Résumé
Excessive sodium/salt intake is the leading dietary risk factor for the loss of healthy life in the Chinese population. The "Healthy China 2030" Action Plan set the goal of reducing salt intake by 20% by 2030. However, salt intake in China is still at a very high level in the world, with adults reaching 11 g/d, more than twice the recommended limit of 5 g/d. The current policies and action plans of China have targeted catering workers, children, adolescents, and home chefs in salt, oil, and sugar reduction actions. However, there are still obvious deficiencies in the coordinated promotion and implementation. This study, therefore, proposed a set of comprehensive strategies (named CHRPS that is composed of communication and education, salt reduction in home cooking, salt reduction in restaurants, reducing salt content in pre-packaged food, and surveillance and evaluation) and key implementation points for further deepening the salt reduction action in China. These strategies were developed based on the main sources of dietary sodium for Chinese residents, the status of "knowledge, attitude and practice" in salt reduction, evidence of effective intervention measures, existing policies and requirements, and the salt reduction strategies of the World Health Organization and experience from some other countries. As a scientific reference, the CHRPS strategies will help the government and relevant organizations quickly implement salt reduction work and facilitate the earlier realization of China's salt reduction goal.
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Adulte , Enfant , Adolescent , Humains , Chlorure de sodium alimentaire , Sodium alimentaire , Régime alimentaire , Aliments , ChineRésumé
Major and profound changes have taken place in China over the past 30 years. Rapid socioeconomic progress has exerted a great impact on lifestyle, ranging from food, clothing, working and living conditions, and means of transportation to leisure activities and entertainment. At the same time, new health problems have emerged, and health services are facing new challenges. Presently, cardiovascular diseases (CVD) are among the top health problems of the Chinese people, and pose a serious challenge to all engaged in the prevention and control of these diseases. An epidemic of CVD in China is emerging as a result of lifestyle changes, urbanization and longevity. Both national policy decision-making and medical practice urgently need an authoritative report which comprehensively reflects the trends in the epidemic of CVD and current preventive measures. Since 2005, guided by the Bureau of Disease Prevention of the Ministry of Health of the People's Republic of China and the National Center for Cardiovascular Diseases of China, nationwide experts in the fields of epidemiology, clinical medicine and health economics in the realms of CVD, cerebrovascular disease, diabetes and chronic kidney disease, completed the Report on Cardiovascular Diseases in China every year. The report aims to provide a timely review of the trend of the epidemic and to assess the progress of prevention and control of CVD. In addition, as the report is authoritative, representative and readable, it will become an information platform in the CVD field and an important reference book for government, academic institutes, medical organizations and clinical physicians. This publication is expected to play a positive role in the prevention and control of CVD in China. We present an abstract from the Report on Cardiovascular Diseases in China (2010), including trends in CVD, morbidity and mortality of major CVDs, up-to-date assessment of risk factors, as well as health resources for CVD, and a profile of medical expenditure, with the aim of providing evidence for decision-making in CVD prevention and control programs in China, and of delivering the most authoritative information on CVD prevention and control for all citizens.
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Humains , Troubles du rythme cardiaque , Épidémiologie , Chine , Épidémiologie , Maladie coronarienne , Épidémiologie , Mortalité , Complications du diabète , Épidémiologie , Régime alimentaire , Dyslipidémies , Épidémiologie , Épidémies , Défaillance cardiaque , Épidémiologie , Mortalité , Hypertension artérielle , Épidémiologie , Défaillance rénale chronique , Épidémiologie , Mortalité , Syndrome métabolique X , Activité motrice , Phénomènes physiologiques nutritionnels , Surpoids , Épidémiologie , Maladie artérielle périphérique , Épidémiologie , Facteurs de risque , Fumer , Accident vasculaire cérébral , Épidémiologie , MortalitéRésumé
<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>
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Adulte , Femelle , Humains , Mâle , Adulte d'âge moyen , Maladies cardiovasculaires , Sang , Épidémiologie , Chine , Épidémiologie , Cholestérol , Sang , Cholestérol LDL , Sang , Incidence , Études prospectives , Facteurs de risqueRésumé
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.
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<p><b>OBJECTIVE</b>To compare the plasma proteome among male normotensive, prehypertensive, and hypertensive subjects.</p><p><b>METHODS</b>Plasma proteome was analyzed by two-dimensional electrophoresis combined with MALDI-TOF mass spectrometry in this case-control study among well matched male normotensive, prehypertensive and hypertensive subjects (n = 26 each).</p><p><b>RESULTS</b>The results showed that there were 22 differentially expressed protein spots among the protein samples derived from the 3 groups which corresponded to 18 proteins associated with inflammation and immunity, lipid metabolism, transport, coagulation and fibrinolysis, cell proliferation and apoptosis, and antioxidation.</p><p><b>CONCLUSION</b>Proteins were differentially expressed in male subjects with various blood pressure levels.</p>
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Adulte , Humains , Mâle , Adulte d'âge moyen , Pression sanguine , Études cas-témoins , Hypertension artérielle , Génétique , Préhypertension , Génétique , Protéomique , Spectrométrie de masse MALDIRésumé
<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>
Sujets)
Humains , Études de cohortes , Maladie coronarienne , Épidémiologie , Ischémie myocardique , Facteurs de risque , Triglycéride , SangRésumé
<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>
Sujets)
Adulte , Femelle , Humains , Mâle , Adulte d'âge moyen , Indice de masse corporelle , Poids , Maladies cardiovasculaires , Épidémiologie , Chine , Épidémiologie , Obésité , Épidémiologie , Valeur prédictive des tests , Études prospectives , Appréciation des risques , Tour de taille , Rapport taille-hanchesRésumé
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.
Résumé
<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>
Sujets)
Adulte , Femelle , Humains , Mâle , Adulte d'âge moyen , Asiatiques , Maladies cardiovasculaires , Épidémiologie , Chine , Épidémiologie , Numération des leucocytes , Études prospectives , Appréciation des risques , Facteurs de risqueRésumé
<p><b>OBJECTIVE</b>To explore the interaction of C-reactive protein (CRP) and hypertension on the risk of carotid plaque.</p><p><b>METHODS</b>A survey for CVD risk factors and a direct measurement of carotid arteries with B-mode ultrasound imaging were performed in a population consisting of 866 subjects in the Peking university residential community in 2002. Carotid plaque was regarded as the endpoint while elevated CRP and hypertension were treated as the impact factors.</p><p><b>RESULTS</b>(1) The partial correlation coefficient of blood pressure levels with CRP quartiles was 0.089 (P = 0.008); (2) The prevalence of carotid plaque in males showed an upward trend with elevated CRP quartiles while male-specific CRP quartile was independently associated with the prevalence of carotid plaque (P < 0.01). (3) The prevalence of carotid plaque in the group of people with both hypertension or elevated CRP was 50.4%, being significantly higher than those in other groups (P < 0.01). (4) When compared with the group of people without hypertension or elevated CRP, the odds ratio increased by 2.0 times in the group of people with both hypertension and elevated CRP (P < 0.01). (5) The odds ratio of interaction between hypertension and elevated CRP was 1.792 (95% CI: 1.189-2.701) (P = 0.005).</p><p><b>CONCLUSION</b>There was an interaction between hypertension and elevated CRP on the rates of carotid plaque prevalence seen in our study. Data also showed that more benefit might be gained from controlling both hypertension and inflammation for preventing plaque.</p>
Sujets)
Sujet âgé , Femelle , Humains , Mâle , Adulte d'âge moyen , Athérosclérose , Métabolisme , Protéine C-réactive , Métabolisme , Hypertension artérielle , Facteurs de risqueRésumé
<p><b>OBJECTIVE</b>This study investigates the plasma vasoactive substances and antioxidant enzymes levels in prehypertensive patients.</p><p><b>METHODS</b>Patients were scruited according to JNC-7 and divided into three groups: 74 normotensive subjects (NT group, 38 males, mean age 47.15 +/- 7.77 years old); 51 prehypertensive patients (PH group, 29 males, mean age 47.82 +/- 5.16 years old) and 71 essential hypertensive patients (EH group, 37 males, mean age 48.25 +/- 7.97 years old). Serum lipids and plasma angiotensin II (Ang II), endothelin (ET), vasopressin (AVP), calcitonin gene-related peptide (CGRP), nitric oxide synthase (NOS), superoxide dismutase (SOD) and glutathione peroxidase (GPX) by radioimmunoassay and enzyme linked immunosorbent assay.</p><p><b>RESULTS</b>Serum Lipids (TG, CHO and LDL) were significantly higher in the PH and EH groups compared to NT group (all P < 0.05). Ang II, AVP and ET were significantly increased while CGRP decreased in the EH group than that in NT group (all P < 0.05). SOD was significantly lower while GPX significantly higher. Further more, in the PH and EH groups than those in the NT group (all P < 0.05).</p><p><b>CONCLUSION</b>SOD was reduced and GPX increased in prehypertensive patients.</p>
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Adulte , Femelle , Humains , Mâle , Adulte d'âge moyen , Angiotensine-II , Sang , Antioxydants , Pression sanguine , Physiologie , Peptide relié au gène de la calcitonine , Sang , Études cas-témoins , Endothélines , Sang , Glutathione peroxidase , Sang , Hypertension artérielle , Sang , Nitric oxide synthase , Sang , Plasma sanguin , Métabolisme , Superoxide dismutase , Sang , Vasopressines , SangRésumé
<p><b>OBJECTIVE</b>To establish cut offs and risk stratification of dyslipidemia in Chinese adults.</p><p><b>METHODS</b>Data from 2 widely cited studies: the PRC-US Collaborative Study of Cardiovascular and Cardiopulmonary Epidemiology and the China Multi-Provincial Cardiovascular Cohort Study, with a total of 40 719 Chinese adults, age 35 to 64 at baseline, about half men and half women, followed up for a total of 345 140.5 person years, were used to analyze the relationship between dyslipidemia and ischemic cardiovascular diseases (ICVD, including coronary heart events and ischemic stroke events) using a common data analysis protocol co-developed by the scientists from the 2 studies. The relative risk was estimated with the Cox proportional hazard model adjusting for other conventional cardiovascular risk factors. The 10-year absolute risk of ICVD for a 50 years-old person at different risk factor combinations was used to develop the risk stratification.</p><p><b>RESULTS</b>(1) There was a continuous linear relationship between baseline TC (or LDL-C) and ICVD risk without a threshold; (2) The incidence (absolute risk) of ICVD was similar for LDL-C < 3.37 mmol/L (130 mg/dl) and for TC < 5.18 mmol/L (200 mg/dl); and similar for LDL-C < 4.14 mmol/L (160 mg/dl) and for TC < 6.22 mmol/L (240 mg/dl); (3) The absolute ICVD risk for TC > or = 6.22 mmol/L (240 mg/dl) was slightly less but close to that for grade 1 hypertension; (4) ICVD risk increased as HDL-C decreased; (5) No significant association was found between baseline TG and subsequent ICVD; (6) At any TC level, the absolute ICVD risk for those having only hypertension was higher than that for those having 3 other risk factors.</p><p><b>CONCLUSION</b>The cut offs for diagnosis of dyslipidemia in Chinese adults can refer to those used in relevant international guidelines: TC < 5.18 mmol/L (200 mg/dl) [or LDL-C < 3.37 mmol/L (130 mg/dl)] as normal, TC 5.18 - 6.19 mmol/L (200 - 239 mg/dl) [or LDL-C 3.37 - 4.12 mmol/L (130 - 159 mg/dl)] as borderline high, and TC > or = 6.22 mmol/L (240 mg/dl) [or LDL-C > or = 4.14 mmol/L (160 mg/dl)] as high; HDL-C < 1.04 mmol/L (40 mg/dl) as low, 1.04 - 1.53 mmol/L (40 - 59 mg/dl) as normal and > or = 1.55 mmol/L (60 mg/dl) as optimal. In risk stratification scheme, hypertension plays a role that equals to that of any other 3 risk factors.</p>
Sujets)
Adulte , Femelle , Humains , Mâle , Adulte d'âge moyen , Chine , Épidémiologie , Études de cohortes , Dyslipidémies , Diagnostic , Épidémiologie , Incidence , Ischémie myocardique , Diagnostic , Épidémiologie , Appréciation des risques , Facteurs de risqueRésumé
<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>
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Sujet âgé , Femelle , Humains , Mâle , Adulte d'âge moyen , Études cas-témoins , Cognition , Physiologie , Études transversales , Hypertension artérielle , Modèles linéaires , Tests neuropsychologiquesRésumé
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
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<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>
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Adulte , Femelle , Humains , Mâle , Adulte d'âge moyen , Syndrome coronarien aigu , Épidémiologie , Chine , Épidémiologie , Incidence , Ischémie , Épidémiologie , Études prospectives , Facteurs de risque , Accident vasculaire cérébral , ÉpidémiologieRésumé
<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>
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Adulte , Femelle , Humains , Mâle , Adulte d'âge moyen , Analyse chimique du sang , Maladies cardiovasculaires , Sang , Épidémiologie , Chine , Épidémiologie , Cholestérol , Sang , Études prospectives , Facteurs de risqueRésumé
<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>
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Adulte , Femelle , Humains , Mâle , Adulte d'âge moyen , Glycémie , Indice de masse corporelle , Chine , Épidémiologie , Études transversales , Acide gras libre , Métabolisme , Insuline , Sang , Insulinorésistance , Modèles logistiques , Syndrome métabolique X , Épidémiologie , Métabolisme , Surpoids , Facteurs de risque , Rapport taille-hanchesRésumé
<p><b>OBJECTIVES</b>To compare changes in body mass index (BMI), prevalence of over weight and obesity of the population in a community cohort of Peking University during 1992 to 2002, and to study their characteristics of individual BMI.</p><p><b>METHODS</b>Totally, 1 985 individuals aged 35-64 years were selected from Peking University community with stratified random sampling method for baseline survey by physical examinations and questionnaire interviews to collect relevant data in 1992. And, a follow-up survey was conducted for each individual of the cohort in 2002. Data were analyzed for 1 437 individuals with complete records of the two surveys.</p><p><b>RESULTS</b>(1) In the period from 1992 to 2002, weight increased averagely 4.89 kg in men and 3.08 kg in women, respectively, and BMI increased to 25.22 kg/m2 in 2002 from 23.49 kg/m2 ten years ago in men and to 25.02 kg/m2 from 23.30 kg/m2 in women. (2) Prevalence of overweight increased by 47.8% in men and 29.5% in women, and prevalence of obesity increased by 124.2% in men and 131.3% in women, respectively. (3) 74.9% of men with overweight ten years ago remained overweight and 22.9% of them became obese in 2002. 85.7% of men with obesity ten years ago remained obese in 2002. 58.2% of women with overweight ten years ago remained overweight and 34.5% of them became obese in 2002. 93.7% of women with obesity ten years ago remained obese in 2002.</p><p><b>CONCLUSIONS</b>Mean BMI and prevalence of overweight and obesity of population in Peking University community increased during 1992 to 2002. Most of those with overweight or obesity ten years ago remained overweight or obese and few of them became normally weighed ten years later. Those with overweight BMI were more liable to become obese than those with normal BMI. All these results indicated once overweight or obesity established, it was difficult to be reversed. Therefore, the key to control overweight and obesity rests on its earlier prevention.</p>
Sujets)
Adulte , Femelle , Humains , Mâle , Adulte d'âge moyen , Indice de masse corporelle , Chine , Épidémiologie , Études de cohortes , Services de santé communautaires , Incidence , Dépistage de masse , Obésité , Épidémiologie , SurpoidsRésumé
<p><b>OBJECTIVE</b>To evaluate the trends of cardiovascular disease (CVD) risk factors between 1992 and 2002 (10 years) in a cohort of Beijing.</p><p><b>METHODS</b>Two separate surveys were carried out for a cohort (2740 subjects) in 1992 and 2002 according to methods of the WHO MONICA project. Systolic blood pressure (SBP) and diastolic blood pressure (DBP), body mass index (BMI), waist circumference (WC) and hip circumference (HC), serum total cholesterol (TC), high density lipoprotein cholesterol (HDL-C), triglyceride (TG), glucose, prevalence of hypertension, rate of hypertension treatment and control were compared between 1992 and 2002.</p><p><b>RESULTS</b>(1) Comparisons of the same age groups showed that CVD risk factors increased significantly during the 10 year period from 1992 to 2002. (2) Nineteen percent of the subjects with optimal BP in 1992 became hypertensive in 2002, and 45.3% of normal BP subjects in 1992 became hypertensive in 2002. (3) 43.8% of the subjects with normal blood lipid in 1992 became hyperlipidemia in 2002. (4) 37.0% of the subjects with normal BMI in 1992 became overweight in 2002, and 43.7% of subjects with normal WC in 1992 became high WC in 2002. (5) 14.6% of the subjects without metabolic syndrome in 1992 became with metabolic syndrome in 2002.</p><p><b>CONCLUSIONS</b>The levels of CVD risk factors in this cohort increased significantly in a 10 year period from 1992 to 2002. Most of the risk factors were related to unhealthy life styles. To modify unhealthy life style and control the increasing rate of major risk factors are the key to reduce CVD incidence.</p>
Sujets)
Adulte , Humains , Mâle , Adulte d'âge moyen , Indice de masse corporelle , Maladies cardiovasculaires , Épidémiologie , Chine , Épidémiologie , Études de cohortes , Hypertension artérielle , Syndrome métabolique X , Épidémiologie , Obésité , Épidémiologie , Facteurs de risque , Rapport taille-hanchesRésumé
<p><b>OBJECTIVE</b>To explore the association of metabolic syndrome with CVD in a cohort study involving 11 provinces.</p><p><b>METHODS</b>A cohort study was carried out in a population of 27 739 subjects (age 35 - 64 years). A baseline survey on the risk factor of cardiovascular disease was done in 1992. Incidence rate and relative risk were calculated for metabolic syndromes.</p><p><b>RESULTS</b>(1) The age-standardized incidence rate of cardiovascular disease for metabolic syndromes (MS) was higher than those without (MS) in this cohort (MS 652.3/100,000, not MS 206.7/100,000, RR = 3.12, P < 0.001). (2) The incidence rate of cardiovascular disease for patients with hypertension but low HDL cholesterol and high waist was the highest (910.2/100,000 in man, 930.7/100,000 in woman) among all metabolic syndromes patients. (3) The predictive risk factors for cardiovascular disease were age, cigarette smoking, BMI, total cholesterol and metabolic syndrome in men, with age, BMI and metabolic syndrome in women.</p><p><b>CONCLUSION</b>The incidence rate of cardiovascular disease on the metabolic syndrome was high in 11 provinces in China. Age, BMI and metabolic syndrome were the predictive risk factors of cardiovascular disease (especially of cerebrovascular disease). It is essential to prevent risk factors of cardiovascular disease in primary and secondary prevention programs in general population.</p>