Abstract
Suboptimal health status (SHS) has become a new public health challenge in urban China. Despite indications that SHS may be associated with progression or development of chronic diseases such as cardiovascular and metabolic diseases, there are few reports on SHS investigations. To explore the relationship between SHS and traditional cardiovascular risk factors, a cross-sectional study was conducted in a sample of 4,881 workers employed in 21 companies in urban Beijing. Blood pressure, glucose, lipid levels (total cholesterol, high-density lipoprotein [HDL] cholesterol, low-density lipoprotein [LDL] cholesterol and triglycerides), cortisol, and body mass index were measured. SHS score was derived from data collection in the SHS questionnaire (SHSQ-25). Univariate analysis and linear two-level model were used to analyze the association of SHS with the cardiovascular risk factors. Serum cortisol level was much higher among the SHS high-score group than that among the low SHS score group (204.31 versus 161.33 ng/ml, P < 0.001). In a linear two-level model, we found correlation between SHS and systolic blood pressure, diastolic blood pressure, plasma glucose, total cholesterol, and HDL cholesterol among men, and correlation between SHS and systolic blood pressure, diastolic blood pressure, total cholesterol, triglyceride, and HDL cholesterol among women after controlling for age, education background, occupation, smoking, and physical activity. SHS is associated with cardiovascular risk factors and contributes to the development of cardiovascular disease. SHS should be recognized in the health care system, especially in primary care.
Similar content being viewed by others
References
Yan YX, Wang W. Advances in research of suboptimal health status. Chin J Pub Health (in Chin). 2008; 24(9): 1037–1038.
Yan YX, Liu YQ, Li M, et al. Development and evaluation of a questionnaire for measuring suboptimal health status in urban Chinese. J Epidemiol. 2009; 19(6): 333–341.
Wang L, Kong LZ, Wu F, Bai YM, Burton R. Preventing chronic diseases in China. Lancet. 2005; 366(9499): 1821–1824.
Idler EL, Kasl SV. Self-ratings of health: do they also predict change in functional ability? J Gerontol B Psychol Sci Soc Sci. 1995; 50(6): S344–S353.
Kaplan GA, Goldberg DE, Everson SA, et al. Perceived health status and morbidity and mortality: evidence from the Kuopio ischemic heart disease risk factor study. Int J Epidemiol. 1996; 25(2): 259–265.
Burström B, Fredlund P. Self rated health: is it as good a predictor of subsequent mortality among adults in lower as well as in higher social classes? J Epidemiol Community Health. 2001; 55(11): 836–840.
Yan YX, Wang W. Analysis of the risk factors and estimation of the cut point for sub-optimal health status. Hong Kong: Asia Conference on Emerging Issues in Public Health; 2009.
Melamed S, Kushnir T, Strauss E, Vigiser D. Negative association between reported life events and cardiovascular disease risk factors in employed men: the CORDIS study. J Psychosom Res. 1997; 43(3): 247–258.
Jenkins CD. Epidemiology of cardiovascular diseases. J Psychosom Res. 1987; 31(6): 661–671.
Krantz DS, Contrada RJ, Hill DR, Friedler E. Environmental stress biobehavioral antecedents of coronary heart disease. J Consult Clin Psychol. 1988; 56(3): 333–341.
Adler N, Matthews K. Health psychology: why do some people get sick and some stay well? Annu Rev Psychol. 1994; 45: 229–259.
Goldstein MG, Niaura R. Psychological factors affecting physical condition: cardiovascular disease literature review (part I). Psychosomatics. 1992; 33(2): 134–155.
Friedman HS, Booth-Kewley S. The disease-prone personality Q: a meta-analytic view of the construct. Am Psychol. 1987; 42(6): 539–555.
Wu Z, Yao C, Zhao D, et al. Sino-MONICA project: a collaborative study on trends and determinants in cardiovascular diseases in China, Part I: morbidity and mortality monitoring. Circulation. 2001; 103(3): 462–468.
Myers GL, Cooper GR, Winn CL, et al. The Centers for Disease Control-National Heart, Lung and Blood Institute Lipid Standardization Program. An approach to accurate and precise lipid measurements. Clin Lab Med. 1989; 9(1): 105–135.
Friedewald WT, Levy N, Fredrickson DS. Estimation of the concentration of low-density lipoprotein cholesterol in plasma, without use of the preparative ultracentrifuge. Clin Chem. 1972; 18(6): 499–502.
Raudenbush SW, Bryk AS. Hierarchical linear models. London, England: Sage; 2002.
Ministry of Health of the Peoples Republic of China. Chinese health statistics yearbook (2009). Beijing, China: Beijing Union Medical College Press; 2009.
Gu D, Reynolds K, Wu X, et al. Prevalence of the metabolic syndrome and overweight among adults in China. Lancet. 2005; 365(9548): 1398–1405.
Further Study of Risk Factors for Stroke and Coronary Heart Disease Cooperation group. The prevalence of metabolic syndrome in a 11 provinces cohort in China. Zhonghua Yu Fang Yi Xue Za Zhi (Chin). 2002; 36(5): 298–300.
Siu OL, Spector PE, Cooper CL, Lu C. Work stress, self-efficacy, Chinese work values, and work well-being in Hong Kong and Beijing. Int J Stress Manag. 2005; 12(3): 274–288.
Zhou Y, You LM, Zhang JB, Guan NH. Causes and prevention of sub-health. Chin J Health Educ (in Chin). 2002; 18(6): 714–715.
Halford C, Anderzén I, Arnetz B. Endocrine measures of stress and self-rated health: a longitudinal study. J Psychosom Res. 2003; 55(4): 317–332.
Kristenson M, Olsson AG, Kucinskiene Z. Good self-rated health is related to psychosocial resources and a strong cortisol response to acute stress: the LiVicordia study of middle-aged men. Int J Behav Med. 2005; 12(2): 153–160.
Weinehall L, Johnson O, Jansson JH, et al. Perceived health modifies the effect of biomedical risk factors in the prediction of acute myocardial infarction. An incident case–control study from northern Sweden. J Intern Med. 1998; 243(2): 99–107.
Emmelin M, Weinehall L, Stegmayr B, Dahlgren L, Stenlund H, Wall S. Self-rated ill-health strengthens the effect of biomedical risk factors in predicting stroke, especially for men—an incident case referent study. J Hypertens. 2003; 21(5): 887–896.
Kang MG, Koh SB, Cha BS, Park JK, Baik SK, Chang SJ. Job stress and cardiovascular risk factors in male workers. Prev Med. 2005; 40(5): 583–588.
Bugajska J, Widerszal-Bazyl M, Radkiewicz P, et al. Perceived work-related stress and early atherosclerotic changes in healthy employees. Int Arch Occup Environ Health. 2008; 81(8): 1037–1043.
Rosengren A, Hawken S, Ounpuu S, et al. Association of psychosocial risk factors with risk of acute myocardial infarction in 11119 cases and 13648 controls from 52 countries (the INTERHEART study): case–control study. Lancet. 2004; 364(9437): 953–962.
Su CT, Yang HJ, Lin CF, Tsai MC, Shieh YH, Chiu WT. Arterial blood pressure and blood lipids as cardiovascular risk factors and occupational stress in Taiwan. Int J Cardiol. 2001; 81(2–3): 181–187.
Smolin B, Leiba R, Levy Y. The effect of stress on markers of cardiovascular health. Nutr Metab Cardiovasc Dis. 2007; 17(6): e15–e17.
Woolfolk RL, Allen LA. Treating somatization: a cognitive-behavioural approach. New York, NY: Guilford; 2007.
Brown RJ. Introduction to the special issue on medically unexplained symptoms: background and future directions. Clin Psychol Rev. 2007; 27(7): 769–780.
al-Windi A, Elmfeldt D, Tibblin G, Svärdsudd K. The influence of sociodemographic characteristics on well-being and symptoms in a Swedish community. Results from a postal questionnaire survey. Scand J Prim Health Care. 1999; 17(4): 201–209.
Hagen KB, Bjørndal A, Uhlig T, Kvien TK. A population study of factors associated with general practitioner consultation for non-inflammatory musculoskeletal pain. Ann Rheum Dis. 2000; 59(10): 788–793.
Fifth National Population Census. Beijing, China: National Bureau of Statistics of China; 2000.
Acknowledgments
This study was funded by the National High Technology Research and Development Grant (863 Program; 2006AA02Z434), the National Science Foundation (81102208), the National Science and Technology Support Program (2012BAI37B03), the Beijing Municipal Project for Developing Advanced Human Resources (20081D0501800211), and the Capital Medical University Grant (10JL16).
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Yan, Y.X., Dong, J., Liu, Y.Q. et al. Association of Suboptimal Health Status and Cardiovascular Risk Factors in Urban Chinese Workers. J Urban Health 89, 329–338 (2012). https://doi.org/10.1007/s11524-011-9636-8
Published:
Issue Date:
DOI: https://doi.org/10.1007/s11524-011-9636-8