Background
Methods
Study population
Incident CVD ascertainment
Risk factors assessment
Biomarker measurements
Statistical analysis
Results
Baseline characteristics
Characteristics | No. (%) | Noncases (n = 90,197) | |||
---|---|---|---|---|---|
Incidence CVD | |||||
At age < 55 y (n = 1241) | At 55 to < 65 y (n = 2693) | At 65 to < 75 y (n = 2273) | At age ≥ 75 y (n = 1380) | ||
Clinical risk factors | |||||
Age, y | 44.29 ± 5.56 | 53.37 ± 4.20 | 62.50 ± 4.95 | 72.66 ± 5.51 | 50.96 ± 12.59 |
Men, n (%) | 1097 (88.40) | 2399 (89.08) | 2028 (89.22) | 1246 (90.29) | 71,048 (78.77) |
High school or above, n (%) | 55 (4.49) | 66 (2.54) | 56 (2.62) | 36 (3.06) | 6389 (7.371) |
Income > 800 yuan/month, n (%) | 143 (11.69) | 296 (11.44) | 254 (11.92) | 191 (16.26) | 12,427 (14.34) |
Current smoker, n (%) | 570 (46.68) | 1112 (42.92) | 767 (35.62) | 302 (24.34) | 29,577 (33.85) |
Current drinker, n (%) | 546 (44.64) | 1000 (38.60) | 730 (33.97) | 354 (28.55) | 32,760 (37.48) |
Physical inactivity, n (%) | 133 (10.88) | 229 (8.88) | 111 (5.23) | 53 (4.51) | 7631 (8.82) |
Hypertension, n (%) | 720 (58.02) | 1734 (64.39) | 1556 (68.46) | 946 (68.55) | 36,969 (40.99) |
Diabetes, n (%) | 175 (14.10) | 486 (18.05) | 434 (19.09) | 209 (15.14) | 7438 (8.25) |
Dyslipidemia, n (%) | 557 (44.88) | 1183 (43.93) | 980 (43.11) | 513 (37.17) | 31,145 (34.53) |
Metabolism syndrome, n (%) | 249 (20.06) | 642 (23.84) | 583 (25.65) | 316 (22.90) | 11,967 (13.27) |
Body mass index, kg/m.2 | 26.18 ± 3.61 | 25.91 ± 3.46 | 25.54 ± 3.37 | 25.12 ± 3.42 | 24.96 ± 3.49 |
Overweight or obese, n (%) | 748 (60.27) | 1562 (58.00) | 1224 (53.85) | 675 (48.91) | 42,098 (46.67) |
Systolic blood pressure, mm Hg | 138.26 ± 23.68 | 141.36 ± 22.75 | 144.56 ± 22.96 | 144.45 ± 21.27 | 129.64 ± 20.41 |
Diastolic blood pressure, mm Hg | 90.05 ± 14.57 | 89.71 ± 13.18 | 88.00 ± 11.95 | 84.04 ± 10.73 | 82.96 ± 11.58 |
Lipids profile | |||||
Total cholesterol, mmol/L | 5.21 ± 1.15 | 5.12 ± 1.18 | 5.11 ± 1.22 | 5.02 ± 1.20 | 4.93 ± 1.14 |
Triglycerides, mmol/L | 2.05 ± 1.62 | 1.97 ± 1.58 | 1.81 ± 1.45 | 1.63 ± 1.21 | 1.66 ± 1.36 |
LDL cholesterol, mmol/L | 2.44 ± 0.93 | 2.40 ± 0.94 | 2.39 ± 1.14 | 2.33 ± 1.08 | 2.34 ± 0.90 |
HDL cholesterol, mmol/L | 1.54 ± 0.40 | 1.55 ± 0.41 | 1.57 ± 0.44 | 1.59 ± 0.49 | 1.55 ± 0.40 |
Total/HDL cholesterol | 3.58 ± 1.37 | 3.48 ± 1.12 | 3.48 ± 1.55 | 3.39 ± 1.47 | 3.39 ± 3.26 |
Triglyceride/HDL cholesterol | 1.44 ± 1.37 | 1.36 ± 1.18 | 1.28 ± 1.48 | 1.13 ± 1.17 | 1.17 ± 2.26 |
Non-HDL-C, mmol/L | 3.67 ± 1.10 | 3.56 ± 1.17 | 3.53 ± 1.21 | 3.42 ± 1.21 | 3.38 ± 1.11 |
Remnant cholesterol, mmol/L | 1.23 ± 1.15 | 1.16 ± 1.25 | 1.14 ± 1.32 | 1.10 ± 1.36 | 1.04 ± 1.15 |
Metabolic and Inflammatory | |||||
Fasting blood glucose, mmol/L | 5.86 ± 2.17 | 6.04 ± 2.29 | 5.92 ± 2.18 | 5.69 ± 1.99 | 5.43 ± 1.61 |
Triglyceride-glucose index | 8.90 ± 0.75 | 8.90 ± 0.73 | 8.81 ± 0.71 | 8.69 ± 0.68 | 8.64 ± 0.69 |
eGFR, ml/min/1.73/m.2 | 86.25 ± 21.83 | 80.9 ± 23.98 | 76.6 ± 27.72 | 71.43 ± 40.79 | 82.56 ± 25.47 |
Creatinine, μmol/L | 94.50 ± 41.98 | 94.74 ± 40.29 | 93.55 ± 33.05 | 95.49 ± 35.58 | 91.56 ± 29.85 |
Serum uric acid, μmol/L | 301.01 ± 88.77 | 295.31 ± 84.63 | 306.58 ± 89.47 | 314.79 ± 94.12 | 287.85 ± 83.18 |
Hs-CRP, mg/L | 2.49 ± 5.32 | 2.66 ± 4.60 | 3.29 ± 7.05 | 3.94 ± 8.60 | 2.33 ± 6.48 |
White blood cell count, *109/L | 7.20 ± 1.98 | 7.04 ± 2.77 | 7.10 ± 13.09 | 6.50 ± 2.13 | 6.83 ± 9.86 |
Neutrophil count, *109/L | 4.34 ± 1.50 | 4.18 ± 1.71 | 4.13 ± 2.36 | 3.91 ± 1.29 | 3.97 ± 2.91 |
Platelet, *109/L | 219.23 ± 82.37 | 205.74 ± 56.82 | 198.56 ± 79.37 | 189.93 ± 78.41 | 211.22 ± 746.16 |
Red blood cell count, *109/L | 4.96 ± 0.50 | 4.89 ± 0.48 | 5.37 ± 16.04 | 4.67 ± 0.48 | 5.05 ± 26.46 |
Clinical risk factors
Incident CVD, adjusted sHR (95%CI) | P for interaction | ||||
---|---|---|---|---|---|
At age < 55 y | At age 55 to 65 y | At age 65 to 75 y | At age ≥ 75 y | ||
Clinical risk factors | |||||
Current smoker | 1.49(1.33–1.67) | 1.28(1.18–1.38) | 1.15(1.05–1.25) | 1.08(0.91–1.29) | 0.0006 |
Current drinker | 0.82(0.73–0.92) | 0.74(0.68–0.80) | 0.82(0.75–0.90) | 0.85(0.75–0.96) | 0.8373 |
Physical inactivity | 1.21(1.05–1.38) | 1.12(0.97–1.31) | 1.14(0.99–1.31) | 1.12(1.00–1.28) | 0.0844 |
Hypertension | 3.77(3.34–4.25) | 2.61(2.41–2.82) | 2.27(2.08–2.48) | 1.59(1.43–1.78) | < 0.0001 |
Diabetes | 4.08(3.47–4.80) | 2.35(2.13–2.59) | 2.08(1.87–2.31) | 1.36(1.18–1.58) | < 0.0001 |
Dyslipidemia | 1.62(1.45–1.82) | 1.35(1.25–1.46) | 1.25(1.15–1.35) | 1.12(1.01–1.25) | < 0.0001 |
Metabolism syndrome | 3.38(2.94–3.88) | 2.22(2.03–2.42) | 1.77(1.61–1.94) | 1.40(1.24–1.58) | < 0.0001 |
BMI, per SD increment | 1.30(1.25–1.36) | 1.24(1.20–1.29) | 1.10(1.06–1.15) | 1.12(1.06–1.17) | < 0.0001 |
Overweight or obese | 1.71(1.52–1.92) | 1.42(1.31–1.53) | 1.19(1.10–1.29) | 1.19(1.07–1.32) | < 0.0001 |
Systolic BP, per SD increment | 2.22(2.12–2.34) | 1.73(1.67–1.78) | 1.58(1.52–1.63) | 1.24(1.18–1.30) | < 0.0001 |
Diastolic BP, per SD increment | 1.88(1.80–1.96) | 1.47(1.42–1.51) | 1.27(1.22–1.32) | 1.09(1.03–1.15) | < 0.0001 |
Lipids, per SD increment | |||||
Total cholesterol | 1.33(1.27–1.38) | 1.10(1.06–1.14) | 1.07(1.03–1.12) | 1.07(1.02–1.13) | < 0.0001 |
Triglycerides | 1.15(1.11–1.19) | 1.10(1.07–1.13) | 1.08(1.05–1.12) | 1.09(1.03–1.15) | 0.0193 |
LDL cholesterol | 1.05(0.98–1.14) | 1.01(0.97–1.06) | 1.04(1.00–1.08) | 1.03(0.99–1.08) | 0.8382 |
HDL cholesterol | 1.14(1.07–1.21) | 1.04(1.00–1.09) | 1.04(1.00–1.08) | 0.98(0.93–1.03) | 0.0023 |
Total/HDL cholesterol | 1.03(1.01–1.05) | 1.04(1.00–1.07) | 1.00(0.99–1.01) | 1.01(1.00–1.02) | 0.0549 |
Triglycerides/HDL cholesterol | 1.01(1.00–1.01) | 1.14(1.09–1.19) | 1.07(1.03–1.11) | 1.04(1.01–1.07) | < 0.0001 |
Non–HDL cholesterol | 1.32(1.26–1.38) | 1.09(1.05–1.13) | 1.06(1.01–1.10) | 1.08(1.03–1.14) | < 0.0001 |
Remnant cholesterol | 1.31(1.25–1.38) | 1.08(1.04–1.12) | 1.02(0.98–1.06) | 1.05(0.99–1.10) | < 0.0001 |
Metabolic, per SD increment | |||||
Fasting blood glucose | 1.31(1.24–1.38) | 1.22(1.19–1.25) | 1.16(1.13–1.19) | 1.09(1.05–1.14) | < 0.0001 |
Triglyceride-glucose index | 1.42(1.35–1.49) | 1.26(1.22–1.31) | 1.19(1.15–1.24) | 1.14(1.09–1.21) | < 0.0001 |
eGFR | 0.78(0.73–0.83) | 0.79(0.75–0.84) | 0.74(0.67–0.81) | 0.96(0.85–1.09) | 0.0030 |
Creatinine | 1.00(0.93–1.06) | 1.04(1.01–1.07) | 1.07(1.04–1.11) | 1.04(1.00–1.08) | 0.1459 |
Serum uric acid | 1.14(1.08–1.21) | 1.10(1.05–1.14) | 1.18(1.13–1.23) | 1.07(1.02–1.12) | 0.0076 |
Inflammatory, per SD increment | |||||
Hs–CRP | 1.12(1.08–1.17) | 1.03(1.01–1.05) | 1.06(1.03–1.09) | 1.03(1.00–1.05) | 0.0001 |
White blood cell count | 1.07(1.01–1.12) | 1.00(0.99–1.01) | 1.02(0.99–1.04) | 0.97(0.94–1.00) | 0.1470 |
Neutrophil count | 1.07(1.05–1.10) | 1.03(1.01–1.04) | 1.06(1.04–1.09) | 1.00(0.97–1.03) | 0.0248 |
Platelet | 1.00(0.99–1.00) | 0.44(0.28–0.69) | 0.68(0.37–1.24) | 0.96(0.55–1.65) | 0.0022 |
Red blood cell count | 0.00(0.00–0.86) | 1.01(0.98–1.04) | 1.01(0.98–1.04) | 0.97(0.94–1.00) | 0.0708 |