Rural-Urban Disparities in Cardiovascular Disease Mortality Among Middle-Age Men in China

Liu, Lee

doi:10.1177/1010539520956446

Cited by 11 publications

(6 citation statements)

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“…Generally, among both males and females, mortality rates in rural areas were higher than those in urban regions, suggesting poor health awareness and behaviors among rural residents. Notably, rural mortality displayed a more complicated trend of change in this study, which may be related to the disparity in the distribution of health resources between rural and urban areas [ 45 , 46 ]. Policy-makers should review health care resources in rural regions and promote the equalization of public health services.…”

Section: Discussionmentioning

confidence: 99%

Trend Analysis of the Mortality Rates of the Top Three Causes of Death Among Chinese Residents from 2003 to 2019

Zhang

et al. 2022

Int J Public Health

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Objective: To delineate the mortality trends of malignant tumors, heart disease and cerebrovascular disease in China.Methods: The crude mortality from 2003 to 2019 was derived from the China Health Statistical Yearbook, and the mortality rates were analyzed through joinpoint regression supplemented by descriptive statistics and χ2 tests.Results: The fitting model of age-standardized mortality due to malignant tumors showed three joinpoints. The APCs from 2003 to 2005, 2005–2008, 2008–2012 and 2012–2019 were −11.00%, 9.63%, −4.67% and −1.40%, respectively, and the AAPC was −1.54%. The mortality rate of cerebrovascular disease consistently decreased (APC = AAPC = −0.98%). In the subgroup analyses, significant differences were observed between sexes and regions. The mortality rate of heart disease among rural females exhibited an upward trend (APC = AAPC = 2.33%). Older adults aged over 75 years had the highest mortality rates and the most drastic change.Conclusion: The three diseases had variable change trends. The government should focus more on policies that promote the equalization of basic public health services. Continuous education on heart disease, which includes not only beneficial behaviors but also knowledge of first aid, should be strengthened for rural females.

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Section: Discussionmentioning

confidence: 99%

Trend Analysis of the Mortality Rates of the Top Three Causes of Death Among Chinese Residents from 2003 to 2019

Zhang

et al. 2022

Int J Public Health

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“…Among them, education status has been proved to be a useful indicator of SES and important predictor of CVD, and total and cardiovascular mortality (13,14). Rural subjects from China have unique SES characters for example, compared with urban citizens, rural residents have relatively lower annual income, poor medical support, and higher rate of chronic diseases (15)(16)(17)(18)(19)(20). Among those characters mentioned previously, the typical one is that lower educational status.…”

Section: Introductionmentioning

confidence: 99%

Low educational status correlates with a high incidence of mortality among hypertensive subjects from Northeast Rural China

Guo

et al. 2022

Front. Public Health

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ObjectiveCumulative evidence indicates that education plays a major role in predicting cardiovascular risk factors. In this study, we intend to examine the possible relationship between education status and mortality in a large general subject from rural China.MethodsAdult hypertensive subjects (n = 5,227, age = 57.22 ± 10.18 years; 49.1% men) were recruited from general population surveys (Northeast China Rural Cardiovascular Health Study). Their educational status was categorized into two groups as follows: (1) Low education (illiterate or lower than primary school) and (2) medium-high education (higher than primary school). Cardiometabolic comorbidities, related cardiovascular risk factors, and echocardiographic measurements were analyzed in both groups.ResultsLess educated hypertensive subjects had significantly higher prevalence of obesity, diabetes, dyslipidemia, and left ventricular hypertrophy than medium-high educated hypertensive subjects. In the medium-high educated subjects, a significant increase in left ventricular ejection fraction and lower rate of antihypertensive medication was found. Cox proportional hazards analysis indicated that medium-high education was independently associated with all-cause mortality (hazard ratio = 0.76; 95% confidence interval, 0.58, 0.99; P = 0.043) and cardiovascular mortality (hazard ratio = 0.65; 95% confidence interval, 0.44, 0.96; P = 0.028).ConclusionEducation may act as the best predictor of all-cause and cardiovascular mortality in rural hypertensive subjects. This finding suggests that in rural areas, education is likely to represent a cardiovascular specific risk factor and should be evaluated in the strategies of hypertension.

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“…The mortality rate due to CVDs in rural residents has increased significantly and continues to be higher than that of urban residents. 3 , 4 From 1980 to 2016, the number of discharged patients with CVD and the cost of hospitalization continued to rise in China. 4 The high morbidity and mortality of CVD have imposed a heavy economic burden on China.…”

Section: Introductionmentioning

confidence: 99%

“…At present CVDs are the leading cause of death in urban and rural residents in China, and the death rate is far higher than that of tumors and other diseases. The mortality rate due to CVDs in rural residents has increased significantly and continues to be higher than that of urban residents 3,4 . From 1980 to 2016, the number of discharged patients with CVD and the cost of hospitalization continued to rise in China 4 .…”

Section: Introductionmentioning

confidence: 99%

Construction of a risk assessment model of cardiovascular disease in a rural Chinese hypertensive population based on lasso‐Cox analysis

Ouyang

Wang

et al. 2021

J of Clinical Hypertension

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Many assessments have been used to predict cardiovascular risks in the general population, but their applicability in patients with hypertension needs to be further evaluated. In the current study, a cardiovascular risk assessment model was constructed in a hypertensive population. This prospective cohort study was conducted with cardiovascular examinations in rural northeast China in 2012 and 2013, and followed up to collect cardiovascular events in 2015 and 2018. Data were derived from 4763 hypertensive patients who were free of cardiovascular disease (CVD) at baseline and completed follow-up. After lasso regression was used to screen for risk factors of CVD at baseline, a multivariate Cox regression risk model was established and a nomogram was developed. The model was validated using an independent test set (one third of data not used for model building). Among 4763 patients, 354 (7.43%) had a cardiovascular event during a median follow-up of 4.66 years. Nine risk factors were screened by lasso regression, including sex, age, current smoking, body mass index (BMI), history of transient ischemic attack (TIA), family history of hypertension, family history of stroke, physical labor intensity, and high low-density lipoprotein cholesterol (LDL-C).The c-index of the CVD model was 0.707, and that of an updated model with baseline blood pressure was 0.732. In the validated cohort the respective c-indexes were 0.665 and 0.714. An assessment model of CVD risk was established in a hypertensive population which may provide an original prevention strategy for hypertensive populations in rural China, and further reduce the CVD burden. K E Y W O R D S cardiovascular disease, hypertension, risk assessment model 1 INTRODUCTION Cardiovascular disease (CVD) is the leading cause of death in China and worldwide. 1,2 With the acceleration of population aging and urbanization in China the increasing prevalence of CVD risk factors is obvious, leading to a continuous increase in the number of CVDs.

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Rural-Urban Disparities in Cardiovascular Disease Mortality Among Middle-Age Men in China

Cited by 11 publications

References 10 publications

Trend Analysis of the Mortality Rates of the Top Three Causes of Death Among Chinese Residents from 2003 to 2019

Trend Analysis of the Mortality Rates of the Top Three Causes of Death Among Chinese Residents from 2003 to 2019

Low educational status correlates with a high incidence of mortality among hypertensive subjects from Northeast Rural China

Construction of a risk assessment model of cardiovascular disease in a rural Chinese hypertensive population based on lasso‐Cox analysis

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