Cardiovascular disease risk factors are highly prevalent in the office-working population of Nanjing in China

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Abstract

Objective

To establish a profile of the modifiable cardiovascular disease (CVD) risk factors in the office-working population of Nanjing, China.

Background

With increasing modernization in China, CVD is now common among Chinese. Relevant information on the prevalence of CVD risk factors in China is, however, limited.

Methods

We recruited 2648 office working people aged 23–79 years without history of CVD or diabetes from 7 work units of Nanjing during the years 2003 to 2005. Information from a self-reported questionnaire on lifestyle, physical examination, fasting blood for lipid profiles, and a 75-gram oral glucose tolerance test (OGTT) were obtained from each participant. We analyzed the following 7 CVD risk factors: smoking, inadequate physical activity, unhealthy dietary habit, obesity, hypertension, dyslipidemia, and hyperglycemia.

Results

The whole study population had an average of 2.8 risk factors, while 95.6%, 79.4% and 55.6% of them had respectively ≥ 1, ≥ 2 and ≥ 3 of the 7 CVD risk factors. Men had a higher proportion of smoking, hypertension, dyslipidemia, hyperglycemia, but lower in light physical activity compared with women. Number of CVD risk factors increased with age. Although risk factors in men were more common than women, they increased alarmingly in postmenopausal women.

Conclusions

CVD risk factors are common in office-working people in Nanjing, China. Effective interventions and treatment against risk factors should be adopted in the high risk population, which may greatly reduce the future burden of CVD in the Chinese population.

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.

Section snippets

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

References (37)

  • A.J. Coats

    Ethical authorship and publishing

    Int J Cardiol

    (2009)
  • Report on cardiovascular disease in china 2007

    (2009)
  • G.T. Ko et al.

    Low levels of awareness of suboptimal health conditions in a high-risk working population: the “Better health for better Hong Kong” Health promotion campaign

    Int J Behav Med

    (2007)
  • E.B. Rimm et al.

    Reproducibility and validity of an expanded self-administered semiquantitative food frequency questionnaire among male health professionals

    Am J Epidemiol

    (1992)
  • W.C. Willett

    Nutritional epidemiology

    (1998)
  • F.B. Hu et al.

    Physical activity and risk of stroke in women

    JAMA

    (2000)
  • F.B. Hu et al.

    Physical activity and risk for cardiovascular events in diabetic women

    Ann Intern Med

    (2001)
  • W.T. Friedewald et al.

    Estimation of the concentration of low-density lipoprotein cholesterol in plasma, without use of the preparative ultracentrifuge

    Clin Chem

    (1972)
  • Cited by (0)

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