Meng Lingbing, Xu Jiapei, Li Jianyi, Hu Jiabin, Xu Hongxuan, Wu Dishan, Hu Xing, Zeng Xuezhai, Zhang Qiuxia, Li Juan, Gong Tao, Liu Deping
Department of Cardiology, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China.
Graduate School, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
Front Cardiovasc Med. 2022 Oct 20;9:979015. doi: 10.3389/fcvm.2022.979015. eCollection 2022.
Aging is an essential national condition throughout China in the 21st century. Cardio-cerebral vascular disease (CCVD) is a common chronic vascular disease in the elderly. Despite aging becoming an increasingly pressing issue, there has been no comprehensive national investigation into the risk factors, prevalence, and management of CCVD among the elderly population in China.
Through the 4th Survey of the Aged Population in Urban and Rural China (SSAPUR), a nationally representative sample of 224,142 adults aged more than 60 years was surveyed using a multistage, stratified sampling method. The 4th SSAPUR was used to investigate CCVD in the elderly. Univariate and multivariate logistic proportional regression analyses explored the risk factors. These risk factors were then entered into a multivariate linear regression model to identify independent predictive factors for CCVD. Disease management was assessed from the self-reported history of physician diagnosis, treatments, and hospital visits among individuals with CCVD.
After excluding samples with missing information, 215,041 individuals were included in the analysis. The overall prevalence of CCVD was 26%. Living in a rural area, being older, being female, having low literacy, smoking, getting little sleep, losing a spouse, being single, not getting enough exercise, having a bad financial situation, and not taking part in public welfare programs were the main risk factors for CCVD among the elderly in China ( < 0.05). In the multivariate linear regression model, holding all other variables at any fixed value, CCVD remained associated with "urban and rural" (β = 0.012, < 0.001), "age" (β = -0.003, < 0.001), "sex" (β = -0.022, < 0.001), "education level" (β = -0.017, < 0.001), "marriage" (β = 0.004, = 0.047), "smoking" (β = 0.012, = 0.003), "drinking" (β = -0.015, = 0.001), and "sleep" (β = 0.008, = 0.005). There were no collinearity problems among these factors.
Major risk factors for prevalent CCVD among the elderly in China include the following: rural residence, female, low literacy level, poor sleep quality, bereavement, non-marriage, living alone, lack of exercise, poor financial situation, and non-participation in public welfare activities. Chinese national policies for preventing, controlling, and managing risk factors for CCVD in the elderly must be urgently developed.
老龄化是21世纪中国的一项基本国情。心脑血管疾病（CCVD）是老年人常见的慢性血管疾病。尽管老龄化问题日益紧迫，但中国尚未对老年人群中心脑血管疾病的危险因素、患病率及管理情况进行全面的全国性调查。
通过中国城乡老年人口第四次抽样调查（SSAPUR），采用多阶段分层抽样方法，对224142名60岁以上成年人进行了全国代表性抽样调查。第四次SSAPUR用于调查老年人的心脑血管疾病。单因素和多因素逻辑比例回归分析探讨了危险因素。然后将这些危险因素纳入多因素线性回归模型，以确定心脑血管疾病的独立预测因素。从患有心脑血管疾病的个体自我报告的医生诊断、治疗和就诊史中评估疾病管理情况。
排除信息缺失的样本后，215041名个体纳入分析。心脑血管疾病的总体患病率为26%。居住在农村地区、年龄较大、女性、文化程度低、吸烟、睡眠少、丧偶、单身、运动不足、经济状况差以及不参加公益项目是中国老年人患心脑血管疾病的主要危险因素（<0.05）。在多因素线性回归模型中，将所有其他变量设定为任何固定值时，心脑血管疾病仍与“城乡”（β=0.012，<0.001）、“年龄”（β=-0.003，<0.001）、“性别”（β=-0.022，<0.001）、“教育程度”（β=-0.017，<0.001）、“婚姻状况”（β=0.004，=0.047）、“吸烟”（β=0.012，=0.003）、“饮酒”（β=-0.015，=0.001）和“睡眠”（β=0.008，=0.005）相关。这些因素之间不存在共线性问题。
中国老年人中普遍存在的心脑血管疾病的主要危险因素包括：农村居住、女性、文化程度低、睡眠质量差、丧亲、未婚、独居、缺乏运动、经济状况差以及不参加公益活动。必须紧急制定中国预防、控制和管理老年人心脑血管疾病危险因素的国家政策。
