Liu Hui, Lin Weiquan, Tu Kexin, Zhou Qin, Wang Chang, Sun Minying, Li Yaohui, Liu Xiangyi, Lin Guozhen, Li Sidong, Bao Wei
Department of Basic Public Health, Center for Disease Control and Prevention of Guangzhou, Guangzhou, China.
Institute of Public Health, Guangzhou Medical University & Guangzhou Center for Disease Control and Prevention, Guangzhou, China.
Front Cardiovasc Med. 2023 Jul 14;10:1092058. doi: 10.3389/fcvm.2023.1092058. eCollection 2023.
Identifying individuals at high risk of atherosclerotic cardiovascular disease (ASCVD) and implementing targeted prevention strategies might be the key to reducing the heavy disease burden in China. This study aimed to evaluate the prevalence, awareness, treatment, and risk factor control among individuals with high 10-year ASCVD risk in Guangzhou, China.
This study included 15,165 adults (aged 18 years and older) from 138 urban and rural communities in the 2018 survey of China Chronic Disease and Risk Factors Surveillance in Guangzhou. 10-year ASCVD risk was estimated using the risk assessment models recommended in the Chinese Guideline for the Prevention of Cardiovascular Disease 2017. The prevalence, awareness, treatment, and risk factor control of high ASCVD risk (defined as 10-year risk ≥10%) were examined.
Among the study population, the weighted proportion of men was 51.9%, and the mean age was 41.27 ± 0.52 years. The overall standardized prevalence of high 10-year ASCVD risk was 13.8% (95% CI, 12.4%-15.3%). The awareness rates for hypertension, diabetes, and hyperlipidemia were 48.0% (95% CI, 42.8%-53.4%), 48.3% (95% CI, 43.0%-53.7%), and 17.9% (95% CI, 14.4%-22.1%) among those with corresponding risk factors. The proportions of drug use in prevention were relatively low in primary prevention, with the rates of using BP-lowering, glucose-lowering, lipid-lowering, and aspirin being 37.7% (95% CI, 32.8%-42.8%), 41.4% (95% CI, 35.8%-47.3%), 6.7% (95% CI, 4.5%-10.0%), and 1.0% (95% CI, 0.6%-1.8%), respectively. As for risk factor control, only 29.3% (95% CI, 25.7%-33.2%), 16.8% (95% CI, 15.0%-18.6%), and 36.0% (95% CI, 31.1%-41.2%) of individuals with high ASCVD risk had ideal levels of blood pressure, LDL-C, and body weight.
The estimated prevalence of 10-year high ASCVD risk was high in Guangzhou, while the rates of treatment and risk factor control in primary prevention were still far from optimal, especially for lipid management. These findings suggested that substantial improvement in ASCVD prevention is needed in this population.
识别动脉粥样硬化性心血管疾病（ASCVD）高危个体并实施针对性预防策略可能是减轻中国沉重疾病负担的关键。本研究旨在评估中国广州10年ASCVD风险高危个体的患病率、知晓率、治疗情况及危险因素控制情况。
本研究纳入了2018年广州市中国慢性病与危险因素监测调查中138个城乡社区的15165名成年人（年龄≥18岁）。使用《中国心血管病预防指南（2017年版）》推荐的风险评估模型估算10年ASCVD风险。检查了ASCVD高风险（定义为10年风险≥10%）的患病率、知晓率、治疗情况及危险因素控制情况。
在研究人群中，男性加权比例为51.9%，平均年龄为41.27±0.52岁。10年ASCVD高风险的总体标准化患病率为13.8%（95%CI，12.4%-15.3%）。有相应危险因素的人群中，高血压、糖尿病和高脂血症的知晓率分别为48.0%（95%CI，42.8%-53.4%）、48.3%（95%CI，43.0%-53.7%）和17.9%（95%CI，14.4%-22.1%）。一级预防中预防用药比例相对较低，降压、降糖、降脂及使用阿司匹林的比例分别为37.7%（95%CI，32.8%-42.8%）、41.4%（95%CI，35.8%-47.3%）、6.7%（95%CI，4.5%-10.0%）和1.0%（95%CI，0.6%-1.8%）。至于危险因素控制，ASCVD高风险个体中分别只有29.3%（95%CI，25.7%-33.2%）、16.8%（95%CI，15.0%-18.6%）和36.0%（95%CI，31.1%-41.2%）的血压、低密度脂蛋白胆固醇（LDL-C）和体重达到理想水平。
广州10年ASCVD高风险的估计患病率较高，而一级预防中的治疗率和危险因素控制率仍远未达到最佳水平，尤其是在血脂管理方面。这些发现表明该人群在ASCVD预防方面需要大幅改善。
