Joint association of depression symptoms and 10-year risk of ischemic cardiovascular disease with the cardiovascular disease in middle-aged and elderly people in China / 北京大学学报(医学版)

OBJECTIVE@#To explore joint association of depression symptoms and 10-year risk of ischemic cardiovascular disease (CVD) in middle-aged and elderly people in China.@*METHODS@#Based on China Health and Retirement Longitudinal Study(CHARLS)database using 2011 baseline data and the follow-up cohort data of 2013, 2015 and 2018, describe the distribution characteristics of baseline depressive symptoms and 10-year risk of ischemic cardiovascular disease in 2011. Cox survival analysis model was used to analyze the individual, independent and joint association of depression symptoms and 10-year risk of ischemic cardiovascular disease with cardiovascular disease.@*RESULTS@#A total of 9 412 subjects were enrolled. The detection rate of depressive symptoms at baseline was 44.7%, and the 10-year middle and high risk of ischemic cardiovascular disease was 13.62%. During an average follow-up of 6.19 (6.19±1.66) years, 1 401 cases of cardiovascular disease were diagnosed in 58 258 person-years, revealing an overall incidence density of 24.048/1 000 person-years. After adjusting the factors, in terms of individual impact, the participants with depressive symptoms had a higher risk of developing CVD (HR=1.263, 95%CI: 1.133-1.408), while medium to high risk of ischemic cardiovascular disease had a higher risk of developing CVD (HR=1.892, 95%CI: 1.662-2.154). Among independent influences, participants with depressive symptoms had a higher risk of developing CVD (HR=1.269, 95% CI: 1.138-1.415), while medium to high risk of 10-year risk of ischemic cardiovascular disease had a higher risk of developing CVD (HR=1.898, 95%CI: 1.668-2.160). Joint impact result showed the incidence of cardiovascular disease in the low risk of 10-year risk of ischemic cardiovascular disease with depressive symptoms group, middle and high risk of 10-year risk of ischemic cardiovascular disease without depressive symptoms group, and 10-year middle and high risk of ischemic cardiovascular disease with depressive symptoms group were 1.390, 2.149, and 2.339 times higher than that of low risk of 10-year risk of ischemic cardiovascular disease without depressive symptoms (P < 0.001).@*CONCLUSION@#The superimposed depression symptoms of the middle and high-risk population at the 10-year risk of ischemic cardiovascular disease will aggravate the risk of cardiovascular disease in middle-aged and elderly people. In combination with the actual lifestyle intervention and physical index health management, attention should be paid to mental health intervention.

Risk assessment of cardiovascular disease in hypertensive patients in Tongxiang / 预防医学

Objective @#To evaluate the risk of cardiovascular disease in hypertensive patients managed by communities in Tongxiang in the next 10 years,and to provide evidence for the development of cardiovascular disease prevention strategies. @*Methods@#The information about hypertensive patients managed by communities was collected from Tongxiang resident health records management system. The risk of ischemic cardiovascular disease（ICVD）in the next 10 years was assessed by the Assessment Scale of 10-Year ICVD Risk in Chinese.@*Results@# A total of 27 173 hypertensive patients managed by communities with complete data were recruited,including 11 868 males,accounting for 43.68%,and 15 305 females,accounting for 56.32%. The median（inter-quartile range）of the total scores of 10-year ICVD risk in hypertensive patients was 8.00（3.00）,with 9.00（2.00）in males and 8.00（2.00）in females. The total scores of 10-year ICVD risk in males was significantly higher than those in females（P<0.05）. A total of 8 764 patients had high 10-year ICVD risk,accounting for 32.25%. The proportion of high10-year ICVD risk in females with hypertension was higher than that in males（P<0.05）. The weights of ICVD risk factors in males were 54.58% in age,17.42% in systolic blood pressure,14.27% in smoking,7.77% in body mass index,4.51% in total cholesterol and 1.45% in diabetes;the ones in females were 63.57% in age,14.63% in systolic blood pressure,9.81% in body mass index,6.00% in total cholesterol,5.88% in diabetes and 0.11% in smoking.@*Conclusion @#The ICVD risk of hypertensive patients managed by communities in Tongxiang is higher in the next 10 years. Male patients should focus on the control of blood pressure and smoking,while female patients should focus on the control of blood pressure and body weight.

Factores de riesgo de cardiopatía isquémica en área intensiva municipal. Pedro Betancourt. 2013- 2014 / Risk factors of ischemic cardiopathy in the municipal intensive care area. Pedro Betancourt. 2013-2014

Introducción: la cardiopatía isquémica es un problema de salud que cobra un gran número de vidas y es causa de invalidez en la población mundial. Constituyó en el 2013, la primera causa de muerte en el mundo, en Cuba y en la provincia de Matanzas. Objetivo: cuantificar la presencia de factores de riesgo de cardiopatía isquémica en el AIM del Policlínico Docente Cesáreo Sánchez, en Pedro Betancourt entre los meses de diciembre 2013 a Mayo del 2014. Materiales y Métodos: se realizó un estudio observacional, descriptivo, transversal de 59 pacientes que ingresaron con este diagnóstico entre los meses de diciembre 2013 a Mayo 2014. Se recogieron variables como la edad, sexo, factores de riesgo, formas clínicas de presentación, complicaciones presentadas durante el ingreso y presencia del síndrome metabólico. Resultado: hubo un predominio del sexo masculino y del grupo de edad de 65 y más. La hipertensión arterial y el sedentarismo fueron los factores de riesgo más sobresalientes, así como la angina estable y las arritmias cardíacas como la forma clínica y complicación más frecuente respectivamente. La presencia del síndrome metabólico caracterizó a los pacientes estudiados. Conclusiones: la detección y control oportuno de los factores de riesgo de la cardiopatía isquémica continuara siendo la piedra angular de cualquier estrategia preventiva esencial (AU).

Introduction: the ischemic cardiopathy or ischemic cardiovascular disease is a health problem claiming a great number of lives, being a cause of disability in the world population. In 2013 it was the first cause of death worldwide, in Cuba and in the province of Matanzas. Objective: to quantify the presence of the ischemic cardiopathy risk factors in the municipal intensive area (AIM as abbreviation in Spanish) of the Teaching Policlinic Cesareo Sanchez, in Pedro Betancourt, from December 2013 to May 2014. Materials and methods: a cross-sectional, descriptive, observational study was carried out in 59 patients who entered the area with this diagnosis from December 2013 to May 2014. The collected variables were age, sex, risk factors, clinical forms of presentation, complications during staying, and presence of the metabolic syndrome. Results: the results showed the predominance of the male sex and the age group of 65 years and more. Arterial hypertension and sedentary lifestyle were the most outstanding risk factors, and the stable angina and heart arrhythmias were the most frequent clinical form and complication, respectively. The presence of metabolic syndrome characterized the studied patients. Conclusions: the timely detection and control of the ischemic cardiopathy risk factors is still going to be the cornerstone of any essential preventive strategy (AU).

Prediction of 10-year Atherosclerotic Cardiovascular Disease Risk among Adults Aged 40-79 Years in China: a Nationally Representative Survey / 生物医学与环境科学（英文）

<p><b>OBJECTIVE</b>To establish the distribution of 10-year atherosclerotic cardiovascular disease (ASCVD) risk among Chinese adults.</p><p><b>METHODS</b>We estimated the 10-year ASCVD risk by applying the 2013 American College of Cardiology/ American Heart Association pooled cohort equations (PCEs) to the data obtained from the 2010 China Chronic Disease and Risk Factor Surveillance that involved 61,541 participants (representing 520,158,652 Chinese adults) aged 40-79 years. We also compared the ASCVD risk with the 10-year ischemic cardiovascular disease (ICVD) risk, which was calculated using the simplified scoring tables recommended by the Chinese Guidelines for Prevention of Cardiovascular Diseases (Chinese model).</p><p><b>RESULTS</b>Based on the PCEs, the average 10-year ASCVD risk among adults without self-reported stroke or myocardial infraction was 12.5%. Approximately 247 million (47.4%) and 107 million (20.6%) adults had ⋝ 7.5% and > 20% 10-year ASCVD risks, respectively. The 10-year ASCVD risk > 20% was higher among men, less educated individuals, smokers, drinkers, and physically inactive individuals than among their counterparts. Overall, 29.0% of adults categorized using the Chinese model were overclassified with the PCEs.</p><p><b>CONCLUSION</b>Our results define the distribution of 10-year ASCVD risk among Chinese adults. The 10-year ASCVD risk predicted by the PCEs was higher than the ICVD risk predicted by the Chinese model.</p>

Prediction of 10-vear risk for ischemic cardiovascular disease in adults aged ≥ 35 years in China / 中华流行病学杂志

Objective To estimate the 10-year risk for ischemic cardiovascular disease (ICVD) in adults aged ≥35 years.Methods In 2010,we conducted a cross sectional survey among 98 712 adults aged ≥ 18 years selected through using multi-stage stratified cluster random sampling,and 67 214 adults without ICVD history and aged ≥35 years were recruited as study subjects.Their information on cardiovascular disease history and related behavior risk factors,including smoking,hypertension and diabetes diagnosis history were collected through face-to-face questionnaire interview,health examination and laboratory detection.The 10-year risk for ICVD in this group was evaluated according to the China 10-year risk for ICVD score tables.Results The average score and 10-year risk for ICVD in the adults aged ≥35 years were 5.1 (95％CI:4.9-5.2) and 4.2％ (95％CI:4.0％-4.4％),respectively.A total of 8.5％ of the adults aged ≥35 years had high 10-year risk for ICVD (95％CI:7.8％-9.2％).This proportion was 12.1％ for males (95％CI:11.1％-13.0％) and 4.9％ for females (95％CI:4.4％-5.5％) (P＜0.05),8.8％ for those living in rural areas (95％CI:7.8％-9.7％) and 8.1％ for those living in urban areas (95％CI:7.2％-8.9％)(P＜0.05).About 19.1％ and 72.4％ of adults had middle and low 10-year risk for ICVD,respectively (95％ CI:18.2％-20.0％,95％ CI:70.9％-73.9％).The proportion of the adults with high and middle risk for ICVD in 10 years was higher among those with lower educational level or with lower income level (P＜0.05).Conclusion About 8.5％ of the adults aged ≥35 years in China have high 10-year risk for ICVD.Being male,living in rural area,with lower education or lower income levels were related with the higher 10-year risk for ICVD.

Prediction of 10-vear risk for ischemic cardiovascular disease in adults aged ≥ 35 years in China / 中华流行病学杂志

Objective To estimate the 10-year risk for ischemic cardiovascular disease (ICVD) in adults aged ≥35 years.Methods In 2010,we conducted a cross sectional survey among 98 712 adults aged ≥ 18 years selected through using multi-stage stratified cluster random sampling,and 67 214 adults without ICVD history and aged ≥35 years were recruited as study subjects.Their information on cardiovascular disease history and related behavior risk factors,including smoking,hypertension and diabetes diagnosis history were collected through face-to-face questionnaire interview,health examination and laboratory detection.The 10-year risk for ICVD in this group was evaluated according to the China 10-year risk for ICVD score tables.Results The average score and 10-year risk for ICVD in the adults aged ≥35 years were 5.1 (95％CI:4.9-5.2) and 4.2％ (95％CI:4.0％-4.4％),respectively.A total of 8.5％ of the adults aged ≥35 years had high 10-year risk for ICVD (95％CI:7.8％-9.2％).This proportion was 12.1％ for males (95％CI:11.1％-13.0％) and 4.9％ for females (95％CI:4.4％-5.5％) (P＜0.05),8.8％ for those living in rural areas (95％CI:7.8％-9.7％) and 8.1％ for those living in urban areas (95％CI:7.2％-8.9％)(P＜0.05).About 19.1％ and 72.4％ of adults had middle and low 10-year risk for ICVD,respectively (95％ CI:18.2％-20.0％,95％ CI:70.9％-73.9％).The proportion of the adults with high and middle risk for ICVD in 10 years was higher among those with lower educational level or with lower income level (P＜0.05).Conclusion About 8.5％ of the adults aged ≥35 years in China have high 10-year risk for ICVD.Being male,living in rural area,with lower education or lower income levels were related with the higher 10-year risk for ICVD.

Relationship Between the Progression Rate of Corotid Maximal Plaque Area and the Risk of New Ischemic Cardiovascular Disease / 中国循环杂志

Objective: To explore the progression rate of cortid maximal plaque area and the risk of new ischemic cardiovascular disease (ICVD) in a rural cohort in Beijing. Methods: The PRC-USA collaborative study had been regularly conducted in Shijingshan area in Beijing. The carotid ultrasound examination, ICVD risk factor and acute cardiovascular events follow-up were conducted in those participants. A total of 1479 subjects who received at least 2 carotid ultrasound examinations and had no cardiovascular disease before the second ultrasound were studied. They were divided into 5 groups:①Control group, the participants had no plaque detected by 2 ultrasounds; ② New plaque group, new plaque was found at the second ultrasound examination; ③ Plaque regression group; ④ Plaque stabilized group and ⑤ Plaque progression group. The hazard ratio (HR) between the progression rate of corotid maximal plaque area and new ICVD events was estimated by Cox proportional hazard regression analysis . Results: Compared with Control group, the HR for new ICVD events were higher in groups②,③,④and⑤at 3.5, 5.7, 6.2 and 7.3 respectively, all P Conclusion: The progression rate of maximal corot id plaque area rate could predict the risk of new ICVD events in clinical practice.

A prospective study on 6-year accumulative incidence rate of ischemic cardiovascular disease and related risk factors among the elderly male population under health care programme / 中华流行病学杂志

Objective To investigate the 6-year accumulative incidence rate of ischemic cardiovascular disease (ICVD) and its related risk factors. Methods Baseline population was all from an elderly population with members all born before 1-1,1938 and under health care programm.Data was recorded in a database of a hospital and baseline of subjects under research was aged ＞65years. People that had had ICVD at baseline were excluded. Risk factors under research would include: age at the baseline study, gender, body mass index, systolic blood pressure, serum cholesterol level, serum triglyceride level, serum high-density lipoprotein level, serum triglyceride level, serum apolipoprotein A1 level, history of diabetes mellitus and cigarette smoking etc. Single factor analysis was carried out using person-years as time of study, then calculating the person-year incidence and the accumulative incidence rate at different levels related to baseline risk factors.Multivariate analysis was under Cox Proportional Hazards Regression Model. Results Baseline population included 2271 elderly men, with the 6-year cumulative prevalence rate of ICVD as 23.56%, and the person-year prevalence rate was 45.41‰. Single factor analysis showed that the ICVD events positively related to variables which including systolic blood pressure, body mass index,serum cholesterol level and serum triglyceride level, serum apolipoprotein A1 level, status of diabetes mellitus and cigarette smoking. The ICVD events negatively related to variables as serum high-density lipoprotein levcl and serum creatinine level. Results of multivariate analysis showed that high systolic pressure, diabetes mellitus, serum creatinine level, Body Mass Index were the main risk factors. The serum high-density lipoprotein level served as the main protective factor. Conclusion The aged male population under health care programme was high in the ICVD prevalence rate, suggesting that programmes as controlling blood pressure, blood glucose, and increasing serum high-density lipoprotein levels were effective measures to decrease the ICVD events.

Establishment of the prediction model for ischemic cardiovascular disease of elderly male population under current health care program / 中华流行病学杂志

Objective To establish and verify the prediction model for ischemic cardiovascular disease(ICVD)among the elderly population who were under the current health care programs. Methods Statistical analysis on data from physical examination, hospitalization of the past years, from questionnaire and telephone interview was carried out in May, 2003. Data was from was randomly selected to generate both module group and verification group. Baseline data was induced to make the verification group into regression model of module group and to generate the predictive value. Distinguished ability with area under ROC curve and the predictive veracity were verified through comparing the predictive incidence rate and actual incidence rate of every deciles group by Hosmer- Lemeshow test. Predictive veracity of the prediction model at population level was verified through comparing the predictive 6-year incidence rates of ICVD with actual 6-year accumulative incidence rates of ICVD with error rate calculated. Results The samples included 2271 males over the age of 65 with 1817 people for modeling population and 454 for verified population.All of the samples were stratified into two layers to establish hierarchical Cox proportional hazard regression model, including one advanced age group(greater than or equal to 75 years old), and another elderly group(less than 75 years old). Data from the statically analysis showed that the risk factors in aged group were age, systolic blood pressure, serum creatinine level, fasting blood glucose level, while protective factor was high density lipoprotein; in advanced age group, the risk factors were body weight index, systolic blood pressure, serum total cholesterol level, serum creatinine level, fasting blood glucose level, while protective factor was HDL-C. The area under the ROC curve (AUC)and 95%CI were 0.723 and 0.687-0.759 respectively. Discriminating power was good. All individual predictive ICVD cumulative incidence and actual incidence were analyzed using Hosmer-Lemshow test, x 2=1.43, P=0.786, showing that the predictive veracity was good.Conclusion The stratified Cox Hazards Regression model was used to establish prediction model of the aged male population under a certain health care program. The common prediction factor of the two age groups were: systolic blood pressure, serum creatinine level, asting blood glucose level and HDL-C. Thc area under the ROWC curve of the verification group was 0.723, showing that the distinguished ability was good and the predict ability at the individual level and at the group level were also satisfactory. It was feasible to using Cox Proportional Hazards Regression Model for predicting the population groups.