Skip to main content
Top
Published in: BMC Public Health 1/2016

Open Access 01-12-2016 | Research article

Ideal cardiovascular health status and its association with socioeconomic factors in Chinese adults in Shandong, China

Authors: J. Ren, X. L. Guo, Z. L. LU, J. Y. Zhang, J. L. Tang, X. Chen, C. C. Gao, C. X. Xu, A. Q. Xu

Published in: BMC Public Health | Issue 1/2016

Login to get access

Abstract

Background

Cardiovascular disease (CVD) is the leading cause of morbidity and mortality in the world. In 2010, a goal released by the American Heart Association (AHA) Committee focused on the primary reduction in cardiovascular risk.

Methods

Data collected from 7683 men and 7667 women aged 18–69 years were analyzed. The distribution of ideal cardiovascular health metrics based on 7 cardiovascular disease risk factors or health behaviors in according to the definition of AHA was evaluated among the subjects. The association of the socioeconomic factors on the prevalence of meeting 5 or more ideal cardiovascular health metrics was estimated by logistic regression analysis, and a chi-square test for categorical variables and the general linear model (GLM) procedure for continuous variables were used to compare differences in prevalence and in means among genders.

Results

Seven of 15350 participants (0.05 %) met all 7 cardiovascular health metrics. The women had a higher proportion of meeting 5 or more ideal health metrics compared with men (32.67 VS.14.27 %). The subjects with a higher education and income level had a higher proportion of meeting 5 or more ideal health metrics than the subjects with a lower education and income level. A comparison between subjects with meeting 5 or more ideal cardiovascular health metrics with subjects meeting 4 or fewer ideal cardiovascular health metrics reveals that adjusted odds ratio [OR, 95 % confidence intervals (95 % CI)] was 1.42 (0.95, 2.21) in men and 2.59 (1.74, 3.87) in women for higher education and income, respectively.

Conclusions

The prevalence of meeting all 7 cardiovascular health metrics was low in the adult population. Women, young subjects, and those with higher levels of education or income tend to have a greater number of the ideal cardiovascular health metrics. Higher socioeconomic status was associated with an increasing prevalence of meeting 5 or more cardiovascular health metrics in women but not in men. It’s urgent to develop comprehensive population-based interventions to improve the cardiovascular risk factors in Shandong Province in China.
Literature
1.
go back to reference Smith Jr SC. Screening for high-risk cardiovascular disease: a challenge for the guidelines. Arch Intern Med. 2010;170:40–2.CrossRefPubMed Smith Jr SC. Screening for high-risk cardiovascular disease: a challenge for the guidelines. Arch Intern Med. 2010;170:40–2.CrossRefPubMed
2.
go back to reference He J, Gu D, Wu X, Reynolds K, Duan X, Yao C, et al. Major causes of death among men and women in China. N Engl J Med. 2005;353:1124–34.CrossRefPubMed He J, Gu D, Wu X, Reynolds K, Duan X, Yao C, et al. Major causes of death among men and women in China. N Engl J Med. 2005;353:1124–34.CrossRefPubMed
3.
go back to reference Keil U, Liese AD, Hense HW, Filipiak B, Döring A, Stieber J, et al. Classical risk factors and their impact on incident non-fatal and fatal myocardial infarction and all-cause mortality in southern Germany. Results from the MONICA Augsburg cohort study 1984–1992. Monitoring Trends and Determinants in Cardiovascular Diseases. Eur Heart J. 1998;19:1197–207.CrossRefPubMed Keil U, Liese AD, Hense HW, Filipiak B, Döring A, Stieber J, et al. Classical risk factors and their impact on incident non-fatal and fatal myocardial infarction and all-cause mortality in southern Germany. Results from the MONICA Augsburg cohort study 1984–1992. Monitoring Trends and Determinants in Cardiovascular Diseases. Eur Heart J. 1998;19:1197–207.CrossRefPubMed
4.
go back to reference Wei M, Mitchell BD, Haffner SM, Stern MP. Effects of cigarette smoking, diabetes, high cholesterol, and hypertension on all-cause mortality and cardiovascular disease mortality in Mexican Americans. The San Antonio Heart Study. Am J Epidemiol. 1996;144:1058–65.CrossRefPubMed Wei M, Mitchell BD, Haffner SM, Stern MP. Effects of cigarette smoking, diabetes, high cholesterol, and hypertension on all-cause mortality and cardiovascular disease mortality in Mexican Americans. The San Antonio Heart Study. Am J Epidemiol. 1996;144:1058–65.CrossRefPubMed
5.
go back to reference Lee J, Ma S, Heng D, Chew SK, Hughes K, Tai ES. Hypertension, concurrent cardiovascular risk factors and mortality: the Singapore Cardiovascular Cohort Study. J Hum Hypertens. 2008;22:468–74.CrossRefPubMed Lee J, Ma S, Heng D, Chew SK, Hughes K, Tai ES. Hypertension, concurrent cardiovascular risk factors and mortality: the Singapore Cardiovascular Cohort Study. J Hum Hypertens. 2008;22:468–74.CrossRefPubMed
6.
go back to reference Ueshima H, Sekikawa A, Miura K, Turin TC, Takashima N, Kita Y. Cardiovascular disease and risk factors in Asia: a selected review. Circulation. 2008;118:2702–9.CrossRefPubMedPubMedCentral Ueshima H, Sekikawa A, Miura K, Turin TC, Takashima N, Kita Y. Cardiovascular disease and risk factors in Asia: a selected review. Circulation. 2008;118:2702–9.CrossRefPubMedPubMedCentral
7.
go back to reference Preis SR, Pencina MJ, Hwang SJ, D’Agostino Sr RB, Savage PJ, Levy D, et al. Trends in cardiovascular disease risk factors in individuals with and without diabetes mellitus in the Framingham Heart Study. Circulation. 2009;120:212–20.CrossRefPubMedPubMedCentral Preis SR, Pencina MJ, Hwang SJ, D’Agostino Sr RB, Savage PJ, Levy D, et al. Trends in cardiovascular disease risk factors in individuals with and without diabetes mellitus in the Framingham Heart Study. Circulation. 2009;120:212–20.CrossRefPubMedPubMedCentral
8.
go back to reference Pemberton VL, McCrindle BW, Barkin S, Daniels SR, Barlow SE, Binns HJ, et al. Report of the National Heart, Lung, and Blood Institute’s Working Group on obesity and other cardiovascular risk factors in congenital heart disease. Circulation. 2010;121:1153–9.CrossRefPubMedPubMedCentral Pemberton VL, McCrindle BW, Barkin S, Daniels SR, Barlow SE, Binns HJ, et al. Report of the National Heart, Lung, and Blood Institute’s Working Group on obesity and other cardiovascular risk factors in congenital heart disease. Circulation. 2010;121:1153–9.CrossRefPubMedPubMedCentral
9.
go back to reference Lloyd-Jones DM, Hong Y, Labarthe D, Mozaffarian D, Appel LJ, Van Horn L, et al. Defining and setting national goals for cardiovascular health promotionand disease reduction: the American Heart Association’s strategic ImpactGoal through 2020 and beyond. Circulation. 2010;121:586–613.CrossRefPubMed Lloyd-Jones DM, Hong Y, Labarthe D, Mozaffarian D, Appel LJ, Van Horn L, et al. Defining and setting national goals for cardiovascular health promotionand disease reduction: the American Heart Association’s strategic ImpactGoal through 2020 and beyond. Circulation. 2010;121:586–613.CrossRefPubMed
10.
go back to reference Wu S, Huang Z, Yang X, Wang A, Chen L, Zhao H, et al. Prevalence of ideal cardiovascular health and its relationship with the 4-year cardiovascular events in a northern Chinese industrial city. Circ Cardiovasc Qual Outcomes. 2012;5:487–93.CrossRefPubMed Wu S, Huang Z, Yang X, Wang A, Chen L, Zhao H, et al. Prevalence of ideal cardiovascular health and its relationship with the 4-year cardiovascular events in a northern Chinese industrial city. Circ Cardiovasc Qual Outcomes. 2012;5:487–93.CrossRefPubMed
11.
go back to reference Artero EG, España-Romero V, Lee DC, Sui X, Church TS, et al. Ideal cardiovascular health and mortality: Aerobics Center Longitudinal Study. Mayo Clin Proc. 2012;87:944–52.CrossRefPubMedPubMedCentral Artero EG, España-Romero V, Lee DC, Sui X, Church TS, et al. Ideal cardiovascular health and mortality: Aerobics Center Longitudinal Study. Mayo Clin Proc. 2012;87:944–52.CrossRefPubMedPubMedCentral
12.
go back to reference Ford ES, Greenlund KJ, Hong Y. Ideal cardiovascular health and mortality from all causes and diseases of the circulatory system among adults in the United States. Circulation. 2012;125:987–95.CrossRefPubMedPubMedCentral Ford ES, Greenlund KJ, Hong Y. Ideal cardiovascular health and mortality from all causes and diseases of the circulatory system among adults in the United States. Circulation. 2012;125:987–95.CrossRefPubMedPubMedCentral
13.
go back to reference Yang Q, Cogswell ME, Flanders WD, Hong Y, Zhang Z, Loustalot F. Trends in cardiovascular health metrics and associations with all-cause and CVD mortality among US adults. JAMA. 2012;307:1273–83.CrossRefPubMed Yang Q, Cogswell ME, Flanders WD, Hong Y, Zhang Z, Loustalot F. Trends in cardiovascular health metrics and associations with all-cause and CVD mortality among US adults. JAMA. 2012;307:1273–83.CrossRefPubMed
14.
go back to reference Villegas R, Yang G, Liu D, Hong Y, Zhang Z, Loustalot F, et al. Validity and reproducibility of the food-frequency questionnaire used in the Shanghai men’s health study. Br J Nutr. 2007;97:993–1000.CrossRefPubMed Villegas R, Yang G, Liu D, Hong Y, Zhang Z, Loustalot F, et al. Validity and reproducibility of the food-frequency questionnaire used in the Shanghai men’s health study. Br J Nutr. 2007;97:993–1000.CrossRefPubMed
15.
go back to reference Ge KY. The transition of Chinese dietary guidelines and the food guide pagoda. Asia Pac J Clin Nutr. 2011;20:439–46.PubMed Ge KY. The transition of Chinese dietary guidelines and the food guide pagoda. Asia Pac J Clin Nutr. 2011;20:439–46.PubMed
16.
go back to reference Deng HB, Macfarlane DJ, Thomas GN. Reliability and validity of the IPAQ-Chinese: the Guangzhou Biobank Cohort study. Med Sci Sports Exerc. 2008;40:303–7.CrossRefPubMed Deng HB, Macfarlane DJ, Thomas GN. Reliability and validity of the IPAQ-Chinese: the Guangzhou Biobank Cohort study. Med Sci Sports Exerc. 2008;40:303–7.CrossRefPubMed
17.
go back to reference Ning F, Pang ZC, Dong YH, Gao WG, Nan HR, Wang SJ, et al. Risk factors associated with the dramatic increase in the prevalence of diabetes in the adult Chinese population in Qingdao, China. Diabet Med. 2009;26:855–63.CrossRefPubMed Ning F, Pang ZC, Dong YH, Gao WG, Nan HR, Wang SJ, et al. Risk factors associated with the dramatic increase in the prevalence of diabetes in the adult Chinese population in Qingdao, China. Diabet Med. 2009;26:855–63.CrossRefPubMed
18.
go back to reference Bambs C, Kip KE, Dinga A, Mulukutla SR, Aiyer AN, et al. Low prevalence of “ideal cardiovascular health” in a community-based population: the heart strategies concentrating on risk evaluation (Heart SCORE) study. Circulation. 2011;123:850–7.CrossRefPubMedPubMedCentral Bambs C, Kip KE, Dinga A, Mulukutla SR, Aiyer AN, et al. Low prevalence of “ideal cardiovascular health” in a community-based population: the heart strategies concentrating on risk evaluation (Heart SCORE) study. Circulation. 2011;123:850–7.CrossRefPubMedPubMedCentral
19.
go back to reference Dong C, Rundek T, Wright CB, Anwar Z, Elkind MS, Sacco RL. Ideal cardiovascular health predicts lower risks of myocardial infarction, stroke, and vascular death across whites, blacks, and hispanics: the northern Manhattan study. Circulation. 2012;125:2975–84.CrossRefPubMedPubMedCentral Dong C, Rundek T, Wright CB, Anwar Z, Elkind MS, Sacco RL. Ideal cardiovascular health predicts lower risks of myocardial infarction, stroke, and vascular death across whites, blacks, and hispanics: the northern Manhattan study. Circulation. 2012;125:2975–84.CrossRefPubMedPubMedCentral
20.
go back to reference Shay CM, Ning H, Allen NB, Carnethon MR, Chiuve SE, Greenlund KJ, et al. Status of cardiovascular health in US adults: prevalence estimates from the National Health and Nutrition Examination Surveys (NHANES) 2003–2008. Circulation. 2012;125:45–56.CrossRefPubMed Shay CM, Ning H, Allen NB, Carnethon MR, Chiuve SE, Greenlund KJ, et al. Status of cardiovascular health in US adults: prevalence estimates from the National Health and Nutrition Examination Surveys (NHANES) 2003–2008. Circulation. 2012;125:45–56.CrossRefPubMed
21.
go back to reference Wu HY, Sun ZH, Cao DP, Wu LX, Zeng Q. Cardiovascular health status in Chinese adults in urban areas: analysis of the Chinese Health Examination Database 2010. Int J Cardiol. 2013;168:760–4.CrossRefPubMed Wu HY, Sun ZH, Cao DP, Wu LX, Zeng Q. Cardiovascular health status in Chinese adults in urban areas: analysis of the Chinese Health Examination Database 2010. Int J Cardiol. 2013;168:760–4.CrossRefPubMed
22.
go back to reference Bi Z, Liang X, Xu A, Wang L, Shi X, Zhao W, et al. Hypertension prevalence, awareness, treatment, and control and sodium intake in Shandong Province, China: baseline results from Shandong-Ministry of Health Action on Salt Reduction and Hypertension (SMASH), 2011. Prev Chronic Dis. 2014;22:E88. Bi Z, Liang X, Xu A, Wang L, Shi X, Zhao W, et al. Hypertension prevalence, awareness, treatment, and control and sodium intake in Shandong Province, China: baseline results from Shandong-Ministry of Health Action on Salt Reduction and Hypertension (SMASH), 2011. Prev Chronic Dis. 2014;22:E88.
23.
go back to reference Winkleby MA, Kraemer HC, Ahn DK, Varady AN. Ethnic and socioeconomic differences in cardiovascular disease risk factors:findings for women from the Third National Health and NutritionExamination Survey, 1988–1994. JAMA. 1998;280:356–62.CrossRefPubMed Winkleby MA, Kraemer HC, Ahn DK, Varady AN. Ethnic and socioeconomic differences in cardiovascular disease risk factors:findings for women from the Third National Health and NutritionExamination Survey, 1988–1994. JAMA. 1998;280:356–62.CrossRefPubMed
24.
go back to reference Winkleby MA, Jatulis DE, Frank E, Fortmann SP. Socioeconomic status and health: how education, income, and occupation contribute to risk factors for cardiovascular disease. Am J Public Health. 1992;82:816–20.CrossRefPubMedPubMedCentral Winkleby MA, Jatulis DE, Frank E, Fortmann SP. Socioeconomic status and health: how education, income, and occupation contribute to risk factors for cardiovascular disease. Am J Public Health. 1992;82:816–20.CrossRefPubMedPubMedCentral
25.
go back to reference Kaplan GA, Keil JE. Socioeconomic factors and cardiovascular disease: a review of the literature. Circulation. 1993;88:1973–98.CrossRefPubMed Kaplan GA, Keil JE. Socioeconomic factors and cardiovascular disease: a review of the literature. Circulation. 1993;88:1973–98.CrossRefPubMed
26.
go back to reference Woodward M, Peters SA, Batty GD, Ueshima H, Woo J, Giles GG, Asia Pacific Cohort Studies Collaboration, et al. Socioeconomic status in relation to cardiovascular disease and cause-specific mortality: a comparison of Asian and Australasian populations in a pooled analysis. BMJ Open. 2015;17, e00640. Woodward M, Peters SA, Batty GD, Ueshima H, Woo J, Giles GG, Asia Pacific Cohort Studies Collaboration, et al. Socioeconomic status in relation to cardiovascular disease and cause-specific mortality: a comparison of Asian and Australasian populations in a pooled analysis. BMJ Open. 2015;17, e00640.
Metadata
Title
Ideal cardiovascular health status and its association with socioeconomic factors in Chinese adults in Shandong, China
Authors
J. Ren
X. L. Guo
Z. L. LU
J. Y. Zhang
J. L. Tang
X. Chen
C. C. Gao
C. X. Xu
A. Q. Xu
Publication date
01-12-2016
Publisher
BioMed Central
Published in
BMC Public Health / Issue 1/2016
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/s12889-016-3632-6

Other articles of this Issue 1/2016

BMC Public Health 1/2016 Go to the issue