Spatiotemporal variations in ischemic heart disease mortality and related risk factors in China between 2010 and 2015: a multilevel analysis.
Ischemic heart disease
Multilevel statistical model
Risk factors
Journal
BMC public health
ISSN: 1471-2458
Titre abrégé: BMC Public Health
Pays: England
ID NLM: 100968562
Informations de publication
Date de publication:
04 01 2021
04 01 2021
Historique:
received:
14
07
2020
accepted:
08
12
2020
entrez:
5
1
2021
pubmed:
6
1
2021
medline:
15
5
2021
Statut:
epublish
Résumé
To explore the relationship between geographical differences of mortality and related risk factors in ischemic heart disease (IHD) in China. Data were collected from the nationally representative China Mortality Surveillance System to calculate annual IHD mortality counts (2010-2015). Descriptive analysis was used to analyze the IHD mortality among Chinese population from 2010 to 2015. Negative binomial regression was used to investigate potential spatiotemporal variation and correlations with age, gender, urbanization, and region. The overall IHD mortality was 221.17/100,000, accounting for 1.51 million deaths in 2015. The standardized IHD mortality rate increased by 5.51% from 2010 to 2015 among people aged 40 years and older. Multilevel analysis indicated significant differences in gender, regions, and age. High urbanization rate (risk ratio [RR] = 0.728, 95% confidence interval [CI] = (0.631, 0.840)) and average high-density lipoprotein (HDL) (RR = 0.741, 95%CI: 0.616,0.891) were negatively associated with IHD mortality. IHD mortality was significantly higher in populations with a low rate of medical insurance coverage (RR = 1.218, 95%CI: 1.007, 1.473), as well as the average body mass index (BMI) (RR = 1.436, 95%CI: 1.135, 1.817) and systolic blood pressure (SBP) (RR = 1.310, 95%CI: 1.019, 1.684). While the relationship with current smoking rate, excessive intake of red meat, insufficient vegetable or fruits intake didn't show the statistical significance. The negative correlation between the average sedentary time and IHD mortality was not conclusive due to the possible deviation of the data. The mortality of IHD showed an upward trend for people aged 40 years and older in China during 2010-2015, which should be paid attention to. Therefore, some risk factors should be controlled, such as SBP, overweight/obesity. HDL is a protective factor, as well as higher urbanization rate, family income level, and medical insurance coverage.
Sections du résumé
BACKGROUND
To explore the relationship between geographical differences of mortality and related risk factors in ischemic heart disease (IHD) in China.
METHODS
Data were collected from the nationally representative China Mortality Surveillance System to calculate annual IHD mortality counts (2010-2015). Descriptive analysis was used to analyze the IHD mortality among Chinese population from 2010 to 2015. Negative binomial regression was used to investigate potential spatiotemporal variation and correlations with age, gender, urbanization, and region.
RESULTS
The overall IHD mortality was 221.17/100,000, accounting for 1.51 million deaths in 2015. The standardized IHD mortality rate increased by 5.51% from 2010 to 2015 among people aged 40 years and older. Multilevel analysis indicated significant differences in gender, regions, and age. High urbanization rate (risk ratio [RR] = 0.728, 95% confidence interval [CI] = (0.631, 0.840)) and average high-density lipoprotein (HDL) (RR = 0.741, 95%CI: 0.616,0.891) were negatively associated with IHD mortality. IHD mortality was significantly higher in populations with a low rate of medical insurance coverage (RR = 1.218, 95%CI: 1.007, 1.473), as well as the average body mass index (BMI) (RR = 1.436, 95%CI: 1.135, 1.817) and systolic blood pressure (SBP) (RR = 1.310, 95%CI: 1.019, 1.684). While the relationship with current smoking rate, excessive intake of red meat, insufficient vegetable or fruits intake didn't show the statistical significance. The negative correlation between the average sedentary time and IHD mortality was not conclusive due to the possible deviation of the data.
CONCLUSIONS
The mortality of IHD showed an upward trend for people aged 40 years and older in China during 2010-2015, which should be paid attention to. Therefore, some risk factors should be controlled, such as SBP, overweight/obesity. HDL is a protective factor, as well as higher urbanization rate, family income level, and medical insurance coverage.
Identifiants
pubmed: 33397345
doi: 10.1186/s12889-020-10019-6
pii: 10.1186/s12889-020-10019-6
pmc: PMC7784031
doi:
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
9Références
Eur Heart J Qual Care Clin Outcomes. 2017 Jan 1;3(1):47-52
pubmed: 28927191
Lancet. 2017 Nov 4;390(10107):2037-2049
pubmed: 28864331
Zhonghua Liu Xing Bing Xue Za Zhi. 1992 Aug;13(4):197-201
pubmed: 1301261
Scand J Work Environ Health. 2016 Jan;42(1):43-51
pubmed: 26649851
Adv Nutr. 2018 May 1;10(suppl_2):S164-S189
pubmed: 31089735
BMC Cardiovasc Disord. 2018 Feb 2;18(1):18
pubmed: 29390974
Am J Hypertens. 2019 Aug 14;32(9):833-841
pubmed: 31045225
Circ Cardiovasc Qual Outcomes. 2019 Jun;12(6):e005375
pubmed: 31163980
Int J Environ Res Public Health. 2018 May 18;15(5):
pubmed: 29783678
J Int Med Res. 2018 Dec;46(12):5257-5268
pubmed: 30442048
BMC Med. 2019 Nov 26;17(1):209
pubmed: 31767015
Atherosclerosis. 2010 Aug;211(2):539-44
pubmed: 20409549
J Epidemiol Community Health. 2005 Sep;59(9):729-36
pubmed: 16100308
Popul Health Metr. 2005 Mar 16;3(1):3
pubmed: 15769298
Bull World Health Organ. 2013 Sep 1;91(9):650-60
pubmed: 24101781
Ann Intern Med. 2015 Jan 20;162(2):123-32
pubmed: 25599350
Int J Environ Res Public Health. 2016 Dec 16;13(12):
pubmed: 27999279
J Am Coll Cardiol. 2017 Mar 7;69(9):1116-1125
pubmed: 28254173
Lancet. 2016 Jan 16;387(10015):251-72
pubmed: 26510778
J Hypertens. 2016 Jan;34(1):39-46
pubmed: 26630211
Stroke. 2014 Jan;45(1):315-53
pubmed: 24309587
J Clin Lipidol. 2015 May-Jun;9(3):334-42
pubmed: 26073391
J Epidemiol Community Health. 2006 Apr;60(4):290-7
pubmed: 16537344
BMC Cardiovasc Disord. 2019 Jul 2;19(1):159
pubmed: 31266467
PLoS One. 2019 May 15;14(5):e0216534
pubmed: 31091295