Prevalence and clustering of cardiovascular risk factors among resident of coastal areas in Qinzhou, Guangxi, China

In this study, we explored the prevalence of CRFs in healthy adults in the region of Qinzhou and evaluated the association between several social-economic factors and the presence of CRFs. The main findings can be summarized as follows: (1) there was a relatively high prevalence of CRFs in the healthy population in Qinzhou; (2) several factors such as age, income and education were associated with the presence of CRFs. To the best of our knowledge, this is the latest study to report the prevalence and clustering of major CRFs in resident of coastal areas. Our results revealed the high prevalence of CRFs in this region and emphasized the importance of early prevention of adverse cardiovascular events. More attention should be paid to the control of these social-economic factors to achieve the precision prevention.

Guangxi is a concentrated region of ethnic minorities, is the most populous minority in Guangxi. Resident of coastal areas have unique lifestyle characterized by rice-based food, high intake of salt and oil, whereas low intake of milk, eggs and fruits. Furthermore, resident of coastal areas like to drink alcohol [21, 22].

This study demonstrated that the age-standardized prevalence of hypertension, dyslipidemia, diabetes, overweight or obesity alcohol consumption, and smoking was 42.7%, 39.5%, 0.9%, 38.5%, 18.4% and 15.7%, respectively. The prevalence of hypertension, dyslipidemia, and diabetes was lower than a previous study among Tibetan in China (62.4%, 42.7%, and 6.4%), whereas the prevalence of overweight or obesity were higher than Tibetan adults (34.3%) [13]. The prevalence of the CRFs increased with age except of alcohol consumption. Higher prevalence of alcohol consumption present in men than in women, even the proportion of man was much smaller than woman. This phenomenon may result from the fact that men are more likely to drink alcohol than women under the influence from local culture and customs. The high prevalence of hypertension and dyslipidemia in adults in this study may due to the diet habits such as the high intake of salt and oil, which were the well-known risk factors of hypertension and dyslipidemia [23]. The location of this survey was selected in several local township, because there were more migrant workers, the left-behind population was insufficient, so the number of investigations was small. But all the respondents were local residents, this study was still representative. Because migrant workers are mostly men, this also explains why the proportion of women is higher than men. [24].

A recent study confirmed that the prevalence of hypertension (54.6%), overweight or obesity (24.5%) and smoking (35.8%) among Kazakh was higher than other ethnic groups in China, dyslipidemia prevalence (54.3%) was higher among Uygur, and diabetes prevalence (7.1%) was higher among Hans [25]. In the present study, the prevalence of the hypertension, diabetes, dyslipidemia, overweight, and current smoking were 24.3%, 4.3%, 49.3%, 32.0%, and 21.7%, respectively [26]. Another study in rural Nepalese aged 40–80 years reported that the prevalence of current smoking, Overweight and obesity, hypertension, diabetes and dyslipidemia were 24.1%,59.4%, 42.9%,16.2% and 56.0%, respectively [27].

Numerous studies have indicated that CVD incidence related to the clustering of CVD risk factors [28, 29]. Previous studies confirmed that the clustering of CRFs has a more harmful cardiovascular effect [30,31,32,33].

In this study, we found that 82.2% and 45.3% of participants had one or more and two or more CRFs. In a representative sample of 23,010 adults from the 2007–2011 cross-sectional survey, the proportions of respondents had one or more and two or more CRFs were 70.3% and 40.3%, respectively [26]. Compared with this study, Guangxi inhabitants had a higher proportion of at least one CRFs. In another cross-sectional survey of 16,371 Chinese suburban resident of coastal areas aged 35 to 74 years, 83.5%, 47.2% of people had at least one and at least two CRFs, respectively [34]. Compared this study, Guangxi resident of coastal areas had a lower prevalence of at least two CRFs. Other countries have also observed the clustering of CRFs. In the United States, most participants (80% of men, 71% of women) had at least one risk factor [35]. Clustering of at least three CRFs was observed in 69.4% of the men and 58.5% of the women in rural Nepalese [27]. In Malaysia, one third of the participants had at least two CRFs [36]. Our study demonstrated that the elderly, and the participants having lower levels of education were more likely to have one or more CRFs compared with the young and had higher levels of education.

Our research has several limitations. First at all, there exist large imbalance between genders, which may give major weight to female populations and influence the results in multinomial logistic analysis. The OR value in single CRF might be overestimate. Second, the sample size was not large enough in this study, the sample size will be expanded for further investigation in follow-up studies. In the future, subsequent large, multicenter studies are warranted to well report the prevalence of CRFs in different subgroups in real-world situation and investigate the causal relationship between social-economic factors and the presence of CRFs in a long period of follow-up. More effort should be undertaken on this topic to improve the primary prevention of adverse cardiovascular events.

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