Distribution of risk factors differs from coronary heart disease and stroke in China: a national population survey

Yapeng Li; Ling Yin; Ying Shen; Anran Wang; Lue Zhou; Yuan Gao; Yusheng Li; Jie Lu; Songhe Shi; Chuansheng Tian; Yuming Xu; Longde Wang; China National Stroke Screening Survey investigators

doi:10.1136/bmjopen-2022-065970

Distribution of risk factors differs from coronary heart disease and stroke in China: a national population survey

BMJ Open. 2022 Nov 24;12(11):e065970. doi: 10.1136/bmjopen-2022-065970.

Authors

Yapeng Li^{1

2}, Ling Yin³, Ying Shen⁴, Anran Wang^{1

2}, Lue Zhou^{1

2}, Yuan Gao^{1

2}, Yusheng Li^{1

2}, Jie Lu⁵, Songhe Shi⁵, Chuansheng Tian⁶, Yuming Xu^{1

2}, Longde Wang^{7

6}; China National Stroke Screening Survey investigators

Affiliations

¹ Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China.
² National Health Commission Key Laboratory of Prevention and treatment of Cerebrovascular Diseases, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China.
³ Department of Neurology, the Chinese PLA General Hospital, Beijing, China.
⁴ Department of Traditional Chinese Medicine, Xuanwu Hospital of Capital Medical University, Beijing, China.
⁵ Department of Epidemiology and Health Statistics, Zhengzhou University, Zhengzhou, China.
⁶ Chinese Preventive Medicine Association, Beijing, China.
⁷ Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China longde_wang@yeah.net.

Abstract

Objectives: This study aimed to explore the distribution differences of common risk factors between coronary heart disease (CHD) and stroke in China.

Setting: The China National Stroke Screening Survey is a cluster sampling survey based on a nationwide general community population, adopting multistage stratified sampling method and covering all 31 provinces in China mainland.

Participants: A total number of 725 707 people aged 40 years and above were included in the study.

Primary and secondary outcome measures: The basic demographic information, lifestyle behaviour, physical examination, traditional risk factors, family history of cardiovascular disease (CVD) and CVD events were collected. Risk factors of CHD and stroke were explored and analysed in the whole investigated population to identify the common risk factors. Multivariate logistic regression analysis was used to analyse the distribution difference of risk factors between CHD and stroke.

Results: There were 13 variables associated with CHD and stroke, in which 11 variables revealed differences in the distribution between CHD and stroke. Family history of stroke (OR: 2.30; 95% CI 2.15 to 2.45), men (OR: 1.92; 95% CI 1.80 to 2.05), rural areas (OR: 1.70; 95% CI 1.60 to 1.80), transient ischaemic attack (OR: 1.41; 95% CI 1.30 to 1.54) and hypertension (OR: 1.28; 95% CI 1.19 to 1.38) indicated significantly stronger association with stroke, while family history of CHD (OR: 0.25; 95% CI 0.23 to 0.27), atrial fibrillation (OR: 0.60; 95% CI 0.51 to 0.71), diabetes (OR: 0.76; 95% CI 0.71 to 0.81), dyslipidaemia (OR: 0.76; 95% CI 0.72 to 0.81), smoking (OR: 0.79; 95% CI 0.73 to 0.85) and overweight/obesity (OR: 0.90; 95% CI 0.86 to 0.93) had closer relationship with CHD.

Conclusions: The distribution of risk factors for CHD and stroke were substantial differences. More specific prevention and control measures should be formulated according to the distribution differences of risk factors related to CVD.

Keywords: Cardiac Epidemiology; Coronary heart disease; EPIDEMIOLOGY; PUBLIC HEALTH; Stroke.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Cardiovascular Diseases* / epidemiology
China / epidemiology
Coronary Disease* / complications
Coronary Disease* / epidemiology
Humans
Male
Risk Factors
Stroke* / epidemiology
Stroke* / etiology