Association of major cardiovascular risk factors, risk factor clustering with cardiovascular diseases from eastern China A population-based cross-sectional study

Abstract

Background: Cardiovascular diseases (CVDs) are serious public health issues and the burden of CVDs is at alarmingly high level in China. The aim of the current study was to estimate the prevalence of CVDs and modifiable risk factors, and explore the association of risk factors, risk factor clustering with CVDs among Nanjing adults from eastern China.Methods: A population-based cross-sectional survey was conducted by a stratified clustered sampling between June and November 2011. A representative sample of 40,896 residents aged over 18 years was interviewed by face-to-face questionnaire survey, anthropometric measurements and laboratory examinations. The prevalence of CVDs including coronary heart disease (CHD) and stroke was determined according to a participant's self-report. Multivariable logistic regression models were used to estimate the relationship between relevant risk factors, their clustering and CVDs.Results: The weighted prevalence of self-reported in the entire population was 1.1% for CHD; and 1.4% for stroke. The weighted prevalence of hypertension, diabetes, dyslipidemia, overweight or obesity, and current smoking was 25.0%, 6.7%, 29.6%, 35.9% and 24.5%, respectively. In multivariable-adjusted models, higher levels of body mass index, systolic blood pressure and fasting plasma glucose could be associated with increased risks of CHD and stroke, whereas higher level of high-density lipoprotein cholesterol could be related to lower risks of CHD. Hypertension, diabetes and dyslipidemia were likely to be positively associated with self-reported CVDs regardless of genders in multivariable logistic regression models. Participants with CVDs had significant higher proportion of at least two of CVD risk factors than their counterparts without CVDs. Compared to those having no risk factor; adults with one, two, three or more CVD risk factors had possibly gradually increased risks of CHD and stroke in both genders.Conclusion: Higher regional prevalence of CVDs was likely to be synergistic effects of risk factors aggregation. Therefore, multifactorial intervention strategies based on associated risk factors may be available for prevention and control of CVDs in Chinese population. Background 4 Cardiovascular diseases (CVDs) are one of the most important public health issues in the world [1].CVDs were the leading cause of deaths and loss of disability worldwide and were responsible for 17.5 million deaths in 2012, which accounted for 31.3% of global deaths [2]. Among these deaths, an estimated 7.4 million and 6.7 million were attributed to heart diseases and strokes, respectively. It is predicted that the overall number of CVD mortality will increase to 20 million by 2030 [3].Additionally, more than 80% of cardiovascular deaths occurred in low-and middle-income countries [2]. The Global Burden of Disease study reported that coronary heart disease (CHD) and stroke were the most common types of CVDs [4].With rapid economic growth, aging population, urbanization and westernization, the burden of CVDs is at alarming...