Bixia Gao1, Fang Wang1, Ming Zhu2, Jinwei Wang1, Maigeng Zhou3, Luxia Zhang4, Minghui Zhao5. 1. Renal Division, Department of Medicine, Peking University First Hospital, China; Renal Division, Department of Medicine, Peking University First Hospital; Institute of Nephrology, Peking University; Key Laboratory of Renal Disease, National Health Commission of the People's Republic of China; Key Laboratory of Chronic Kidney Disease Prevention and Treatment, Ministry of Education, Beijing, China. 2. Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou, China; Renal Division, Department of Medicine, Peking University First Hospital, China. 3. National Center for Chronic and Non-communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China. 4. Renal Division, Department of Medicine, Peking University First Hospital, China; Renal Division, Department of Medicine, Peking University First Hospital; Institute of Nephrology, Peking University; Key Laboratory of Renal Disease, National Health Commission of the People's Republic of China; Key Laboratory of Chronic Kidney Disease Prevention and Treatment, Ministry of Education, Beijing, China; National Institute of Health Data Science at Peking University, Beijing, China. Electronic address: zhanglx@bjmu.edu.cn. 5. Renal Division, Department of Medicine, Peking University First Hospital, China; Renal Division, Department of Medicine, Peking University First Hospital; Institute of Nephrology, Peking University; Key Laboratory of Renal Disease, National Health Commission of the People's Republic of China; Key Laboratory of Chronic Kidney Disease Prevention and Treatment, Ministry of Education, Beijing, China; Peking-Tsinghua Center for Life Sciences, Beijing, China.
Abstract
BACKGROUND: Increasing evidence indicates that an ideal cardiovascular health (CVH) profile is beneficial not only for cardiovascular disease (CVD), but also for other non-communicable diseases (NCDs). By using a national representative sample of Chinese adults, we aimed to evaluate the association of CVH metrics with long-term all-cause mortality and major NCDs mortality. METHODS: We used data from 45,984 Chinese adults without previous history of CVD who participated in a national representative survey between January 2007 and September 2010 and whose mortality until December 2017 was determined via linkage to the Mortality Registration and Reporting System. Altogether, five CVH metrics (body mass index, smoking status, blood pressure, total cholesterol, and fasting blood glycemia) were adopted according to the American Heart Association definition. Outcomes included all-cause, and major NCDs mortality. RESULTS: During a mean follow-up of 9.7 years, altogether 1451 deaths occurred. Among them, 541 deaths were of cardiovascular origin and 555 deaths were due to cancer. Participants with four to five ideal CVH metrics were associated with 42% (hazard ratio [HR] 0.58; 95% CI 0.39-0.85), 59% (HR 0.41; 95% CI 0.23-0.73), and 62% (HR 0.38; 95% CI 0.20-0.72) decreased risk of all-cause mortality, CVD-related mortality, and cancer-related mortality, respectively, relative to those with a poor CVH score (0-1 ideal CVH metrics). CONCLUSIONS: Our findings highlight the benefit of better CVH with respect to all-cause and major NCDs-related mortality in a Chinese adult population. The assessment of CVH profile at the population level should be advocated in China.
BACKGROUND: Increasing evidence indicates that an ideal cardiovascular health (CVH) profile is beneficial not only for cardiovascular disease (CVD), but also for other non-communicable diseases (NCDs). By using a national representative sample of Chinese adults, we aimed to evaluate the association of CVH metrics with long-term all-cause mortality and major NCDs mortality. METHODS: We used data from 45,984 Chinese adults without previous history of CVD who participated in a national representative survey between January 2007 and September 2010 and whose mortality until December 2017 was determined via linkage to the Mortality Registration and Reporting System. Altogether, five CVH metrics (body mass index, smoking status, blood pressure, total cholesterol, and fasting blood glycemia) were adopted according to the American Heart Association definition. Outcomes included all-cause, and major NCDs mortality. RESULTS: During a mean follow-up of 9.7 years, altogether 1451 deaths occurred. Among them, 541 deaths were of cardiovascular origin and 555 deaths were due to cancer. Participants with four to five ideal CVH metrics were associated with 42% (hazard ratio [HR] 0.58; 95% CI 0.39-0.85), 59% (HR 0.41; 95% CI 0.23-0.73), and 62% (HR 0.38; 95% CI 0.20-0.72) decreased risk of all-cause mortality, CVD-related mortality, and cancer-related mortality, respectively, relative to those with a poor CVH score (0-1 ideal CVH metrics). CONCLUSIONS: Our findings highlight the benefit of better CVH with respect to all-cause and major NCDs-related mortality in a Chinese adult population. The assessment of CVH profile at the population level should be advocated in China.