The Lancet Regional Health. Western Pacific (Dec 2021)
Age-specific modifiable risk factor profiles for cardiovascular disease and all-cause mortality: a nationwide, population-based, prospective cohort study
- Tiange Wang,
- Zhiyun Zhao,
- Xuefeng Yu,
- Tianshu Zeng,
- Min Xu,
- Yu Xu,
- Ruying Hu,
- Gang Chen,
- Qing Su,
- Yiming Mu,
- Lulu Chen,
- Xulei Tang,
- Li Yan,
- Guijun Qin,
- Qin Wan,
- Zhengnan Gao,
- Guixia Wang,
- Feixia Shen,
- Zuojie Luo,
- Yingfen Qin,
- Li Chen,
- Yanan Huo,
- Qiang Li,
- Zhen Ye,
- Yinfei Zhang,
- Chao Liu,
- Youmin Wang,
- Shengli Wu,
- Tao Yang,
- Huacong Deng,
- Jiajun Zhao,
- Yiping Xu,
- Mian Li,
- Yuhong Chen,
- Shuangyuan Wang,
- Guang Ning,
- Yufang Bi,
- Lixin Shi,
- Jieli Lu,
- Weiqing Wang
Affiliations
- Tiange Wang
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Shanghai National Clinical Research Center for Endocrine and Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai National Center for Translational Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Zhiyun Zhao
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Shanghai National Clinical Research Center for Endocrine and Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai National Center for Translational Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Xuefeng Yu
- Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Tianshu Zeng
- Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Min Xu
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Shanghai National Clinical Research Center for Endocrine and Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai National Center for Translational Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Yu Xu
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Shanghai National Clinical Research Center for Endocrine and Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai National Center for Translational Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Ruying Hu
- Zhejiang Provincial Center for Disease Control and Prevention, China
- Gang Chen
- Fujian Provincial Hospital, Fujian Medical University, Fuzhou, China
- Qing Su
- Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Yiming Mu
- Chinese People's Liberation Army General Hospital, Beijing, China
- Lulu Chen
- Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Xulei Tang
- The First Hospital of Lanzhou University, Lanzhou, China
- Li Yan
- Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
- Guijun Qin
- The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
- Qin Wan
- The Affiliated Hospital of Southwest Medical University, Luzhou, China
- Zhengnan Gao
- Dalian Municipal Central Hospital, Dalian, China
- Guixia Wang
- The First Hospital of Jilin University, Changchun, China
- Feixia Shen
- The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
- Zuojie Luo
- The First Affiliated Hospital of Guangxi Medical University, Nanning, China
- Yingfen Qin
- The First Affiliated Hospital of Guangxi Medical University, Nanning, China
- Li Chen
- Qilu Hospital of Shandong University, Jinan, China
- Yanan Huo
- Jiangxi Provincial People's Hospital Affiliated to Nanchang University, Nanchang, China
- Qiang Li
- The Second Affiliated Hospital of Harbin Medical University, Harbin, China
- Zhen Ye
- Zhejiang Provincial Center for Disease Control and Prevention, China
- Yinfei Zhang
- Central Hospital of Shanghai Jiading District, Shanghai, China
- Chao Liu
- Jiangsu Province Hospital on Integration of Chinese and Western Medicine, Nanjing, China
- Youmin Wang
- The First Affiliated Hospital of Anhui Medical University, Hefei, China
- Shengli Wu
- Karamay Municipal People's Hospital, Xinjiang, China
- Tao Yang
- The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
- Huacong Deng
- The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
- Jiajun Zhao
- Shandong Provincial Hospital affiliated to Shandong University, Jinan, China
- Yiping Xu
- Clinical Trials Center, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Mian Li
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Shanghai National Clinical Research Center for Endocrine and Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai National Center for Translational Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Yuhong Chen
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Shanghai National Clinical Research Center for Endocrine and Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai National Center for Translational Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Shuangyuan Wang
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Shanghai National Clinical Research Center for Endocrine and Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai National Center for Translational Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Guang Ning
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Shanghai National Clinical Research Center for Endocrine and Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai National Center for Translational Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Correspondence authors at: Weiqing Wang, MD, PhD, Shanghai National Clinical Research Center for Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, 197 Rujin 2nd Road, Shanghai, China, Tel: 86-021-64370045; Jieli Lu, MD, PhD, Shanghai National Clinical Research Center for Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, 197 Rujin 2nd Road, Shanghai, China, Tel: 86-021-64370045; Lixin Shi, MD, PhD, Affiliated Hospital of Guiyang Medical College, 28 Guiyi Street, Guiyang, China, Tel: 86-851-6855119; Yufang Bi, MD, PhD, Shanghai National Clinical Research Center for Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, 197 Rujin 2nd Road, Shanghai, China, Tel: 86-021-64370045; Guang Ning, MD, PhD, Shanghai National Clinical Research Center for Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, 197 Rujin 2nd Road, Shanghai, China, Tel: 86-021-64370045.
- Yufang Bi
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Shanghai National Clinical Research Center for Endocrine and Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai National Center for Translational Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Correspondence authors at: Weiqing Wang, MD, PhD, Shanghai National Clinical Research Center for Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, 197 Rujin 2nd Road, Shanghai, China, Tel: 86-021-64370045; Jieli Lu, MD, PhD, Shanghai National Clinical Research Center for Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, 197 Rujin 2nd Road, Shanghai, China, Tel: 86-021-64370045; Lixin Shi, MD, PhD, Affiliated Hospital of Guiyang Medical College, 28 Guiyi Street, Guiyang, China, Tel: 86-851-6855119; Yufang Bi, MD, PhD, Shanghai National Clinical Research Center for Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, 197 Rujin 2nd Road, Shanghai, China, Tel: 86-021-64370045; Guang Ning, MD, PhD, Shanghai National Clinical Research Center for Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, 197 Rujin 2nd Road, Shanghai, China, Tel: 86-021-64370045.
- Lixin Shi
- Affiliated Hospital of Guiyang Medical College, 28 Guiyi Street, Guiyang, China; Correspondence authors at: Weiqing Wang, MD, PhD, Shanghai National Clinical Research Center for Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, 197 Rujin 2nd Road, Shanghai, China, Tel: 86-021-64370045; Jieli Lu, MD, PhD, Shanghai National Clinical Research Center for Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, 197 Rujin 2nd Road, Shanghai, China, Tel: 86-021-64370045; Lixin Shi, MD, PhD, Affiliated Hospital of Guiyang Medical College, 28 Guiyi Street, Guiyang, China, Tel: 86-851-6855119; Yufang Bi, MD, PhD, Shanghai National Clinical Research Center for Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, 197 Rujin 2nd Road, Shanghai, China, Tel: 86-021-64370045; Guang Ning, MD, PhD, Shanghai National Clinical Research Center for Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, 197 Rujin 2nd Road, Shanghai, China, Tel: 86-021-64370045.
- Jieli Lu
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Shanghai National Clinical Research Center for Endocrine and Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai National Center for Translational Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Correspondence authors at: Weiqing Wang, MD, PhD, Shanghai National Clinical Research Center for Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, 197 Rujin 2nd Road, Shanghai, China, Tel: 86-021-64370045; Jieli Lu, MD, PhD, Shanghai National Clinical Research Center for Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, 197 Rujin 2nd Road, Shanghai, China, Tel: 86-021-64370045; Lixin Shi, MD, PhD, Affiliated Hospital of Guiyang Medical College, 28 Guiyi Street, Guiyang, China, Tel: 86-851-6855119; Yufang Bi, MD, PhD, Shanghai National Clinical Research Center for Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, 197 Rujin 2nd Road, Shanghai, China, Tel: 86-021-64370045; Guang Ning, MD, PhD, Shanghai National Clinical Research Center for Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, 197 Rujin 2nd Road, Shanghai, China, Tel: 86-021-64370045.
- Weiqing Wang
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Shanghai National Clinical Research Center for Endocrine and Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai National Center for Translational Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Correspondence authors at: Weiqing Wang, MD, PhD, Shanghai National Clinical Research Center for Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, 197 Rujin 2nd Road, Shanghai, China, Tel: 86-021-64370045; Jieli Lu, MD, PhD, Shanghai National Clinical Research Center for Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, 197 Rujin 2nd Road, Shanghai, China, Tel: 86-021-64370045; Lixin Shi, MD, PhD, Affiliated Hospital of Guiyang Medical College, 28 Guiyi Street, Guiyang, China, Tel: 86-851-6855119; Yufang Bi, MD, PhD, Shanghai National Clinical Research Center for Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, 197 Rujin 2nd Road, Shanghai, China, Tel: 86-021-64370045; Guang Ning, MD, PhD, Shanghai National Clinical Research Center for Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, 197 Rujin 2nd Road, Shanghai, China, Tel: 86-021-64370045.
- Journal volume & issue
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Vol. 17
p. 100277
Abstract
Summary: Background: National investigations on age-specific modifiable risk factor profiles for cardiovascular disease (CVD) and mortality are scarce in China, the country that is experiencing a huge cardiometabolic burden exacerbated by population ageing. Methods: This is a nationwide prospective cohort study of 193,846 adults in the China Cardiometabolic Disease and Cancer Cohort Study, 2011-2016. Among 139,925 participants free from CVD at baseline, we examined hazard ratios and population-attributable risk percentages (PAR%s) for CVD and all-cause mortality attributable to 12 modifiable socioeconomic, psychosocial, lifestyle, and metabolic risk factors by four age groups (40-<55 years, 55-<65 years, 65-<75 years, and ≥75 years). Findings: Metabolic risk factors accounted for 52·4%, 47·2%, and 37·8% of the PAR% for CVD events in participants aged 40-<55 years, 55-<65 years, and 65-<75 years, respectively, with hypertension being the largest risk factor. While in participants aged ≥75 years, lifestyle risk factors contributed to 34·0% of the PAR% for CVD, with inappropriate sleep duration being the predominant risk factor. Most deaths were attributed to metabolic risk factors (PAR% 25·3%) and lifestyle risk factors (PAR% 24·6%) in participants aged 40-<55 years, with unhealthy diet and diabetes being the main risk factors. While in participants aged ≥55 years, most deaths were attributed to lifestyle risk factors (PAR% 26·6%-41·0%) and socioeconomic and psychosocial risk factors (PAR% 26·1%-27·7%). In participants aged ≥75 years, lifestyle risk factors accounted for 41·0% of the PAR% for mortality, with inappropriate sleep duration being the leading risk factor. Interpretation: We identified age-specific modifiable risk profiles for CVD and all-cause mortality in Chinese adults, with remarkable differences between adults aged ≥75 years and their younger counterparts. Funding: National Natural Science Foundation of China.
