Objective:To analysis and compare the burden of ischemic heart disease (IHD) attributable to metabolic risks in population aged 25 years and older in 2011 and 2017 in Nanjing.Methods:The data were extracted from the Nanjing Chronic Disease and Risk Factor Surveillance (2011 and 2017), the Nanjing Mortality Surveillance (2011 and 2017) and the 2016 Global Burden of Disease Study (GBD). Using GBD′s Comparative Risk Assessment Theory, the attribution burden was estimated by comparing the observed health outcomes with the health outcomes that may be observed when exposed to counterfactual levels. Based on population attributable fractions, the deaths and life expectancy losses of ischemic heart disease due to high systolic blood pressure (SBP), high fasting plasma glucose (FPG), high total cholesterol (TC), high body mass index (BMI) and combination of four risks were estimated in 2011 and 2017. The average population structure of the world′s population from 2000 to 2025 wasusedas the standard population for standardization.Results:The number of IHD deaths attributable to four metabolic risks combination was 3 204, andwhich resulted in a loss of life expectancy of 0.90 years in 2017. High SBP appeared as the major cause of IHD deaths and Years of Life Lost (YLL). In 2017, the world standardized mortality rate (25.60×10 －5, 19.94×10 －5 and 6.83×10 －5) and the standardized YLL rate (389.31×10 －5, 335.16×10 －5, 134.60×10 －5) of the population due to high systolic blood pressure, high total cholesterol and high body mass index were significantly lower than those in 2011 (31.75×10 －5, 26.74×10 －5, 7.45×10 －5 and 469.07×10 －5, 463.70×10 －5, 142.66×10 －5); the world standardized rate and the standardized YLL rate due to high blood sugar (11.90×10 －5 and 174.61×10 －5) were significantly higher than those in 2011 (9.67×10 －5 and 150.61×10 －5) (all P<0.05). Males appeared to have higher standardized rate of YLL of IHD deaths than females, due to having metabolism risks( P<0.05). Conclusion:Metabolic exposures especially high SBP are the important risk factors whichleadto IHD deaths in Nanjing.

Objective: To analyze the attributable burden of smoking on the deaths of cardio-cerebral vascular diseases (CCVD) in inhabitants aged 30 years and above in Jiangsu Province. Methods: Comparative risk assessment approach in Global Burden of Disease (GBD) was used with the data from Jiangsu Non-communicable Disease and Behavioral Risk Factor Surveillance System and Death Monitoring Surveillance System in 2013, and population attributable fraction (PAF), years of life lost (YLL), work of potential years of life lost, index of life lost and life loss attributed to smoking were calculated. Results: In 2013, there were 162 158 CCVD deaths aged 30 years and above in the surveillance areas of Jiangsu Province, of which 25 102 deaths were attributed to smoking (PAF: 15.48%, attributed mortality rate: 55.13/100 000). The YLL, work of potential years of life lost and index of life lost were 532 494 person years, 78 024 person years and 9.15 years respectively. The decline of life expectancy was 0.58 years. The PAF of CCVD attributed to smoking in male and female were 27.97% and 3.18%, respectively, and the mortality rate of cardio-cerebral diseases attributed to smoking in male and female were 100.13/100 000 and 11.27/100 000, respectively. The burden of ischemic heart disease and hemorrhagic stroke were most severe, with standardized YLL rate were 3.65‰ and 3.20‰, respectively. Conclusion Smoking caused a great burden of cardio-cerebral disease deaths in inhabitants in Jiangsu province.

Objective: To evaluate the risk of 10-year risk of ischemic cardiovascular disease (ICVD) in patients with type 2 diabetes aged 35 years old and above in two cities of Jiangsu province. Methods: From December 2013 to January 2014, a total of 15 624 patients with type 2 diabetes aged 35 years old and above, who received national basic public health service in Changshu county of Suzhou city, Huai′an and Qinghe districts of Huai′an city, Jiangsu province, were recruited by cluster sampling method. Face-to-face questionnaire survey, anthropometric and laboratory measurements were conducted to collect exposures to ICVD risk factors. Improved Ten Year Risk Assessment Table of ICVD in Chinese was used to assess the risk score and the absolute risk of developing ICVD. Results: The participants were (62.2±9.7) years old, of which 6 137 were men (39.3%). Among the participants, the highest rate of exposure to ICVD risk factors was high systolic blood pressure (74.8%, n=11 685), followed by high total cholesterol (70.7%, n= 11 051).The score of 10-year risk for ICVD was (10.4±3.3) and the median (P₂₅-P₇₅) value of absolute risk was 15.6% (6.8%-32.7%). 16.7% (n=2 602) participants were under extremely high risk of 10-year risk for ICVD, 23.8% (n=3 714) under high-risk and 24.0% (n=3 746) under middle-risk. Among the total risk score of ICVD, age (49.1%), hypertension (17.7%) and diabetes (15.5%) accounted for relatively high proportion, however, smoking (11.0%) was the most important risk factor except for age (47.4%) and systolic blood pressure (20.5%) in male participants. Conclusion Patients with type 2 diabetes aged 35 years old and above in two cities of Jiangsu Province have a high risk of developing ICVD for 10 years, especially in elderly, female, hypertension patients and male smokers.

Objective: To analyze the disease burden of stroke and its health loss attributable to passive smoking in people aged 60 years and over in Jiangsu province. Methods: Data were retrieved from the Chronic and Non-communicable Diseases and Risk Factors Surveillance in Jiangsu in 2013 and the death registry system in Jiangsu. Combined with the method in Global Burden of Disease Study 2016 (GBD2016), the indicators, such as population attributable fraction (PAF) and disability-adjusted life years (DALY) for stroke due to passive smoking were calculated. Results: In 2013, the mortality rate, age-standardized mortality rate, DALY and DALY rate of stroke in people aged 60 years and over in Jiangsu were 718.15/100 000, 439.28/100 000, 1 179 602 person years and 9 234.99/100 000, respectively. Year of life lost (YLL) accounted for 87.00% of the total DALY. The DALY and corresponding rate of stroke increased rapidly with age, and were higher in women (612 084 person years and 9 319.71/100 000, respectively) than those in men (567 518 person years and 9 145.33/100 000, respectively). The prevalence of passive smoking was 34.04% in people aged 60 years and over in Jiangsu. The PAF, attributable DALY, attributable DALY rate and its age- standardized rate of stroke due to passive smoking in people aged 60 years and over in Jiangsu were 3.88%, 45 769 person years, 358.12/100 000 and 920.64/100 000, respectively; and were also higher for men (4.35%, 24 687 person years, 397.82/100 000 and 515.30/100 000, respectively) than those for women (3.44%, 21 056 person years, 320.60/100 000, 405.34/100 000, respectively). Conclusions The disease burden of stroke was heavy in the elderly in Jiangsu, and passive smoking might have great influence on the disease burden of stroke. Prevention and control of stroke and passive smoking exposure should be taken actively to improve health for the elderly.