white blood cell count, the white blood cell count might be used to predict future risk of CVD, especially risk for ICVD.</p>

A cross-sectional study on cognitive function and influencing factors in patients with hypertension / 中华流行病学杂志

<p><b>OBJECTIVE</b>To compare the differences of cognitive functions in patients with hypertension and normotensives, and to analyze the primary influencing factors on cognitive functions.</p><p><b>METHODS</b>This was a cross-sectional study carried out in two community populations of Beijing in 2001. The study subjects consisted of 83 hypertensive individuals aged 50-65 years, who were both stroke and dementia-free, the control group was chosen with 83 normotensives who were matched one by one with hypertensive individuals on age, sex, educational level and occupation. Socio-demographic, behavioral, medical history, and physiological data were collected on all participants through interview and medical examination. A comprehensive and computerized neuropsychological battery was administered.</p><p><b>RESULTS</b>The total score of Basic Cognitive Ability Examination on hypertension (63.62) was worse than that among controls (68.58) with P < 0.01. Mean reaction time of Digit Discrimination of hypertensive (1.25) was longer than controls (1.17) with P < 0.05. The span of Digit Working Memory of hypertensive (4.96) was shorter than controls (5.63) with P < 0.05. The Score of Dual-Word Recognition of hypertensive (12.05) was lower than controls (13.45) with P < 0.01. Educational level, age and hypertension were the primary influencing factors on cognitive function.</p><p><b>CONCLUSION</b>Patients with hypertension performed significantly worse than controls on velocity of perception, working memory and word memory. The findings suggested that the prevention of hypertension could protect cognitive function.</p>

A comparison of three diagnostic criterions for metabolic syndrome applied in a Chinese population aged 35-64 in 11 provinces / 中华流行病学杂志

<p><b>OBJECTIVE</b>To compare the differences of three diagnostic criterions for metabolic syndrome( MS), issued by the National Cholesterol Education Program(NECP), International Diabetes Federation(IDF) and CDS,in a Chinese population aged 35-64 years in 11 provinces.</p><p><b>METHODS</b>A total of 29 564 Chinese resedents aged 35-64 years were recruited from 11 provinces and a survey on cardiovascular risk factors was conducted in 1992. Additionally,3129 participants were added into the study from 1996 to 1999. MS prevalence was calculated according to three definitions and results of MS components distributions and risk factor aggregation were analyzed.</p><p><b>RESULTS</b>(1)The age-adjusted prevalence of MS in Chinese population were 18.7% for ATP III criterion, 14.6% for IDF criterion and 9.0% for CDS criterion,respectively. (2)Seventy-seven point eight percent of the subjects with MS diagnosed by ATP II criterion presented central obesity. Four point six percent of subjects without MS diagnosed by IDF criterion and 11.2% of subjects without MS diagnosed by CDS criterion presented at least 3 risk factors, respectively. (3)Kappa index showed 0.795 for ATPIII criterion and 0.899 for IDF criterion when applied in Chinese population. (4)The shortest distance in ROC curve for forecasting risk factor aggregation of MS was 0.40 in male and 0.34 in female when waist circumferences were 85 cm in males and 80 cm in females respectively.</p><p><b>CONCLUSION</b>ATPIII definition could be used to detect the highest prevalence of MS and the percent of risk factor aggregation among three definitions. The appropriate cut-off points of waist circumference for Chinese were 85 cm for male and 80 cm for female respectively.</p>

Association Between Plasma Fibrinogen Concentration and Ten-year Accumulative Risk of Essential Hypertension / 中华高血压杂志

Background Studies showed plasma fibrinogen (FIB) is not only the independent risk factor of cardiovascular disease,but also associated with the prevalence and incidenc of hypertension.A gender difference was shown in the association of FIB with hypertension,while no epidemiological study has been reported in Chinese population.Objective To explore the association between plasma FIB concentration and ten-year accumulative risk of hypertension.Methods A prospective study of relationship between blood pressure and other traditional risk factors were carried out in a cohort of Chinese population of 2115 people aged 35-64 years old in 1992 and 2002. The association of plasma FIB concentration with ten-year accumulative risk of hypertension was analyzed.Results The ten-year accumulative incidence rate of hypertension was 34.8%,and incidence in males (39.3%) was signifi- cantly higher than that in females (31.5%) (P

Serum total cholesterol and 10-year cardiovascular risk in a Chinese cohort aged 35-64 years / 中华心血管病杂志

<p><b>OBJECTIVE</b>To evaluate the association between serum total cholesterol (TC) and the risk of cardiovascular diseases (CVD) in subjects aged 35-64 years.</p><p><b>METHODS</b>This prospective study was performed from 1992 to 2002 in 11 provinces of China and the association between baseline TC level and the development of cardiovascular diseases was analyzed in 30 384 subjects aged 35-64 years using Cox multivariate proportional hazards regression.</p><p><b>RESULTS</b>(1) Compared with the group of TC < 3.64 mmol/L (140 mg/dl), multivariate-adjusted relative risk of ischemic cardiovascular disease (ICVD, including CHD and ischemic stroke) increased continuously with increasing TC level. (2) TC level was positively related to the occurrence of ischemic stroke, but not to hemorrhagic stroke. The risk of CHD increased by 74% (RR = 1.743) and the risk of ischemic stroke increased by 12% (RR = 1.119) in the group with TC > or = 5.72 mmol/L compared with the group with TC < 5.72 mmol/L (220 mg/dl). (3) High serum cholesterol was responsible to 5.9% of ICVD, 11.7% of the acute CHD and 2.9% of the acute stroke. (4) At each TC level, the 10-year risk of ICVD increased in the presence of other risk factors.</p><p><b>CONCLUSION</b>Starting from TC of 3.64 mmol/L, the risk of ICVD increases continuously with increasing TC level. Multiple risk factor intervention should be strengthened to reduce the overall risk of CVD.</p>

Risk factors comparison in Chinese patients developing acute coronary syndrome, ischemic or hemorrhagic stroke: a multi-provincial cohort study / 中华心血管病杂志

<p><b>OBJECTIVE</b>To observe the risk factors characteristic of patients developing acute coronary syndrome, ischemic or hemorrhagic stroke in a Chinese population aged 35 - 64 (n = 30 378).</p><p><b>METHOD</b>This prospective study was carried out in 11 provinces in China from 1992 to 2003. The association between baseline risk factors and events in the 10-year follow-up period was analyzed.</p><p><b>RESULTS</b>(1) A total of 809 events were recorded during the follow up period and 227 with acute coronary syndrome, 582 with stroke (ischemic 419, hemorrhagic 146, undefined 17) and the 10-year cumulative person-year incidence rates were 114/100,000, 209/100,000 and 73/100,000 for acute coronary syndrome, acute ischemic stroke and acute hemorrhagic stroke, respectively. (2) Rate of having > or = 1 modifiable risk factors was significantly higher in event group than that in subjects without events (89% vs. 64.7%, P < 0.01). (3) Sorted by intensity, the sequence of independently risk factors obtained from multivariate analysis for acute coronary syndrome were hypertension, smoking, hypercholesterolemia and low-HDL-C; for acute ischemic stroke event were hypertension, diabetes, low-HDL-C, smoking and obesity; for acute hemorrhagic stroke was hypertension.</p><p><b>CONCLUSION</b>The morbidity for cardiovascular diseases is higher in Chinese population with various traditional risk factors than those without or having fewer traditional risk factors and there are various distinct independent risk factors pattern in patients with different cardiovascular diseases subtypes.</p>

Association between the metabolic syndrome and free fatty acid / 中华心血管病杂志

<p><b>OBJECTIVE</b>To explore the association of free fatty acid (FFA) with the metabolic syndrome (MS) and its components.</p><p><b>METHODS</b>A cross-sectional study on cardiovascular risk factors was carried out in a natural population of Beijing in 1999, recruited by a stratified-random sampling method. The association of FFA with MS and its components was analyzed in a sample of 997 subjects aged 35-64 years.</p><p><b>RESULTS</b>(1) The prevalence of MS increased with FFA level. (2) After adjustment for age, sex, smoking, alcohol consumption, body mass index (BMI) and insulin resistance index using a multi-variable logistic regression, FFA was significantly associated with MS. The odds ratio (OR) for the second, third, and fourth quartiles of FFA was 3.1, 3.1 and 4.1, respectively (all P < 0.001). (3) FFA correlated significantly with triglycerides (TG), glucose, systolic blood pressure, diastolic blood pressure, and waist circumference in the correlation analysis (all P < 0.001). The strongest correlation was found between FFA and TG, but no significant correlation was found between FFA and high-density lipoprotein cholesterol (HDL-C). (4) After adjustment for other factors in the logistic regression, FFA was significantly associated with central obesity, hypertriglyceridemia, hypertension, and hyperglycemia, but not with low HDL-C. (5) After adjustment for FFA, BMI and other factors, insulin resistance was also associated with central obesity, hypertriglyceridemia, low HDL-C, and hyperglycemia, but not hypertension.</p><p><b>CONCLUSION</b>FFA was associated with MS and four of the five components of MS, i.e. central obesity, hypertriglyceridemia, hypertension, and hyperglycemia. It is suggested that FFA be one of the underlying pathogenic factors or risk factors for MS. FFA and insulin resistance may lead to MS through different but synergistic mechanisms.</p>

The trends of body mass index and overweight in population aged 25 - 64 in Beijing during 1984 - 1999 / 中华流行病学杂志

<p><b>OBJECTIVE</b>To analyse the trends of body mass index (BMI) and overweight in a population aged 25 through 64 years in Beijing.</p><p><b>METHOD</b>During 1984 to 1999, five cross-sectional surveys on cardiovascular disease (CVD) risk factors were carried out in the CVD monitoring population in Beijing. The mean levels and trends of BMI as well overweight in different sexs, age groups and areas were analysed.</p><p><b>RESULTS</b>(1) In the period of 1984 to 1999, the mean BMI increased from 23.3 to 24.0 (kg/m(2)) in population aged 25 to 64 years, and overweight increased from 27.5% to 35.9%. (2) From 1984 to 1999, the prevalence of overweight increased from 23.5% to 43.3% in males. This increasing trend was seen in both urban and rural populations and in all age groups. Prevalence of overweight decreased from 36.0% to 23.3% in urban females, but increased from 28.4% to 46.0% in rural females. (3) From 1984 to 1999, prevalence of overweight increased from 29.1% to 31.8% in urban population, while 22.1% to 49.6% in rural population. BMI and prevalence of overweight were higher in urban than in rural (P < 0.05) in 1984 to 1985 but the levels in rural were approaching and exceeding the levels in urban (P < 0.05) in 1999.</p><p><b>CONCLUSION</b>Trends of BMI and overweight increased in the urban males and both males and females in the rural, while the increase of both BMI and overweight was seen more rapid in rural than in urban.</p>