Prevalence and Clustering of Cardiovascular Disease Risk Factors among Tibetan Adults in China: A Population-Based Study.

Shaopeng Xu,Hong Zhu,Zepei Jiayong,Xianjia Ning,Zhengxuan Gao,Jinghua Wang,Bin Li,Wei Shi,Hong Chang,Rachel A Nugent

doi:10.1371/journal.pone.0129966

Abstract

ObjectivesThe prevalence of cardiovascular disease risk factors has increased worldwide. However, the prevalence and clustering of cardiovascular disease risk factors among Tibetans is currently unknown. We aimed to explore the prevalence and clustering of cardiovascular disease risk factors among Tibetan adults in China.MethodsIn 2011, 1659 Tibetan adults (aged ≥18 years) from Changdu, China were recruited to this cross-section study. The questionnaire, physical examinations and laboratory testing were completed and the prevalence of cardiovascular disease risk factors, including hypertension, diabetes, overweight/obesity, dyslipidemia, and current smoking, were counted. The association between the clustering of cardiovascular disease risk factors and demographic characteristics, and geographic altitude were assessed.ResultsThe age-standardized prevalence of hypertension, diabetes, overweight or obesity, dyslipidemia, and current smoking were 62.4%, 6.4%, 34.3%, 42.7%, and 6.1%, respectively, and these risk factors were associated with age, gender, education level, yearly family income, altitude, occupation, and butter tea consumption (P < 0.05). Overall, the age-adjusted prevalence of clustering of ≥1, ≥2, and ≥3 cardiovascular disease risk factors were 79.4%, 47.1%, and 20.9%, respectively. There appeared higher clustering of ≥2 and ≥3 cardiovascular disease risk factors among Tibetans with higher education level and family income yearly, and those living at an altitude < 3500 m and in a township.ConclusionsThe prevalence of cardiovascular disease risk factors, especially hypertension, was high in Tibetans. Moreover, there was an increased clustering of cardiovascular disease risk factors among those with higher socioeconomic status, lamas and those living at an altitude < 3500 m. These findings suggest that without the immediate implementation of an efficient policy to control these risk factors, cardiovascular disease will eventually become a major disease burden among Tibetans.

Highlights

Cardiovascular disease (CVD) is a leading cause of death in both developed and developing countries worldwide
There appeared higher clustering of 2 and 3 cardiovascular disease risk factors among Tibetans with higher education level and family income yearly, and those living at an altitude < 3500 m and in a township
There was an increased clustering of cardiovascular disease risk factors among those with higher socioeconomic status, lamas and those living at an altitude < 3500 m

Summary

Introduction

Cardiovascular disease (CVD) is a leading cause of death in both developed and developing countries worldwide. The economic burden of coronary heart disease and stroke in 2009 were estimated to be $234 billion in the United States alone [1]. Statistics from 2010 indicate that CVD is the leading cause of death in China; CVD accounted for nearly 42% of all deaths in 2010. In China, the economic burden of CVD is estimated to be $550 billion from 2005 to 2015[5]. The epidemiologic transition of CVD coincides with the increased prevalence of CVD risk factors, resulting from rapid economic development and lifestyle changes. Several studies have indicated that the prevalence of CVD risk factors have increased in China over past decades [6,7,8]. Most studies of CVD risk factors have been performed in urban Han populations [9,10,11], the epidemiology of CVD in minority ethnic populations is lacking

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Conclusion