An analysis of risk factors for cardio-cerebrovascular disease in middle-aged and elderly adults / 中华老年医学杂志

ABSTRACT

Objective:To analyze the risk factors for cardio-cerebrovascular disease(CCVD)in adults aged 45 years and over, so as to provide the basis for formulating intervention and control measures of risk factors and improving the prognosis.Methods:In-service and retired employees of Tianjin First Central Hospital who underwent health examinations from September 2016 to August 2017 were enrolled in this cross-sectional study.A total of 4815 subjects aged 45 years and over were included, and they were divided into the CCVD group(n=947)and the control group(n=3868)according to previous history of myocardial infarction or coronary stent implantation, cerebral hemorrhage and cerebral infarction.Meanwhile, subjects were divided into the 45-59 years old group(n=2123), the 60-74 years old group(n=1434)and the 75-84 years old group(n=1258). Fasting blood glucose(FBG), glycated hemoglobin(HbA1c), blood lipids, blood pressure(BP)and body mass index(BMI)were measured and recorded.Risk factors for CCVD were analyzed by logistic regression analysis.Results:A total of 4 815 valid samples were obtained.There were statistically significant differences in BMI, BP, FBG, HbA1c, triglyceride and high-density lipoprotein cholesterol(HDL-C)between the CCVD group and the control group( P<0.05).60-74 years old( OR=1.67, 95% CI 1.37-2.02, P<0.01), 75-84 years old( OR=2.95, 95% CI 2.42-3.61, P<0.01), emaciation( OR=1.44, 95% CI 1.21-2.26, P<0.05), overweight( OR=1.24, 95% CI 1.04-1.48, P<0.05)and obesity( OR=1.49, 95% CI 1.17-1.91, P<0.01)were risk factors for CCVD.The risk of CCVD was higher in diabetes mellitus patients with poor blood glucose control than in subjects without diabetes mellitus( OR=1.74, 95% CI 1.42-2.14, P<0.01). With the increase of hypertension grade, the risk of coronary heart disease(CHD)was also increased( OR=1.50, 1.78 and 2.96, respectively). Compared with subjects without hypertension, hypertensive patients with target blood pressure control had a higher risk for CHD( OR=1.92, 95% CI 1.46-2.54, P<0.01). Gender, smoking history, dyslipidemia and fatty liver were not correlated with CCVD in people aged 45 years and above. Conclusions:The prevention and treatment of CCVD should be focused on proper body weight maintenance, BP control, FBG adjustment and comprehensive management of complications in people aged 45 years and above.