Cardiovascular and Cognitive Health Study in Middle-Aged and Elderly Residents of Beijing(CCHS-Beijing): Design and Rationale

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Abstract

The Cardiovascular and Cognitive Health Study (CCHS-Beijing) is a population-based study of cardiovascular disease (CVD) and cognitive impairment in adults aged 55 and older in Beijing. The main aims of the study are to investigate the prevalence rates of CVD, asymptomatic atherosclerosis, and cognitive impairment, as well as validate the risk factors related to the onset and development of CVD, Alzheimer's disease (AD) and mild cognitive impairment (MCI). The study was designed to detect the traditional and new risk factors in this age group. Participants were recruited randomly from residential regions in the greater Beijing municipality area based on the average levels of development in Beijing, China in 2012 (based on socioeconomic, demographic, and geographical characteristics). Thorough physical and laboratory examination were performed at baseline (also the cross-sectional survey) to identify the risk factors such as hypertension, dyslipidemia, diabetes, as well as newly defined risk factors like elevated homocysteine, high sensitivity C-reactive protein, and urine micro-albumin. Subclinical disease of the cerebral vasculature included atherosclerosis of carotid arteries, intracranial arteries, and retinal vessels. Subclinical cardiac diseases included left ventricular enlargement, arrhythmias, chamber hypertrophy and myocardial ischemia. Blood pressure was documented using the ankle-arm method. In addition, neuropsychological assessments were performed for all subjects aged 65 and above. Baseline evaluation began during the period August 2013 to December 2014. Follow-up examination will occur in 5 years. The initial and recurrent CVD, AD and MCI events will be verified and validated during the follow-up period.

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Prevalence, Awareness, Treatment, and Control of Hypertension in China

Dongfeng Gu, Kristi Reynolds, Xigui Wu … (2002)

The objective of this study was to estimate the prevalence and distribution of hypertension and to determine the status of hypertension awareness, treatment, and control in the general adult population in China. The International Collaborative Study of Cardiovascular Disease in ASIA (InterASIA), conducted in 2000-2001, used a multistage cluster sampling method to select a nationally representative sample. A total of 15 540 adults, age 35 to 74 years, were examined. Three blood pressure measurements were obtained by trained observers by use of a standardized mercury sphygmomanometer after a 5-minute sitting rest. Information on history of hypertension and use of antihypertensive medications was obtained by use of a standard questionnaire. Hypertension was defined as a mean systolic blood pressure > or =140 mm Hg, diastolic blood pressure > or =90 mm Hg, and/or use of antihypertensive medications. Overall, 27.2% of the Chinese adult population age 35 to 74 years, representing 129 824 000 persons, had hypertension. The age-specific prevalence of hypertension was 17.4%, 28.2%, 40.7%, and 47.3% in men and 10.7%, 26.8%, 38.9%, and 50.2% in women age 35 to 44 years, 45 to 54 years, 55 to 64 years, and 65 to 74 years, respectively. Among hypertensive patients, only 44.7% were aware of their high blood pressure, 28.2% were taking antihypertensive medication, and 8.1% achieved blood pressure control (<140/90 mm Hg). Our results indicate that hypertension is highly prevalent in China. The percentages of those with hypertension who are aware, treated, and controlled are unacceptably low. These results underscore the urgent need to develop national strategies to improve prevention, detection, and treatment of hypertension in China.

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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).

Anjali Gupta, Shengshou Hu, Jiao-Jiang He … (2005)

The prevalence of cardiovascular disease (CVD) risk factors has been increasing in China. 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 > or =1, > or =2, and > or =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 > or =1, > or =2, and > or =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 > or =1, > or =2, and > or =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. 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.

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Prevalence of the metabolic syndrome and its relation to cardiovascular disease in an elderly Chinese population.

Kang Feng, Qing Chang, Yao-Hua He … (2006)

This study sought to assess the prevalence of the metabolic syndrome (MetS) and its association with cardiovascular disease (CVD) in elderly Chinese people. The information available about the prevalence of MetS based on the National Cholesterol Education Program (NCEP) and the International Diabetes Federation (IDF) in China is limited. We conducted a population-based cross-sectional study in an urban Beijing sample of 2,334 participants age 60 to 95 years (943 men, 1,391 women). The CVD included diagnosed coronary heart disease (CHD), stroke, and peripheral arterial disease (PAD). The prevalence of MetS by the NCEP criteria was 30.5% (17.6% in men, 39.2% in women). Use of the new IDF definition significantly increased the prevalence to 46.3% (34.8% in men, 54.1% in women). Odds ratios (OR) for CHD, stroke, PAD, and CVD in those with MetS using the NCEP criteria were 1.43 (95% confidence interval [CI] 1.18 to 1.74), 1.45 (95% CI 1.14 to 1.85), 1.47 (95% CI 1.18 to 1.84), and 1.50 (95% CI 1.25 to 1.81), respectively. Corresponding ORs using new IDF criteria were 1.69 (95% CI 1.40 to 2.02), 1.58 (95% CI 1.26 to 2.00), 1.42 (95% CI 1.14 to 1.76), and 1.73 (95% CI 1.46 to 2.07), respectively. Those who met the IDF but not the NCEP criteria (n = 436, 18.7%) had significantly elevated ORs for CHD (1.66, 95% CI 1.31 to 2.10) and stroke (1.53, 95% CI 1.13 to 2.06). The MetS is highly prevalent in elderly people in Beijing, particularly among women. Individuals with MetS defined by either criteria are at significantly elevated ORs for CHD, stroke, and PAD. The IDF criteria seem to be better suited than the NCEP criteria for screening and estimating risk of MetS in Chinese people.

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Author and article information

Journal

Journal ID (publisher-id): NED

Journal ID (nlm-ta): Neuroepidemiology

Journal ID (doi): 10.1159/issn.0251-5350

Title: Neuroepidemiology

Abbreviated Title: Neuroepidemiology

Publisher: S. Karger AG (Basel, Switzerland karger@ 123456karger.com http://www.karger.com )

ISSN (Print): 0251-5350

ISSN (Electronic): 1423-0208

Publication date (Print): April 2016

Publication date (Electronic): 09 February 2016

Volume: 46

Issue: 3

Pages: 182-190

Affiliations

^aEvidence-Based Medical Center, ^bCentral Laboratory, Departments of ^cNeurology, ^dVascular Ultrasound, ^eNeurobiology, ^fOphthalmology, Xuanwu Hospital, Capital Medical University, and ^gDepartment of Echocardiography, Beijing Anzhen Hospital, ^hDepartment of Gerontology, Fuxing Hospital, Capital Medical University, and ⁱBeijing Geriatric Medical Research Center, ^jKey Laboratory of Neurodegenerative Diseases, Ministry of Education, ^kBeijing Municipal Key Laboratory of Clinical Epidemiology, ^lState Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Disease, Chinese Academy of Medical Science, and Peking Union Medical College, ^mDepartment of Neurology, Beijing Tsinghua Changgung Hospital Medical Center, Tsinghua University, Beijing, China

Article

Publisher ID: NED2016046003182 Other ID: Neuroepidemiology 2016;46:182-190

DOI: 10.1159/000443707

PubMed ID: 26854473

SO-VID: 6d2fd43f-ef8b-46ec-bb1b-59623765d79d

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Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher or, in the case of photocopying, direct payment of a specified fee to the Copyright Clearance Center. Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug. Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.

History

Date received : 09 August 2015

Date accepted : 30 December 2015

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Figures: 1, References: 45, Pages: 9

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Cardiovascular and Cognitive Health Study in Middle-Aged and Elderly Residents of Beijing(CCHS-Beijing): Design and Rationale

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Karger: Neurology and Neuroscience

Most cited references 20

Prevalence, Awareness, Treatment, and Control of Hypertension in China

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).

Prevalence of the metabolic syndrome and its relation to cardiovascular disease in an elderly Chinese population.

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