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(Circulation. 2005;112:658-665.)
© 2005 American Heart Association, Inc.

Epidemiology

Prevalence of Cardiovascular Disease Risk Factor Clustering Among the Adult Population of China

Results From the International Collaborative Study of Cardiovascular Disease in Asia (InterAsia)

Dongfeng Gu, MD, MSc; Anjali Gupta, MPH; Paul Muntner, PhD, MHS; Shengshou Hu, MD; Xiufang Duan, MD; Jichun Chen, MS; Robert F. Reynolds, ScD; Paul K. Whelton, MD, MSc; Jiang He, MD, PhD

From the Cardiovascular Institute and Fu Wai Hospital (D.G., S.H., X.D., J.C.), Chinese Academy of Medical Sciences and Peking Union Medial College, Beijing, China; the Department of Epidemiology (A.G., P.M., P.K.W., J.H.), Tulane University School of Public Health and Tropical Medicine, and Department of Medicine (P.M., P.K.W., J.H.), Tulane University School of Medicine, New Orleans, La; and Global Epidemiology (R.F.R.), Pfizer Inc, New York, NY.

Correspondence to Paul Muntner, Department of Epidemiology Tulane University SPHTM, 1430 Tulane Ave, SL-18, New Orleans, LA 70112. E-mail pmuntner{at}tulane.edu

Received October 18, 2004; revision received April 9, 2005; accepted April 12, 2005.

Background— The prevalence of cardiovascular disease (CVD) risk factors has been increasing in China.

Methods and Results— We examined the prevalence of CVD risk factor clustering among Chinese adults aged 35 to 74 years with data from the International Collaborative Study of Cardiovascular Disease in Asia (InterAsia), a cross-sectional survey of a nationally representative sample (n=14 690) conducted during 2000 to 2001 and compared these data with those of US adults from the National Health and Nutrition Examination Survey of 1999 to 2000. Overall, 80.5%, 45.9%, and 17.2% of Chinese adults had 1, 2, and 3 modifiable CVD risk factors (dyslipidemia, hypertension, diabetes, cigarette smoking, and overweight), respectively. By comparison, 93.1%, 73.0%, and 35.9% of US adults had 1, 2, and 3 of these risk factors, respectively. In a multivariate model including age, sex, and area of residence, the odds ratio (95% confidence interval [CI]) of having 1, 2, and 3 CVD risk factors versus none of the studied risk factors was 2.61 (95% CI, 2.09 to 3.27), 3.55 (95% CI, 2.77 to 4.54), and 4.97 (95% CI, 3.67 to 6.74), respectively, for Chinese adults 65 to 74 years old versus 35 to 44 years old; 3.65 (95% CI, 3.21 to 4.15), 4.67 (95% CI, 4.06 to 5.38), and 5.60 (95% CI, 4.70 to 6.67), respectively, for men compared with women; 1.18 (95% CI, 1.07 to 1.30), 1.34 (95% CI, 1.21 to 1.50), and 1.84 (95% CI, 1.60 to 2.12), respectively, for urban compared with rural residents; and 1.98 (95% CI, 1.76 to 2.22), 2.75 (95% CI, 2.42 to 3.13), and 4.36 (95% CI, 3.68 to 5.18), respectively, for residents of northern compared with southern China.

Conclusions— Clustering of CVD risk factors is common in China. Prevention, detection, and treatment of CVD risk factor clustering should be an important component of a national strategy to reduce the increasing burden of CVD in China.

Key Words: diabetes mellitus • risk factors • hypertension • lipids • obesity

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