JACC: Status of cardiovascular health in chinese adults

J Am Coll Cardiol. 2015 Mar 17;65(10):1013-25. doi: 10.1016/j.jacc.2014.12.044.

Status of cardiovascular health in chinese adults.

Abstract

BACKGROUND:

Cardiovascular disease has become the leading cause of death in China.

OBJECTIVES:

The goal of this study was to evaluate the current status of cardiovascular health in Chinese adults.

METHODS:

Cardiovascular health data were collected from a nationally representative sample of 96,121 Chinese adults age ≥20 years in 2010. Idealcardiovascular health was defined according to the American Heart Association’s 2020 Strategic Impact Goals as follows: the simultaneous presence of 4 favorable health behaviors (ideal smoking status, ideal body mass index, physical activity at goal, and healthy dietary habits) and 4 favorablehealth factors (ideal smoking status, untreated total cholesterol <200 mg/dl, untreated blood pressure <120/<80 mm Hg, and untreated fasting plasma glucose <100 mg/dl) in the absence of a history of cardiovascular disease.

RESULTS:

The estimated percentage of ideal cardiovascular health was 0.2% in the general adult population in China (0.1% in men and 0.4% in women). An estimated 0.7% (0.4% in men and 1.0% in women) of Chinese adults had all 4 ideal health behaviors, and 13.5% (5.0% in men and 22.3% in women) had all 4 ideal health factors. Men most frequently had 3 to 4 ideal components, and women most commonly had 4 to 5 ideal components of the 7 cardiovascular health metrics. Ideal diet (1.6%) was the least common among all cardiovascular health metrics. Female sex and younger age were the 2 most common protective factors for cardiovascular health in Chinese adults.

CONCLUSIONS:

The percentage of ideal cardiovascular health in Chinese adults is extremely low. Both population-wide and high-risk strategies should be implemented with great effort to promote cardiovascular health in China.

Copyright © 2015 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

KEYWORDS:

China; cardiovascular disease; epidemiology; health status

PMID:
25766949
[PubMed – in process]

Author information

  • 1State Key Laboratory of Medical Genomics, Key Laboratory for Endocrine and Metabolic Diseases of Ministry of Health, National Clinical Research Center for Metabolic Diseases, Collaborative Innovation Center of Systems Biomedicine and Shanghai Clinical Center for Endocrine and Metabolic Diseases, Rui-Jin Hospital, Shanghai Jiao-Tong University School of Medicine, Shanghai, China.
  • 2National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China.
  • 3Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, Louisiana.
  • 4State Key Laboratory of Medical Genomics, Key Laboratory for Endocrine and Metabolic Diseases of Ministry of Health, National Clinical Research Center for Metabolic Diseases, Collaborative Innovation Center of Systems Biomedicine and Shanghai Clinical Center for Endocrine and Metabolic Diseases, Rui-Jin Hospital, Shanghai Jiao-Tong University School of Medicine, Shanghai, China; Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, Louisiana.
  • 5Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland.
  • 6State Key Laboratory of Medical Genomics, Key Laboratory for Endocrine and Metabolic Diseases of Ministry of Health, National Clinical Research Center for Metabolic Diseases, Collaborative Innovation Center of Systems Biomedicine and Shanghai Clinical Center for Endocrine and Metabolic Diseases, Rui-Jin Hospital, Shanghai Jiao-Tong University School of Medicine, Shanghai, China. Electronic address: wqingw@hotmail.com.
  • 7National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China. Electronic address: linhong@chinawch.org.cn.
  • 8State Key Laboratory of Medical Genomics, Key Laboratory for Endocrine and Metabolic Diseases of Ministry of Health, National Clinical Research Center for Metabolic Diseases, Collaborative Innovation Center of Systems Biomedicine and Shanghai Clinical Center for Endocrine and Metabolic Diseases, Rui-Jin Hospital, Shanghai Jiao-Tong University School of Medicine, Shanghai, China. Electronic address: gning@sibs.ac.cn.
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NEJM: Outcomes of Anatomical versus Functional Testing for Coronary Artery Disease

http://www.nejm.org/doi/full/10.1056/NEJMoa1415516?query=OF

Outcomes of Anatomical versus Functional Testing for Coronary Artery Disease — NEJM// // // // //

Outcomes of Anatomical versus Functional Testing for Coronary Artery Disease

Pamela S. Douglas, M.D., Udo Hoffmann, M.D., M.P.H., Manesh R. Patel, M.D., Daniel B. Mark, M.D., M.P.H., Hussein R. Al-Khalidi, Ph.D., Brendan Cavanaugh, M.D., Jason Cole, M.D., Rowena J. Dolor, M.D., Christopher B. Fordyce, M.D., Megan Huang, Ph.D., Muhammad Akram Khan, M.D., Andrzej S. Kosinski, Ph.D., Mitchell W. Krucoff, M.D., Vinay Malhotra, M.D., Michael H. Picard, M.D., James E. Udelson, M.D., Eric J. Velazquez, M.D., Eric Yow, M.S., Lawton S. Cooper, M.D., M.P.H., and Kerry L. Lee, Ph.D. for the PROMISE Investigators

March 14, 2015DOI: 10.1056/NEJMoa1415516

Outcomes of Anatomical versus Functional Testing for Coronary Artery Disease — NEJM// // // // //

Background

Many patients have symptoms suggestive of coronary artery disease (CAD) and are often evaluated with the use of diagnostic testing, although there are limited data from randomized trials to guide care.

Methods

We randomly assigned 10,003 symptomatic patients to a strategy of initial anatomical testing with the use of coronary computed tomographic angiography (CTA) or to functional testing (exercise electrocardiography, nuclear stress testing, or stress echocardiography). The composite primary end point was death, myocardial infarction, hospitalization for unstable angina, or major procedural complication. Secondary end points included invasive cardiac catheterization that did not show obstructive CAD and radiation exposure.

Results

The mean age of the patients was 60.8±8.3 years, 52.7% were women, and 87.7% had chest pain or dyspnea on exertion. The mean pretest likelihood of obstructive CAD was 53.3±21.4%. Over a median follow-up period of 25 months, a primary end-point event occurred in 164 of 4996 patients in the CTA group (3.3%) and in 151 of 5007 (3.0%) in the functional-testing group (adjusted hazard ratio, 1.04; 95% confidence interval, 0.83 to 1.29; P=0.75). CTA was associated with fewer catheterizations showing no obstructive CAD than was functional testing (3.4% vs. 4.3%, P=0.02), although more patients in the CTA group underwent catheterization within 90 days after randomization (12.2% vs. 8.1%). The median cumulative radiation exposure per patient was lower in the CTA group than in the functional-testing group (10.0 mSv vs. 11.3 mSv), but 32.6% of the patients in the functional-testing group had no exposure, so the overall exposure was higher in the CTA group (mean, 12.0 mSv vs. 10.1 mSv; P<0.001).

Conclusions

In symptomatic patients with suspected CAD who required noninvasive testing, a strategy of initial CTA, as compared with functional testing, did not improve clinical outcomes over a median follow-up of 2 years. (Funded by the National Heart, Lung, and Blood Institute; PROMISE ClinicalTrials.gov number, NCT01174550.)

ACC 2015 Scientific meeting of the American College of Cardiology

ACC.15, March 14 – 16, 2015, in San Diego, CA.

http://accscientificsession.acc.org/ACC.aspx

ACC.15 Opening Showcase and the Joint ACC/JACC Late-Breaking Clinical Trials
Session 400
Saturday, March 14, 8:00 a.m. – 10:00 a.m.
ACC.15 Main Tent (Hall H)

  • A Randomized Comparison of Anatomic versus Functional Diagnostic Testing Strategies in Symptomatic Patients with Suspected Coronary Artery Disease: Results from the PROMISE Trial (PROspective Multicenter Imaging Study for Evaluation of chest pain)
  • Prevention of Cardiovascular Events in Patients with Prior Heart Attack Using Ticagrelor Compared to Placebo on a Background of Aspirin (PEGASUS) -Thrombolysis in Myocardial Infarction (TIMI) 54

Joint American College of Cardiology/Journal of the American Medical Association Late-Breaking Clinical Trials
Session 402
Sunday, March 15, 8:00 a.m. – 9:15 a.m.
ACC.15 Main Tent (Hall H)

  • Effect of the PCSK9 Inhibitor Evolocumab on Cardiovascular Outcomes (OSLER-1 and -2)
  • The EMBRACE STEMI Study: A Phase 2a, Randomized, Double-Blind, Placebo-Controlled Trial to Evaluate the Safety, Tolerability and Efficacy of Intravenous Bendavia™ on Reperfusion Injury in Patients Treated with Standard Therapy Including Primary PCI and Stenting for ST-segment Elevation Myocardial Infarction (EMBRACE STEMI)
  • A Randomized, Open-Label, Multi-Center, Active-Controlled, Parallel Group Study To Determine the Efficacy and Safety of the REG1 Anticoagulation System Compared to Bivalirudin in Patients Undergoing Percutaneous Coronary Intervention (REGULATE-PCI)
  • Computed Tomography Coronary Angiography In Patients With Suspected Angina Due To Coronary Heart Disease (The SCOT-HEART Trial)
  • Economic Comparison of Anatomic Versus Functional Diagnostic Testing Strategies in Symptomatic Patients with Suspected CAD: Results from the PROspective Multicenter Imaging Study for Evaluation of chest pain (PROMISE) Trial

Late-Breaking Clinical Trials III
Session 404
Sunday, March 15, 10:45 a.m. – Noon
ACC.15 Main Tent (Hall H)

  • Five-Year Outcomes after Randomization to Transcatheter or Surgical Aortic Valve Replacement: Final Results of the PARTNER 1 Trial
  • A Randomized Comparison of Self-expanding Transcatheter and Surgical Aortic Valve Replacement in Patients with Severe Aortic Stenosis Deemed at Increased Risk for Surgery 2-Year Outcomes (CoreValve US Pivotal High Risk Trial)
  • Early Clinical and Echocardiographic Outcomes with the SAPIEN 3 Transcatheter Aortic Valve Replacement System in Inoperable, High-Risk and Intermediate-Risk Aortic Stenosis Patients
  • First Report of the DEFLECT III Trial Results: A Prospective Randomized Evaluation of The TriGuardTM HDH Embolic DEFLECTion Device During Transcatheter Aortic Valve Replacement
  • Outcomes of the Initial Experience with Commercial Transcatheter Mitral Valve Repair in the United States

Featured Clinical Research Session I
Session 406
Sunday, March 15, 12:30 p.m. – 1:45 p.m.
Room 9

  • An All-comers Randomized Clinical Trial Comparing Transcatheter with Surgical Aortic Valve Replacement in Patients with Aortic Valve Stenosis
  • Ulnar Artery Intervention Non Inferior To Radial Approach: A Reality Or Myth. AJmer ULnar ARtery (AJULAR) Working Group Study
  • Long-Term Outcomes After Stenting Versus Coronary Artery Bypass Grafting for Unprotected Left Main Coronary Artery Disease: 5-Year Results of the PRECOMBAT Study
  • Dual Antiplatelet Therapy Beyond One Year in Patients Receiving Coronary Stents For Treatment of Acute Coronary Syndrome: Analysis from the Dual Antiplatelet Therapy Study
  • Perioperative Results And Complications In 15,964 Transcatheter Aortic Valve Implantations From The German Gary Registry

Joint American College of Cardiology/New England Journal of Medicine Late-Breaking Clinical Trials
Session 408
Monday, March 16, 8:00 a.m. – 9:15 a.m.
ACC.15 Main Tent (Hall H)

  • Ablation vs. Amiodarone for Treatment of Persistent Atrial Fibrillation in Patients With Congestive Heart Failure and an Implanted device: Results from the AATAC Multicenter Randomized Trial
  • Effectiveness of Surgical Ablation of Atrial Fibrillation during Mitral Valve Surgery: A Randomized Clinical Trial from the Cardiothoracic Surgical Trials Network
  • Long-Term Effect of Goal Directed Weight Management on an Atrial Fibrillation Cohort: A 5-Year Follow-Up Study (LEGACY Study)
  • Everolimus-Eluting Stents versus Bypass Surgery for Multivessel Coronary Artery Disease (BEST)
  • Effect of Remote Ischemic Preconditioning on Clinical Outcomes in Patients Undergoing Coronary Artery Bypass Graft Surgery: A Multi-Center Randomized Controlled Clinical Trial (ERRICA)

Late-Breaking Clinical Trials V: TCT@ACC-i2 Interventional Cardiology
Session 410
Monday, March 16, 10:45 a.m. – Noon
ACC.15 Main Tent (Hall H)

  • The Total Trial: A Randomized Trial Of Routine Aspiration Thrombectomy With Percutaneous Coronary Intervention (PCI) Versus PCI Alone In Patients With St-elevation Myocardial Infarction Undergoing Primary PCI
  • Transradial Versus Transfemoral Access In Patients With Acute Coronary Syndromes Undergoing Invasive Management: Results From The Minimizing Adverse Haemorrhagic Events By Transradial Access Site And Systemic Implementation Of Angiox (matrix) Access Site Program
  • Bivalirudin Infusion Compared To Unfractionated Heparin In Patients With Acute Coronary Syndromes Undergoing Invasive Management: Results From The Minimizing Adverse Haemorrhagic Events By Transradial Access Site And Systemic Implementation Of Angiox (matrix) Anti-thrombin Program
  • The Third DANish Study of Optimal Acute Treatment of Patients with ST-segment Elevation Myocardial Infarction: PRImary PCI in MULTIvessel Disease
  • After Eighty Study