Abstract 4159: Changes in Modifiable Cardiovascular Risk Factors over 9 Years in Chinese Adults
China has undergone rapid economic development, paralleling a shift in mortality from infectious disease to cardiovascular disease (CVD). However, little is known regarding recent CVD risk factor changes. We evaluated changes in modifiable CVD risk factors over the 9-year period, 1991–1999, among a population-based sample of Chinese adults. Changes in blood pressure (BP), body weight, body mass index (BMI), cigarette use, alcohol intake, and hypertension prevalence, awareness, treatment, and control were calculated between baseline and follow-up among 6,145 Chinese men and 6,186 Chinese women aged ≥40 years at baseline. The percent of heavy drinkers decreased among most age groups in both genders, while the percentages of current smokers and overweight/obese individuals increased uniformly in all age groups among both genders. Men, compared to women, experienced greater 9-year increases in systolic BP (10.6 vs. 9.3 mm Hg, respectively), diastolic BP (4.2. vs. 2.4 mm Hg, respectively), and body weight (4.4 vs. 1.4 kg, respectively), (all p<0.001), and lesser decreases in number of alcoholic drinks per week (-0.8 vs. -15.1, respectively; p<0.001) after multivariable adjustment. Urban areas, compared to rural areas, experienced larger increases in systolic BP, body weight, and BMI, and greater decreases in alcohol intake after multivariable adjustment. North China, compared to South China, experienced greater increases in all risk factors, except systolic BP which increased more in South China. Among men, the frequency of hypertension increased 2-fold over the 9 years (16.8% to 35.9%), while the percentages of hypertensives aware of their diagnosis, receiving treatment, and with controlled BP dramatically decreased over the 9 year period (from 22.5% to 11.3% for awareness; 11.2% to 3.6% for treatment; and 1.7% to 0.4% for control). Results were similar for women. Over the 1990’s, adverse changes in modifiable risk factors were seen among Chinese adults, including large increases in cigarette smoking and decreases in awareness, treatment, and control of hypertension. With economic development continuing, these data underscore the urgent need for consistent CVD risk factor monitoring and aggressive prevention and treatment strategies in China.