Ideal cardiovascular health and mortality: pooled results of three prospective cohorts in Chinese adults.

Yanbo Zhang; Canqing YU; Shuohua Chen; Zhouzheng TU; Mengyi Zheng; Jun LV; Guodong Wang; Yan Liu; Jiaxin YU; Yu Guo; Ling Yang; Yiping Chen; Kunquan Guo; Kun Yang; Handong Yang; Yanfeng Zhou; Yiwen Jiang; Xiaomin Zhang; Meian HE; Gang Liu; Zhengming Chen; Tangchun WU; Shouling WU; Liming LI; An Pan

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Ideal cardiovascular health and mortality: pooled results of three prospective cohorts in Chinese adults.

VernacularTitle:Ideal cardiovascular health and mortality: pooled results of three prospective cohorts in Chinese adults
Author: Yanbo ZHANG ¹ ; Canqing YU ² ; Shuohua CHEN ³ ; Zhouzheng TU ¹ ; Mengyi ZHENG ³ ; Jun LV ² ; Guodong WANG ³ ; Yan LIU ³ ; Jiaxin YU ⁴ ; Yu GUO ⁵ ; Ling YANG ⁶ ; Yiping CHEN ⁶ ; Kunquan GUO ⁷ ; Kun YANG ⁷ ; Handong YANG ⁷ ; Yanfeng ZHOU ¹ ; Yiwen JIANG ¹ ; Xiaomin ZHANG ¹ ; Meian HE ¹ ; Gang LIU ¹ ; Zhengming CHEN ⁶ ; Tangchun WU ¹ ; Shouling WU ³ ; Liming LI ² ; An PAN ¹
Author Information

1. Ministry of Education Key Laboratory of Environment and Health, State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430030, China.
2. Department of Epidemiology and Biostatistics, School of Public Health, Peking University Center for Public Health and Epidemic Preparedness & Response, Peking University Health Science Center, Beijing 100191, China.
3. Department of Cardiology, Kailuan Hospital, North China University of Science and Technology, Tangshan, Hebei 063000, China.
4. Department of Cardiology, Tangshan Worker's Hospital, Tangshan, Hebei 063000, China.
5. Chinese Academy of Medical Sciences, Beijing 100191, China.
6. Clinical Trial Service Unit and Epidemiological Studies Unit, Nuffield Department of Population Health, University of Oxford, Oxford OX3 7LF, United Kingdom.
7. Affiliated Dongfeng Hospital, Hubei University of Medicine, Shiyan, Hubei 442001, China.
Publication Type:Journal Article
MeSH: Adult; Humans; Cardiovascular Diseases/prevention & control*; East Asian People; Prospective Studies; Risk Factors; Smoking
From: Chinese Medical Journal 2023;136(2):141-149
CountryChina
Language:English
Abstract: BACKGROUND:Evidence on the relations of the American Heart Association's ideal cardiovascular health (ICH) with mortality in Asians is sparse, and the interaction between behavioral and medical metrics remained unclear. We aimed to fill the gaps.
METHODS:A total of 198,164 participants without cancer and cardiovascular disease (CVD) were included from the China Kadoorie Biobank study (2004-2018), Dongfeng-Tongji cohort (2008-2018), and Kailuan study (2006-2019). Four behaviors (i.e., smoking, physical activity, diet, body mass index) and three medical factors (i.e., blood pressure, blood glucose, and blood lipid) were classified into poor, intermediate, and ideal levels (0, 1, and 2 points), which constituted 8-point behavioral, 6-point medical, and 14-point ICH scores. Results of Cox regression from three cohorts were pooled using random-effects models of meta-analysis.
RESULTS:During about 2 million person-years, 20,176 deaths were recorded. After controlling for demographic characteristics and alcohol drinking, hazard ratios (95% confidence intervals) comparing ICH scores of 10-14 vs. 0-6 were 0.52 (0.41-0.67), 0.44 (0.37-0.53), 0.54 (0.45-0.66), and 0.86 (0.64-1.14) for all-cause, CVD, respiratory, and cancer mortality. A higher behavioral or medical score was independently associated with lower all-cause and CVD mortality among the total population and populations with different levels of behavioral or medical health equally, and no interaction was observed.
CONCLUSIONS:ICH was associated with lower all-cause, CVD, and respiratory mortality among Chinese adults. Both behavioral and medical health should be improved to prevent premature deaths.