Cardiovascular disease risk factors are highly prevalent in the office-working population of Nanjing in China
Introduction
With increasing modernization in China, cardiovascular diseases (CVD) have become one of the major diseases causing significant morbidity, disability and mortality among Chinese. Almost three million people in mainland China died of CVD every year that accounted for about 40% of all-cause mortality [1]. The ongoing deterioration in CVD risk factors seems to be the major reason that induces the surge of CVD in China.
There are modifiable and non-modifiable factors that contribute to CVD risk. Non-modifiable risk factors such as age, gender, race, and family history are those that cannot be changed. Modifiable risk factors including hypertension, dyslipidemia, smoking, diabetes, obesity, and sedentary lifestyle are those that can be altered or eliminated through proper management. More the risk factors, higher the risk of developing CVD. According to the 1st NHANES Epidemiologic Follow-up Study with data after follow-up for 21 years, the relative risks of coronary heart disease after adjustment for age, gender, race and education in adults with 1, 2, 3 and ≥ 4 risk factors (high blood pressure, high cholesterol level, diabetes, overweight, and smoking) were 1.6, 2.2, 3.1, and 5.0, respectively as compared to those who had none of these risk factors. Relative risks for stroke associated with the same risk levels were 1.4, 1.9, 2.3, and 4.3, respectively [2]. Although CVD are emerging in China, little has been known about their level of the CVD risk factors. Relevant information on the prevalence of CVD risk factors is essential to the government and health professionals in China to set goals and objectives for effective CVD intervention programs.
The aim of this study is to establish a profile of the modifiable CVD risk factors in the working population in a representative urban city in China. Working population has shown to be “high risk group” for CVD [3]. Their health status is of major significance due to the large population in China and the adverse economic impact if a substantial proportion of working people are affected. Information collected from this study may help the health care system adopt relevant and appropriate plan to prevent the further deterioration of CVD risk factors in China.
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Study population
Nanjing is the capital of Jiangsu Province and located in the east of China. It includes 6 urban, 5 suburban and 2 rural districts, holding 7.4 million permanent residents, of whom, more than 75% are urban population. The survey was approved by Jiangsu Province Health Administrative Department and its Ethics Committee.
Subjects of the study came from seven work units including government offices, scientific research institutions and banks in four major urban districts of Nanjing. All staff of the
Results
Of the 2648 subjects, 1611 (60.8%) were men and 1037 (39.2%) were women. Their mean age was 47.4 ± 11.6 years (median 46 years, range 23 to 79 years). Of the 1037 women, 361 (34.8%) were postmenopausal. Table 2 shows their clinical and biochemical characteristics. Compared to women, men had higher BMI, BP, PG, TG and lower HDL-C. Table 3 summarizes the CVD risk factors of the subjects. The average number of CVD risk factors was 2.8, and 95.6%, 79.4% and 55.6% of the subjects had ≥ 1, ≥ 2 and ≥ 3 risk
Discussion
In developing countries, the increase in CVD burden is largely the result of an increase in the prevalence of risk factors and a relative lack of access to relevant interventions. As a result, a relatively younger population in developing countries is afflicted by CVD as compared to more developed areas. This has led to an increased mortality in the working population [16]. In the present study, we examined 7 modifiable CVD risk factors, namely, smoking, inadequate physical activity, unhealthy
Conclusions
The present study indicated that CVD risk factors were common in the working populations in China. Most of these people (four fifth) had 2 or more and half of them had 3 or more of the 7 CVD risk factors. The number of CVD risk factors increased with age. Overall speaking men had more risk factors than women, but the risk in postmenopausal women was exceedingly high. Effective interventions and treatment against CVD risk factors should be adopted in the high risk populations, which could
Acknowledgements
The authors of this manuscript have certified that they comply with the Principles of Ethical Publishing in the International Journal of Cardiology [37]. This study was funded by the Jiangsu Province Science and Technology Department (BS2006073)and Jiangsu Province Health Department (H200213 and H200931).
We would like to express our sincere thanks to all medical and nursing staff of Diabetes Care and Research Center of Jiangsu Province Institute of Geriatrics for the design and conduct of the
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