Gao Bixia, Wang Fang, Zhu Ming, Wang Jinwei, Zhou Maigeng, Zhang Luxia, Zhao Minghui
Renal Division, Department of Medicine, Peking University First Hospital, China; Renal Division, Department of Medicine, Peking University First Hospital; Institute of Nephrology, Peking University; Key Laboratory of Renal Disease, National Health Commission of the People's Republic of China; Key Laboratory of Chronic Kidney Disease Prevention and Treatment, Ministry of Education, Beijing, China.
Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou, China; Renal Division, Department of Medicine, Peking University First Hospital, China.
Int J Cardiol. 2020 Aug 15;313:123-128. doi: 10.1016/j.ijcard.2020.04.048. Epub 2020 Apr 19.
Increasing evidence indicates that an ideal cardiovascular health (CVH) profile is beneficial not only for cardiovascular disease (CVD), but also for other non-communicable diseases (NCDs). By using a national representative sample of Chinese adults, we aimed to evaluate the association of CVH metrics with long-term all-cause mortality and major NCDs mortality.
We used data from 45,984 Chinese adults without previous history of CVD who participated in a national representative survey between January 2007 and September 2010 and whose mortality until December 2017 was determined via linkage to the Mortality Registration and Reporting System. Altogether, five CVH metrics (body mass index, smoking status, blood pressure, total cholesterol, and fasting blood glycemia) were adopted according to the American Heart Association definition. Outcomes included all-cause, and major NCDs mortality.
During a mean follow-up of 9.7 years, altogether 1451 deaths occurred. Among them, 541 deaths were of cardiovascular origin and 555 deaths were due to cancer. Participants with four to five ideal CVH metrics were associated with 42% (hazard ratio [HR] 0.58; 95% CI 0.39-0.85), 59% (HR 0.41; 95% CI 0.23-0.73), and 62% (HR 0.38; 95% CI 0.20-0.72) decreased risk of all-cause mortality, CVD-related mortality, and cancer-related mortality, respectively, relative to those with a poor CVH score (0-1 ideal CVH metrics).
Our findings highlight the benefit of better CVH with respect to all-cause and major NCDs-related mortality in a Chinese adult population. The assessment of CVH profile at the population level should be advocated in China.
越来越多的证据表明，理想的心血管健康（CVH）状况不仅对心血管疾病（CVD）有益，对其他非传染性疾病（NCDs）也有益。通过使用具有全国代表性的中国成年人样本，我们旨在评估CVH指标与长期全因死亡率和主要非传染性疾病死亡率之间的关联。
我们使用了45984名无CVD病史的中国成年人的数据，这些人参加了2007年1月至2010年9月的全国代表性调查，并通过与死亡率登记和报告系统的关联确定了截至2017年12月的死亡率。根据美国心脏协会的定义，共采用了五项CVH指标（体重指数、吸烟状况、血压、总胆固醇和空腹血糖）。结局包括全因死亡率和主要非传染性疾病死亡率。
在平均9.7年的随访期间，共发生1451例死亡。其中，541例死亡源于心血管疾病，555例死亡归因于癌症。与CVH评分较差（0 - 1项理想CVH指标）的参与者相比，具有四至五项理想CVH指标的参与者全因死亡率、CVD相关死亡率和癌症相关死亡率的风险分别降低了42%（风险比[HR] 0.58；95%置信区间[CI] 0.39 - 0.85）、59%（HR 0.41；95% CI 0.23 - 0.73）和62%（HR 0.38；95% CI 0.20 - 0.72）。
我们的研究结果凸显了在中国成年人群体中，更好的CVH对于全因死亡率和主要非传染性疾病相关死亡率的益处。在中国应提倡在人群层面评估CVH状况。
