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      Distribution of High-Sensitivity C-Reactive Protein and Its Relationship with Other Cardiovascular Risk Factors in the Middle-Aged Chinese Population

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          Abstract

          Background: An increased concentration of high-sensitivity C-reactive protein (hs-CRP) indicates risk for cardiovascular disease (CVD). Because the available data is limited, a cross-sectional survey was conducted in 2009–2010 to describe hs-CRP distribution and its relationship with established CVD risk factors. Methods: A population-based sample of adults aged 35 to 64 years ( n = 14,046) was taken from 12 research populations across China. Demographic and clinical characteristics were recorded, and hs-CRP measured. Pearson’s and Kendall’s tau-b correlation coefficient, and multiple regression analyses were used to test the relationship between hs-CRP and other CVD risk factors. Results: For 8389 (4412 females) eligible participants, hs-CRP was 1.89 ± 4.37 mg/L (median (25th, 75th): 0.80 (0.40, 1.80)), and increased with age, BP, glucose, and BMI ( p < 0.05), males had significantly higher hs-CRP than females (2.07 (4.89) vs. 1.73 (3.83), p < 0.001). About 24.3% had the hs-CRP concentrations more than the top quartile (25.8% in males, 22.9% in females), 12.3% (13.3% in males, 11.5% in females) >3 mg/L. There was a significant positive correlation of quartiles of hs-CRP concentrations with age, SBP, DBP, glucose level, BMI, LDL-C/HDL-C ratio, and LDL-C/total cholesterol ratio ( p < 0.001). The elevated hs-CRP (>1.80 mg/L) related positively with age, LDL-C, BP, glucose, BMI, and living north and negatively with HDL-C/TC, LDL-C/TC, TC independently ( p < 0.05). For subjects with coexisting hypertension, diabetes, high cholesterol, and obesity, about 63.0% were in the top quartile of hs-CRP concentrations. Conclusions: Hs-CRP was associated with most of the known CVD risk factors. Measurement of hs-CRP may provide a more comprehensive view of the patient’s overall risk profile in the Chinese population.

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          2010 ACCF/AHA guideline for assessment of cardiovascular risk in asymptomatic adults: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines.

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            Race and gender differences in C-reactive protein levels.

            This study sought to determine whether there are race and gender differences in the distribution of C-reactive protein (CRP) levels. Few data are available comparing CRP distributions in different race and gender groups. Recent clinical practice recommendations for CRP testing for cardiovascular risk assessment suggest a uniform threshold to define high relative risk (>3 mg/l). We measured CRP in 2,749 white and black subjects ages 30 to 65 participating in the Dallas Heart Study, a multiethnic, population-based, probability sample, and compared levels of CRP between different race and gender groups. Black subjects had higher CRP levels than white subjects (median, 3.0 vs. 2.3 mg/l; p 3 mg/l was 31%, 40%, 51%, and 58% in white men, black men, white women, and black women, respectively (p 3 mg/l remained more common in white women (odds ratio [OR] 1.6; 95% confidence interval [CI] 1.1 to 2.5) and black women (OR 1.7; 95% CI 1.2 to 2.6) but not in black men (OR, 1.3; 95% CI, 0.8 to 1.9) when compared with white men. Significant race and gender differences exist in the population distribution of CRP. Further research is needed to determine whether race and gender differences in CRP levels contribute to differences in cardiovascular outcomes, and whether thresholds for cardiovascular risk assessment should be adjusted for different race and gender groups.
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              Prevalence of ideal cardiovascular health and its relationship with the 4-year cardiovascular events in a northern Chinese industrial city.

              The American Heart Association Committee recently developed definitions of "ideal," "intermediate," and "poor" cardiovascular health based on 7 cardiovascular disease (CVD) risk factors or health behaviors. This study evaluated the prevalence of "ideal" American Heart Association cardiovascular health metrics from June 2006 to October 2007 in the Kailuan cohort (n=101 510; age 18-98 years) in northern China and its relationship with the 4-year CVD incidence. We used Cox proportional hazards regression to calculate hazard ratios and 95% confidence intervals for baseline health behaviors and risk factor categories. The majority of participants (63,676; 69.45%) presented with ≤3 ideal cardiovascular health metrics, whereas 8342 participants (9.1%) had 5 to 7 ideal metrics. Only 93 of 91,698 participants (0.1%) had all 7 metrics in the ideal range. There was a strong relationship between the cumulative incidence of CVD events in the 4-year follow-up and the number of ideal health metrics at baseline; the 1111 participants with 6 and 7 ideal metrics had a significantly lower cumulative incidence of CVD than subjects with no or only 1 ideal health metric (0.8% versus 3.3%). Men had higher rates of CVD events than women (2.46% versus 1.18%). Few adults had ideal cardiovascular health according to the modified American Heart Association definition. We detected a strong inverse relationship between the cumulative CVD incidence and the number of ideal health metrics at baseline. Population-wide prevention, especially lifestyle improvement, is critical to increase the low-risk prevalence and thereafter decrease CVD events. Clinical Trial Registration- URL: http://www.chictr.org/cn/proj/show.aspx?proj=1441. Unique identifier: ChiCTR-TNC-11001489.
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                Author and article information

                Contributors
                Role: Academic Editor
                Journal
                Int J Environ Res Public Health
                Int J Environ Res Public Health
                ijerph
                International Journal of Environmental Research and Public Health
                MDPI
                1661-7827
                1660-4601
                31 August 2016
                September 2016
                : 13
                : 9
                : 872
                Affiliations
                Division of Prevention and Community Health, National Center for Cardiovascular Disease, Fuwai Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences, No. 167, Beilishi Road, Xicheng District, Beijing 100037, China; wangxinfw@ 123456163.com (X.W.); chenzuo007@ 123456sina.com (Z.C.); lf_zh@ 123456sina.com (L.Z.); manluzhu@ 123456126.com (M.Z.)
                Author notes
                [* ]Correspondence: wang.zengwu@ 123456nccd.org.cn ; Tel.: +86-10-6086-6161
                Article
                ijerph-13-00872
                10.3390/ijerph13090872
                5036705
                27589783
                08f940fb-484b-4311-86c4-92f80d5d1619
                © 2016 by the authors; licensee MDPI, Basel, Switzerland.

                This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC-BY) license ( http://creativecommons.org/licenses/by/4.0/).

                History
                : 11 June 2016
                : 26 August 2016
                Categories
                Article

                Public health
                high-sensitivity c-reactive protein,cardiovascular disease,risk factor,blood pressure

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