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Potentially modifiable risk factors associated with myocardial infarction in China: the INTERHEART China study.
Heart. 2009 Nov; 95(22):1857-64.H

Abstract

BACKGROUND

Lifestyle changes associated with the rapidly developing economy increase cardiovascular disease (CVD), myocardial infarction (MI) and cardiovascular risk factors (CVRFs) in China.

OBJECTIVE

To assess and compare regionally, and with other regions of the world, distribution of the nine INTERHEART CVRFs, their relationship to MI and the CVD epidemic in China in order to determine how this may influence the future of CVD in China.

METHODS

Patients with first acute MI (n = 3030) and age- and sex-matched controls (n = 3056) were enrolled from 26 centres in China.

RESULTS

Northern Chinese had higher rates of smoking and hypertension, whereas southern Chinese reported lower fruit and vegetable intake and higher rates of depression. Compared with other regions, participants from China were older, with lower body mass index and waist to hip ratios, lower total and low-density lipoprotein cholesterol levels, ApoB lipoprotein and ApoB to ApoA-1 ratios, but higher high-density lipoprotein cholesterol and ApoA-1. All nine INTERHEART CVRFs, education and income were significantly associated with MI in the Chinese cohort. There was significant heterogeneity in the strength of association between certain CVRFs and MI for China versus other regions, with stronger associations for the Chinese for diabetes (OR 5.10 vs 2.84), depression (2.27 vs 1.37) and permanent stress (2.67 vs 2.06); and lower for the Chinese for abdominal obesity (1.33 vs 2.62) (p for heterogeneity, all <0.001).

CONCLUSIONS

Diabetes and psychosocial factors have strong associations with risk of MI in China, indicating that future increases in these risk factors with societal change in China may hasten rapid increases in CVD.

Authors+Show Affiliations

Population Health Research Institute, McMaster University/Hamilton Health Sciences, Hamilton, Ontario, Canada. teok@mcmaster.caNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Multicenter Study
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

19482846

Citation

Teo, K K., et al. "Potentially Modifiable Risk Factors Associated With Myocardial Infarction in China: the INTERHEART China Study." Heart (British Cardiac Society), vol. 95, no. 22, 2009, pp. 1857-64.
Teo KK, Liu L, Chow CK, et al. Potentially modifiable risk factors associated with myocardial infarction in China: the INTERHEART China study. Heart. 2009;95(22):1857-64.
Teo, K. K., Liu, L., Chow, C. K., Wang, X., Islam, S., Jiang, L., Sanderson, J. E., Rangarajan, S., & Yusuf, S. (2009). Potentially modifiable risk factors associated with myocardial infarction in China: the INTERHEART China study. Heart (British Cardiac Society), 95(22), 1857-64. https://doi.org/10.1136/hrt.2008.155796
Teo KK, et al. Potentially Modifiable Risk Factors Associated With Myocardial Infarction in China: the INTERHEART China Study. Heart. 2009;95(22):1857-64. PubMed PMID: 19482846.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Potentially modifiable risk factors associated with myocardial infarction in China: the INTERHEART China study. AU - Teo,K K, AU - Liu,L, AU - Chow,C K, AU - Wang,X, AU - Islam,S, AU - Jiang,L, AU - Sanderson,J E, AU - Rangarajan,S, AU - Yusuf,S, AU - ,, Y1 - 2009/05/28/ PY - 2009/6/2/entrez PY - 2009/6/2/pubmed PY - 2009/12/22/medline SP - 1857 EP - 64 JF - Heart (British Cardiac Society) JO - Heart VL - 95 IS - 22 N2 - BACKGROUND: Lifestyle changes associated with the rapidly developing economy increase cardiovascular disease (CVD), myocardial infarction (MI) and cardiovascular risk factors (CVRFs) in China. OBJECTIVE: To assess and compare regionally, and with other regions of the world, distribution of the nine INTERHEART CVRFs, their relationship to MI and the CVD epidemic in China in order to determine how this may influence the future of CVD in China. METHODS: Patients with first acute MI (n = 3030) and age- and sex-matched controls (n = 3056) were enrolled from 26 centres in China. RESULTS: Northern Chinese had higher rates of smoking and hypertension, whereas southern Chinese reported lower fruit and vegetable intake and higher rates of depression. Compared with other regions, participants from China were older, with lower body mass index and waist to hip ratios, lower total and low-density lipoprotein cholesterol levels, ApoB lipoprotein and ApoB to ApoA-1 ratios, but higher high-density lipoprotein cholesterol and ApoA-1. All nine INTERHEART CVRFs, education and income were significantly associated with MI in the Chinese cohort. There was significant heterogeneity in the strength of association between certain CVRFs and MI for China versus other regions, with stronger associations for the Chinese for diabetes (OR 5.10 vs 2.84), depression (2.27 vs 1.37) and permanent stress (2.67 vs 2.06); and lower for the Chinese for abdominal obesity (1.33 vs 2.62) (p for heterogeneity, all <0.001). CONCLUSIONS: Diabetes and psychosocial factors have strong associations with risk of MI in China, indicating that future increases in these risk factors with societal change in China may hasten rapid increases in CVD. SN - 1468-201X UR - https://www.unboundmedicine.com/medline/citation/19482846/Potentially_modifiable_risk_factors_associated_with_myocardial_infarction_in_China:_the_INTERHEART_China_study_ L2 - http://heart.bmj.com/cgi/pmidlookup?view=long&amp;pmid=19482846 DB - PRIME DP - Unbound Medicine ER -