• Adults
• Alcohol consumption
• Cardiovascular risk
• Lipid profile
• Wine consumption

• Cardiovascular disease
• Risk factors
• Rural settings Ghana
• Sub-Saharan Africa

• Humans
• Ghana/epidemiology
• Cross-Sectional Studies
• Male
• Female
• Middle Aged
• Cardiovascular Diseases/epidemiology
• Cardiovascular Diseases/diagnosis
• Cardiovascular Diseases/prevention & control
• Adult
• Risk Assessment
• Heart Disease Risk Factors
• Rural Health
• Aged
• Health Knowledge, Attitudes, Practice
• Health Resources/economics
• Young Adult
• Risk Factors
• Risk Reduction Behavior
• Developing Countries/economics
• Prevalence

• Anthropogenic heat emissions
• Chinese adults
• dyslipidemia
• serum lipid

• electroencephalogram
• epilepsy
• post-stroke epilepsy
• seizures
• stroke

• National University of Malaysia

• Cardiac Epidemiology
• Cardiology
• Factor Analysis, Statistical

• Male
• Humans
• Female
• Aged
• Adult
• Middle Aged
• Young Adult
• Cohort Studies
• Overweight/complications
• Prospective Studies
• Multiomics
• Hypertension/epidemiology
• Hypertension/complications
• Cardiovascular Diseases/etiology
• Risk Factors
• Diabetes Mellitus
• Obesity/epidemiology
• Obesity/complications
• Hyperlipidemias/complications

• the National Key Research and Development Program of China
• the Key Research and Development Program of Hubei Province

• cardiovascular disease risk factors
• gender
• inflammatory biomarkers
• rheumatic diseases

• Humans
• Adult
• Male
• Female
• Cardiovascular Diseases
• Independent Living
• C-Reactive Protein/analysis
• Biomarkers
• Risk Factors

• Cardiovascular disease
• Descriptive study
• Epidemiology
• Indices of health and disease and standardisation of rates
• Public Health

• Adult
• Humans
• Aged
• Female
• Cardiovascular Diseases/epidemiology
• Longitudinal Studies
• Cross-Sectional Studies
• Social Class
• China/epidemiology

• Fundamental Research Funds for the Central Universities
• Key PLA logistics research projects

• 2017 ACC/AHA guideline
• blood pressure
• cardiometabolic multimorbidity
• stage 1 hypertension

• No. 2019B020227005 Key Area R&D Program of Guangdong Province
• DFJH2020022 Climbing Plan of Guangdong Provincial People's Hospital
• 2020B1111170011 Guangdong Provincial Clinical Research Center for Cardiovascular disease
• 20211124162510276 Guangdong Provincial Medical Science and Technology Research Fund Project

• adiposity indices
• obesity
• prehypertension

• Male
• Adult
• Humans
• Female
• Adiposity
• Cross-Sectional Studies
• Prehypertension/diagnosis
• Prehypertension/epidemiology
• Hypertension/diagnosis
• Hypertension/epidemiology
• East Asian People
• Obesity/complications
• Obesity/epidemiology
• Risk Factors
• Body Mass Index
• Waist Circumference
• Waist-Height Ratio
• China/epidemiology
• ROC Curve

• Cardiovascular diseases
• Nationality
• Risk factor

• cholecystectomy
• gallstone disease
• insulin resistance
• meta-analysis
• metabolic syndrome
• nonalcoholic fatty liver disease

• Humans
• Non-alcoholic Fatty Liver Disease/complications
• Non-alcoholic Fatty Liver Disease/epidemiology
• Metabolic Syndrome/complications
• Metabolic Syndrome/epidemiology
• Risk Factors
• Body Mass Index
• Gallstones/complications
• Gallstones/epidemiology
• Gallstones/surgery

• cardiology
• epidemiology
• geriatric medicine

• Aged
• Cardiovascular Diseases/etiology
• China/epidemiology
• Cluster Analysis
• Cross-Sectional Studies
• Hot Temperature
• Humans
• Independent Living
• Male
• Middle Aged
• Prevalence
• Risk Factors

• National Natural Science Foundation of China

Dyslipidemia is one of the major public health problems in China. It is characterized by multisystem dysregulation and inflammation, and oxidant/antioxidant balance has been suggested as an important factor for its initiation and progression. The objective of this study was to determine the relationship between prevalence of dyslipidemia and measured changes in the levels of proinflammatory cytokines (IL-6, TNF-a, and MCP-1), thiobarbituric acid-reactant substances (TBARS), and serum total antioxidant capacity (TAC) in serum samples.

A cross-sectional survey with a purposive sampling of 2,631 enrolled participants (age 18–85 years) was performed using the adult population of long-term residents of the municipality of east coast China in Fujian province between the years 2017 and 2019. Information on general health status, dyslipidemia prevalence, and selected mediators of inflammation was collected through a two-stage probability sampling design according to socioeconomic level, sex, and age.

The lipid profile was conducted by measuring the levels of total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), and triglycerides (TG) with an autoanalyzer. Dyslipidemia was defined according to National Cholesterol Education Program Adult Treatment Panel III diagnostic criteria, and patients with it were identified by means of a computerized database. Serum parameters including IL-6/TNF-a/MCP-1, TBARS, and TAC were measured in three consecutive years. Familial history, education level, risk factors, etc. were determined. The association between dyslipidemia and serum parameters was explored using multivariable logistic regression models. Sociodemographic, age, and risk factors were also investigated among all participants.

The mean prevalence of various dyslipidemia in the population at baseline (2017) was as follows: dyslipidemias, 28.50%; hypercholesterolemia, 26.33%; high LDL-C, 26.10%; low HDL-C, 24.44%; and hypertriglyceridemia, 27.77%. A significant effect of aging was found among all male and female participants. The mean levels of serum Il-6/TNF-a/MCP-1 were significantly higher in all the types of dyslipidemia among male participants. Female participants with all types of dyslipidemia but low HDL-C showed an elevation of IL-6 and MCP-1 levels, and those with dyslipidemias and hypercholesterolemia presented higher levels of TNF-a compared to the normal participants. The oxidative stress marker TBARS increased among all types of dyslipidemia except hypertriglyceridemia. All participants with different types of dyslipidemia had a lower total antioxidant capacity. Correlation analysis showed that cytokines and TBARS were positively associated with age, obesity, and diabetes mellitus, but not sex, sedentary leisure lifestyle, hypertension, and CVD/CHD history. The activity of TAC was negatively associated with the above parameters.

The correlation between the prevalence of dyslipidemia and the modification of inflammation status was statistically significant. The levels of proinflammatory cytokines, oxidative stress, and antioxidant capacity in serum may reflect the severity of the lipid abnormalities. These promising results further warrant a thorough medical screening in enhanced anti-inflammatory and reduced oxidative stress to better diagnose and comprehensively treat dyslipidemia at an early stage.

• Adolescent
• Adult
• Aged
• Aged, 80 and over
• Antioxidants
• China
• Cholesterol
• Cholesterol, LDL
• Cross-Sectional Studies
• Dyslipidemias
• Female
• Humans
• Hypercholesterolemia
• Hyperlipidemias
• Hypertriglyceridemia
• Inflammation
• Interleukin-6
• Male
• Middle Aged
• Thiobarbituric Acid Reactive Substances
• Young Adult

• Cardiometabolic risk factors
• Cardiovascular Disease
• China
• Review

• Cardiometabolic Risk Factors
• Cardiovascular Diseases/diagnosis
• Cardiovascular Diseases/epidemiology
• Cardiovascular Diseases/prevention & control
• China/epidemiology
• Humans
• Hypertension/epidemiology
• Obesity/complications
• Prevalence
• Risk Factors

• AF, atrial fibrillation
• Adult
• Atrial fibrillation
• BMI, body mass index
• CHD, coronary heart disease
• CHF, chronic heart failure
• CI, confidence interval
• China
• DM, diabetes mellitus
• ECG, electrocardiogram
• Factor
• HTN, hypertension
• OR, odds ratio
• Prevalence
• SD, standard deviation
• TIA, transient ischaemic attack

The majority of risk factors for cardiovascular diseases (CVDs) are modifiable. Continuous monitoring and control of these factors could significantly reduce the risk of CVDs-related morbidity and mortality. This study estimated the prevalence of modifiable risk factors in Indonesia and its co-occurence of multiple risk factors stratified by prior CVDs diagnosis status and sex.

Adult participants (> 15 years, N = 36,329, 57% women) with median age of 40 years were selected from a nationwide Indonesian cross-sectional study called Basic Health Research or Riset Kesehatan Dasar (Riskesdas) conducted in 2018. Thirteen risk factors were identified from the study, including smoking, a high-risk diet, inadequate fruit and vegetable consumption, a low physical activity level, the presence of mental-emotional disorders, obesity, a high waist circumference (WC), a high waist-to-height ratio (WtHR), hypertension, diabetes, a high total cholesterol level, a high low-density lipoprotein (LDL) cholesterol level, and a low high-density lipoprotein (HDL) cholesterol level. Age-adjusted prevalence ratios stratified by CVDs status and sex were calculated using Poisson regression with the robust covariance estimator.

CVDs were found in 3% of the study population. Risk factor prevalence in the overall population ranged from 5.7 to 96.5% for diabetes and inadequate fruit and vegetable consumption respectively. Smoking, a high-risk food diet, and a low HDL cholesterol level were more prevalent in men, whereas a low physical activity level, the presence of mental-emotional disorders, obesity, a high WC, a high WtHR, hypertension, diabetes, a high total cholesterol level, and a high LDL cholesterol level were more prevalent in women. Approximately 22% of men and 18% of women had at least 4 risk factors, and these proportions were higher in participants with prior CVDs diagnosis.

There is a high prevalence of modifiable risk factors in the Indonesian adult population. Sex, age, and the presence of CVD are major determinants of the variations in risk factors. The presence of multiple risk factors, which are often inter-related, requires a comprehensive approach through health promotion, lifestyle modification and patient education.

• Cardiovascular diseases
• Epidemiology
• Lifestyle
• Prevalence
• Prevention
• Risk factors

• EPIDEMIOLOGY
• PREVENTIVE MEDICINE
• PUBLIC HEALTH

• Adult
• Cardiovascular Diseases/epidemiology
• Cardiovascular Diseases/etiology
• Cross-Sectional Studies
• Ethiopia/epidemiology
• Humans
• Hypertension/complications
• Hypertension/epidemiology
• Male
• Middle Aged
• Risk Factors

• This work was supported by the South Ethiopia Network of Universities in Public Health (SENUPH); which in turn was funded by the Norwegian Program for Capacity Development in Higher Education and Research for Development (NORHED). Award/ grant number: N/A. The funders had no role in the study design, data collection, and analysis, decision to publish, or preparation of the manuscript.

To understand the association between cardiometabolic risk factor (CMRF) clustering and physical activity (PA) levels, we included 86520 Chinese adults aged 18–64 years having at least one CMRF (hypertension, diabetes, dyslipidemia, or obesity) from the China Chronic Disease and Nutrition Surveillance survey in 2015, a nationally and provincially representative investigation with a multistage clustering sampling design. Self-reported PA information was collected with the Global Physical Activity Questionnaire through face-to-face interviews. In view of the obesity epidemic in CMRF patients, PA energy expenditure (PAEE) per kilogram body weight was used, and was defined into four categories: (i) inactivity: 0 ​kJ/kg/day; (ii) low activity: 0–5 ​kJ/kg/day; (iii) moderate activity: 6–11 ​kJ/kg/day; and (iv) vigorous activity: ≥ 12 ​kJ/kg/day. The estimated weighted prevalence (95% confidence interval [CI]) of having 1, 2, 3, and 4 CMRFs was 60.57% (59.48%–61.67%), 28.10% (27.40%–28.79%), 9.82% (9.22%–15.42%) and 1.50% (1.37%–1.63%), respectively. The rate (95%CI) of inactivity, low activity, moderate activity, and vigorous activity was 34.52% (32.69%–36.35%), 22.22% (21.37%–23.37%), 15.98% (15.38%–16.58%) and 27.28% (26.02%–28.53%), respectively. For those having 2, 3 and 4 CMRFs (compared to those having 1 CMRF), the adjusted odds ratio (95%CI) for moderate activity and vigorous activity were 0.91 (0.85–0.98) and 0.92 (0.85–0.99), 0.87 (0.80–0.95) and 0.84 (0.77–0.92), and 0.77 (0.67–0.89) and 0.85 (0.72–1.00), respectively. In conclusion, CMRF clustering was a pandemic among Chinese adults in 2015 and was inversely associated with PA level. PAEE (in kJ/kg/day) may be introduced into PA management practice, especially for populations with high body weight.

This study aimed to develop a screening tool based on a risk scoring approach that could identify individuals at high risk for hypertension in Shanghai, China.

A total of 3147 respondents from the 2013 Shanghai Chronic Disease and Risk Factor Surveillance were randomly divided into the derivation group and validation group. The coefficients obtained from multivariable logistic regression were used to assign a score to each variable category. The receiver operating characteristic (ROC) curve was used to find the optimal cut-off point and to evaluate the screening performance.

Age, family history of hypertension, having diabetes, having dyslipidemia, body mass index, and having abdominal obesity contributed to the risk score. The area under the ROC curve was 0.817 (95% CI: 0.797–0.836). The optimal cut-off value of 20 had a sensitivity of 83.4%, and a specificity of 64.3%, demonstrating good performance.

We developed a simple and valid screening tool to identify individuals at risk for hypertension. Early detection could be beneficial for high-risk groups to better manage their conditions and delay the progression of hypertension and related complications.

• the National Natural Science Foundation of China
• he National Science &Technology Pillar Program during the Twelfth Five-year Plan Period
• the Major Project of the National Social Science Fund of China
• the Shanghai Foundation for Talents Development

• Disability
• Multiple health behaviors
• Self-rated health

• Body Mass Index
• Cluster Analysis
• Health Behavior
• Health Status
• Humans
• Life Style
• Male
• Middle Aged

In this study, we focus on the information available in WeChat official accounts about cardiovascular diseases (CVDs), which are a leading cause of death in China. We are particularly interested in information targeting the Chinese Hui minority people, who have a high prevalence of cardiovascular risk factors (CVRFs). Our exploratory research therefore investigates whether and how the articles on WeChat official accounts are targeted at the Hui people. We used a qualitative approach to analyze 108 articles. Two related themes emerged: descriptions of how to live a healthy life; and explanations of CVDs and CVRFs. Traditional Chinese medicine likewise surfaced from the analysis as a specific and unique theme in the Chinese social and cultural context. Despite the high prevalence of CVRFs among the Hui, none of the articles included information tailored to them.

• Chinese Hui ethnic minority people
• WeChat official accounts
• cardiovascular diseases
• health information
• qualitative content analysis
• traditional Chinese medicine

• insuficiência cardíaca
• pontuação de propensão
• mortalidade
• alta hospitalar
• epidemiologia

• Aftercare
• China/epidemiology
• Female
• Heart Failure
• Hospitalization
• Humans
• Patient Discharge
• Prognosis
• Risk Assessment
• Risk Factors
• United States

This study explored whether lipid disorders or an elevated atherogenic index of plasma (AIP, a risk factor for cardiovascular diseases) could predict major kidney function decline.

We conducted a retrospective 7-year cohort study of 3712 Chinese adults followed up between 2010 and 2017. Major kidney function decline was defined as a ≥ 30% reduction in the estimated glomerular filtration rate (eGFR) from baseline. Multivariable logistic regression models were used to evaluate the relationship between lipid profiles and major kidney function decline. Smoking habits, waist circumference, and physical activity were not assessed.

During the 7-year follow-up, 1.70% (n = 63) of the participants developed major kidney function decline. After adjustment for potential confounders, the odds ratios (ORs) for developing eGFR decline with per standard deviation increase were 1.23 [95% confidence interval (CI): 1.06–1.43] for triglyceride and 2.55 (95% CI: 1.01–6.42) for AIP in all participants. Furthermore, in the stratified analysis, we found sex-related differences; triglyceride and AIP were only independently associated with the risk of eGFR decline in men (OR, 1.27, 95% CI: 1.08–1.48; OR, 3.98, 95% CI: 1.22–12.99, respectively). When the participants were divided into groups according to the baseline lipid status, association was observed only between abnormal AIP and eGFR decline (all p values < 0.05).

Our findings suggest that a higher serum triglyceride level or an elevated AIP increases the risk of major kidney function decline in Chinese men with normal kidney function. Thus, assessment of AIP may help identify the risk of eGFR decline.

• Atherogenic index of plasma
• glomerular filtration rate
• risk factors
• triglyceride

This study aims to add to the knowledge about information depicted in television health programs in China. Cardiovascular diseases (CVDs) are the leading cause of death in the country. The threat it poses is particularly notable among the Hui ethnic minority people, who have a higher prevalence of cardiovascular risk factors. Little research has been conducted thus far on content concerning CVDs in Chinese television health programs, and this study aims to fill this lacuna. Qualitative content analysis was conducted to analyze The Doctor Is In and Health Body Light. The results revealed that these two programs presented information about what CVDs and CVRFs are, how the former are treated, and what strategies are used to communicate health information. A new topic also stood out: discussions on how traditional Chinese medicine prevents and cures these diseases.

• cardiovascular diseases
• entertainment strategies
• health information
• qualitative content analysis
• television health programs
• traditional Chinese medicine

• body mass index
• cardiovascular disease
• cigarette smoking
• diabetes
• hypertension
• modifiable risk factors
• occupation
• seafarers

• 1276/2018 ITF Trust

Effective management of dyslipidemia is important. This study aimed to determine the awareness, treatment, control, and determinants of dyslipidemia in middle-aged and older Chinese adults in China. Using data from the 2015 China National Stroke Screening and Prevention Project (CNSSPP), a nationally representative sample of 135,403 Chinese adults aged 40 years or more were included in this analysis. Dyslipidemia was defined by the Third Report of the National Cholesterol Education Program Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults final report (NCEP-ATP III) and the 2016 Chinese guidelines for the management of dyslipidemia in adults. Models were constructed to adjust for subjects’ characteristics with bivariate and multivariable logistic regression analyses. Overall, 51.1% of the subjects were women. Sixty-four percent were aware of their condition, of whom 18.9% received treatment, and of whom 7.2% had adequately controlled dyslipidemia. Dyslipidemia treatment was higher in men from rural areas than their urban counterparts. The multivariable logistic regression models revealed that women, urban residents, and general obesity were positively related to awareness. Women, married respondents, and current drinkers had higher odds of treatment. Age group, overweight, general obesity, urban residence, and women were independent determinants of control. Dyslipidemia awareness rate was moderately high, but treatment and control rates were low. Results can be used to develop policies and health promotion strategies with special focus on middle-aged and older adults.

Recent changes in population-based prevalence for circulatory system diseases (CSDs) remain unreported either nationally or locally for China. Data were from the two-round health service household interview survey of Hunan Province, China, in 2013 and 2018. A Rao–Scott chi-square test was performed to examine prevalence differences across socio-demographic variables. The overall age-standardized prevalence of CSDs increased substantially between 2013 and 2018 for inhabitants aged 20 years and older (14.25% vs. 21.25%; adjusted odds ratio (OR) = 1.59, 95% CI: 1.24–2.04). Hypertensive disease was the most prevalent type of CSD, accounting for 87.24% and 83.83% of all CSDs in 2013 and in 2018, respectively. After controlling for other socio-demographic factors, the prevalence of CSDs was significantly higher in 2018 (adjusted OR = 1.40), urban residents (adjusted OR = 1.43), females (adjusted OR = 1.12) and older age groups (adjusted OR = 5.36 for 50–59 years, 9.51 for 60–69 years, 15.19 for 70–79 years, and 12.90 for 80 years and older) than in 2013, rural residents, males and the youngest age group (20–49 years). The recent increase in the overall age-standardized CSD prevalence and the large prevalence disparities across urban/rural residents, sex and age groups merit the attention of policymakers and researchers. Further prevention efforts are needed to curb the increasing tendency and to reduce the prevalence of disparities across socio-demographic groups.

• China
• circulatory system disease
• household interview survey
• prevalence

• Adult
• Aged
• Cardiovascular System
• China/epidemiology
• Cross-Sectional Studies
• Female
• Humans
• Hypertension
• Male
• Prevalence
• Rural Population
• Urban Population
• Young Adult

• atherogenic index of plasma
• dyslipidaemia
• gerontology
• sex difference
• vitamin D

Commercial motor vehicle drivers (CMVDs) have worst health profiles among different occupations, yet the presence of clusters of cardiovascular disease (CVD) risk factors in this group have not been described in a resource-limited setting.

The prevalence of CVD risk factors and the clusters among CMVDs was evaluated.

A cross-sectional descriptive study.

Four motor parks in three local government areas of Ibadan city, Nigeria.

Consented and conveniently sampled 152 intra-city CMVDs aged ≥ 18 years.

Prevalence of CVD risk factors (hypertension, diabetes, high triglyceride, low HDLc, high waist-hip ratio, central obesity, physical inactivity, smoking, alcohol, and overweight/obesity) and their clusters were determined.

All participants were male from 20 – 77 years old. Most of the CMVDs were physically inactive (80, 52.6%), take alcohol (78, 51.3%), and few smokes (35, 12.4%). The prevalence of hypertension, diabetes, hypertriglyceridemia, obesity, and central obesity were 36.2%, 5.9%, 23.7%, 4.6%, and 5.3%, respectively. Four clusters of CVD risk factors in the CMVDs with the prevalence of 36.2%. 33.5%, 17.1% and 13.2% were identified with significant differences (p<0.05) in the risk factors.

The prevalence of diabetes, obesity, central obesity, and smoking was low while the prevalence of hypertension and hypertriglyceridemia was moderate among the CMVDs, but the prevalence of alcohol intake and physical inactivity were high. Four distinct clusters of CVD risk factors were observed among the drivers.

The study was self-funded.

• Cardiovascular diseases
• Commercial vehicle drivers
• Motor vehicles
• Nigeria
• Risk factors

Cardiovascular disease (CVD) accounts for approximately 30% of all deaths worldwide and its prevalence is constantly increasing despite advancements in medical treatments. Cardiac remodeling and dysfunction are independent risk factors for CVD. Recent studies have demonstrated that cardiac structure and function are genetically influenced, suggesting that understanding the genetic basis for cardiac structure and function could provide new insights into developing novel therapeutic targets for CVD. Regular exercise has long been considered a robust non-therapeutic method of treating or preventing CVD. However, recent studies also indicate that there is inter-individual variation in response to exercise. Nevertheless, the genetic basis for cardiac structure and function as well as their responses to exercise training have yet to be fully elucidated. Therefore, this review summarizes accumulated evidence supporting the genetic contribution to these traits, including findings from population-based studies and unbiased large genomic-scale studies in humans.

Atrial natriuretic peptide (ANP), one of the main members of the natriuretic peptides system, has been associated with hypertension and related complications, but the underlying molecular mechanisms are not very clear. Here, we aimed to examine whether DNA methylation, a molecular modification to the genome, of the natriuretic peptide A gene (NPPA), the coding gene of ANP, was associated with hypertension.

Peripheral blood DNA methylation of NPPA promoter was quantified by target bisulfite sequencing in 2498 community members (mean aged 53 years, 38% men) as a discovery sample and 1771 independent participants (mean aged 62 years, 54% men) as a replication sample. In both samples, we conducted a single CpG association analysis, followed by a gene-based association analysis, to examine the association between NPPA promoter methylation and hypertension, adjusting for age, sex, education level, cigarette smoking, alcohol consumption, obesity, fasting glucose, and lipids. Multiple testing was controlled by the false discovery rate approach.

Of the 9 CpG loci assayed, hypermethylation at 5 CpGs (CpG1, CpG3, CpG6, CpG8, and CpG9) was significantly associated with a lower odds of prevalent hypertension in the discovery sample, and one CpG methylation (CpG1 located at Chr1:11908353) was successfully replicated in the replication sample (OR = 0.82, 95%CI 0.74–0.91, q = 0.002) after adjusting for covariates and multiple testing. The gene-based analysis found that DNA methylation of the 9 CpGs at NPPA promoter as a whole was significantly associated with blood pressure and prevalent hypertension in both samples (all P < 0.05).

DNA methylation levels at NPPA promoter were decreased in Chinese adults with hypertension. Aberrant DNA methylation of the NPPA gene may participate in the mechanisms of hypertension.

• Atrial natriuretic peptide
• DNA methylation
• Hypertension

• clinical outcome
• dyslipidemia
• fixed-dose combination
• hypertension
• new-onset diabetes mellitus

• Cardiovascular diseases
• Cardiovascular risk factor
• Physical activity

Background: Cardiovascular disease (CVD) risk factors tend to cluster and progress from adolescence to young adulthood. Reliable and meaningful clustering of CVD risk factors is essential to circumvent loss of information. Tracking adverse and high-risk profiles of adolescents is hoped to curb CVD progression later in life. The study aims to investigate the clustering of biological CVD risk factor among adolescents in Malaysia and the transitions between clusters over time.

Method: The Malaysian Health and Adolescents Longitudinal Research Team study (MyHeARTs) examined school students aged 13 in 2012 and re-examined them in 2014 and 2016. In a two-stage stratified cluster sampling, 1,361 students were recruited, of which, 1,320 had complete data. In the follow-up, there were 881 and 637 students in 2014 and in 2016, respectively. Pearson's correlation coefficients were used to identify and remove highly correlated CVD risk factors. All risk factors were standardized into z-scores. The hierarchical and non-hierarchical (k-means) cluster analyses were used to classify students into high, medium and low risk clusters in each screening year. The tracking and stability of cluster transitions through cross-classification were enumerated with Pearson's inter-age correlations and percentages.

Results: Three significant clusters of high, medium and low risk groups were derived from the clustering of eight biological CVD risk factors. The transitions between risk clusters from one screening year to the other were categorized as either stagnant, improved or adverse. The number of students who had adverse transitions increased from 15.5% (13–15 year) to 19.5% (15–17 year), 13.8 to 18.2% among the girls and 19.9 to 22.8% among the boys. For girls, the number of them who remained at high risk over the two transition periods were about the same (13.6 vs. 13.8%) whereas for boys, the percentage reduced from 14.6 to 12.3%.

Conclusion: Over time, more than 12% of adolescents remained in the high risk cluster. There were sizable adverse transitions over time as more adolescents appear to be shifting toward an increased risk of having CVD. Collaborative and constant measures should be taken by parents, school, health promotion boards and policy makers to curb the multiplicative effect of clustering CVD risk factors among adolescents.

• adolescents
• cardiovascular diseases (CVD)
• clustering
• risk factors
• tracking

Background: Epidemiological studies about cardiovascular disease in rural areas of developing countries are rare. This study aimed to estimate the prevalence and influencing factors of coronary heart disease (CHD) and stroke in Chinese rural population.

Methods: 39,259 subjects (15,490 males) aged 18–79 years were enrolled from the Henan Rural Cohort Study. Age-standardized prevalence was calculated according to Chinese 6th Population Census. Associations between risk factors and diseases were estimated by the odds ratios and 95% confidence intervals with generalized linear mixed model.

Results: Among the participants, 1,734 with CHD and 2,642 with stroke were identified. Crude prevalence of CHD was 4.42%, and prevalence in male (4.01%) was significantly lower than female (4.68%). Corresponding age-standardized prevalence was 2.23% (2.05% for male and 2.37% for female). Crude prevalence of stroke was 6.73%, and in male (7.92%) was higher than female (5.95%). Age-standardized prevalence was 2.98% (3.42% for male and 2.69% for female). The results identified that old age, female, smoking, obesity, hypertension, diabetes, and dyslipidemia were positively associated with CHD. Being Female and a higher level of physical activity were negatively related to stroke, while old age, high-risk drinking, and chronic disease were positively related to stroke.

Conclusion: CHD and stroke were not rare in Chinese rural area. Healthy lifestyles and control of chronic disease should be improved to curb the epidemic of cardiovascular disease among rural population.

Clinical Trial Registration: The Henan Rural Cohort Study has been registered at Chinese Clinical Trial Register (Registration number: ChiCTR-OOC-15006699). http://www.chictr.org.cn/showproj.aspx?proj=11375.

• coronary heart disease
• influencing factors
• prevalence
• rural population
• stroke

Dyslipidemia is a modifiable risk factor for cardiovascular disease (CVD). We investigated the prevalence and associated risk factors of dyslipidemia- raised total cholesterol (TC), raised triglycerides (TG), raised low-density lipoprotein (LDL-C), low high-density lipoprotein (HDL-C), and raised non-high-density lipoprotein (non-HDL-C) in rural and urban China.

We analyzed data from 136,945 participants aged 40–100 years of the CNSSPP project for 2014. Dyslipidemia was defined by the NCEP-ATP III and the 2016 Chinese guidelines for the management of dyslipidemia in adults. Complete data on demographic, metabolic and lifestyle characteristics were used. Chi-square tests and multivariable logistic regression were used to obtain age- and sex-adjusted prevalence and risk factors for dyslipidemia among participants.

A total of 53.1% participants lived in rural areas. The prevalence of dyslipidemia was similar among rural and urban participants (43.2% vs. 43.3%). Regarding the components of dyslipidemia: urban compared with rural participants had a higher prevalence of low HDL-C (20.8% vs. 19.2%), whereas the prevalence of raised LDL-C (7.8% vs. 8.3%), raised TC (10.9% vs.11.8%) and raised non-HDL-C (10.0% vs. 10.9%) were lower in urban residents, (all p < 0.001). Women were more likely to have raised TC than men (adjusted OR [AOR] =1.83, 95% confidence interval [CI]:1.75–1.91), raised LDL-C (AOR = 1.55, 95% CI: 1.47–1.63) and high non-HDL-C (AOR = 1.52 95% CI: 1.45–1.59) (all p < 0.001). Compared with rural, urban participants had higher odds of dyslipidemia: low HDL-C (AOR = 1.04, 95% CI: 1.01–1.07), and raised TG (AOR = 1.06, 95% CI: 1.04–1.09). Hypertension and current drinker were less likely to get low HDL-C with AOR 0.93 (95% CI: 0.90–0.96) and AOR 0.73 (95% CI: 0.70–75), respectively. Overweight, obesity, central obesity and diabetes had higher odds of all dyslipidemias (p < 0.001).

Low HDL-C was higher in urban areas, whereas the remaining dyslipidemia types were more common in rural areas. Dyslipidemia was more common in women in both areas of residence. Overweight, obesity, central obesity and diabetes were associated with dyslipidemias. The need to intensify intervention programs to manage dyslipidemia and risk factors should be prioritized.

• Dyslipidemia
• Prevalence
• Risk factors
• Rural
• Urban

• Burden of disease
• Cause of death
• Health disparities
• Morbidity and mortality trends
• Non-communicable diseases