Age-specific modifiable risk factor profiles for cardiovascular disease and all-cause mortality: a nationwide, population-based, prospective cohort study.

Tiange Wang,Zhen Ye,Zhengnan Gao,Yu Xu,Qiang Li,Zhiyun Zhao,Yinfei Zhang,Xulei Tang,Yingfen Qin,Youmin Wang,Li Yan,Yufang Bi,Tao Yang,Gang Chen,Qin Wan,Shengli Wu,Zuojie Luo,Yanan Huo,Tianshu Zeng,Lulu Chen,Min Xu,Li Chen,Guixia Wang,Jieli Lu,Qing Su,Feixia Shen,Ruying Hu,Lixin Shi,Weiqing Wang,Yuhong Chen,Jiajun Zhao,Yiming Mu,Shuangyuan Wang,Xuefeng Yu,Chao Liu,Guijun Qin,Guang Ning,Mian Li,Yawei Xu ,Hongkui Deng

doi:10.1016/j.lanwpc.2021.100277

Abstract

SummaryBackgroundNational investigations on age-specific modifiable risk factor profiles for cardiovascular disease (CVD) and mortality are scarce in China, the country that is experiencing a huge cardiometabolic burden exacerbated by population ageing.MethodsThis is a nationwide prospective cohort study of 193,846 adults in the China Cardiometabolic Disease and Cancer Cohort Study, 2011-2016. Among 139,925 participants free from CVD at baseline, we examined hazard ratios and population-attributable risk percentages (PAR%s) for CVD and all-cause mortality attributable to 12 modifiable socioeconomic, psychosocial, lifestyle, and metabolic risk factors by four age groups (40-<55 years, 55-<65 years, 65-<75 years, and ≥75 years).FindingsMetabolic risk factors accounted for 52·4%, 47·2%, and 37·8% of the PAR% for CVD events in participants aged 40-<55 years, 55-<65 years, and 65-<75 years, respectively, with hypertension being the largest risk factor. While in participants aged ≥75 years, lifestyle risk factors contributed to 34·0% of the PAR% for CVD, with inappropriate sleep duration being the predominant risk factor. Most deaths were attributed to metabolic risk factors (PAR% 25·3%) and lifestyle risk factors (PAR% 24·6%) in participants aged 40-<55 years, with unhealthy diet and diabetes being the main risk factors. While in participants aged ≥55 years, most deaths were attributed to lifestyle risk factors (PAR% 26·6%-41·0%) and socioeconomic and psychosocial risk factors (PAR% 26·1%-27·7%). In participants aged ≥75 years, lifestyle risk factors accounted for 41·0% of the PAR% for mortality, with inappropriate sleep duration being the leading risk factor.InterpretationWe identified age-specific modifiable risk profiles for CVD and all-cause mortality in Chinese adults, with remarkable differences between adults aged ≥75 years and their younger counterparts.FundingNational Natural Science Foundation of China.

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