Neighborhood socioeconomic status and the prevalence of stroke and coronary heart disease in rural China: a population-based study.
Neighborhood socioeconomic status and the prevalence of stroke and coronary heart disease in rural China: a population-based study.
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中国农村社区社会经济状况与脑卒中和冠心病患病率：一项基于人群的研究
DOI：
10.1111/ijs.12343
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发表时间：
2015-04
期刊：
影响因子：
--
通讯作者：
Goldstein LB
中科院分区：
文献类型：
--
作者：
Tang X;Laskowitz DT;He L;Østbye T;Bettger JP;Cao Y;Li N;Li J;Zhang Z;Liu J;Yu L;Xu H;Hu Y;Goldstein LB
背景：在发达国家，较低的社区社会经济地位（SES）与血管疾病风险增加有关。目的本研究旨在确定中国农村人口中风和冠心病（CHD）的村庄和个人水平的决定因素。方法我们分析了来自54个村庄的14424名40岁以上的中国农村成年人的人口调查数据。主要结局是卒中和冠心病（CHD）患病率。村级SES是根据中国政府官方统计年鉴确定的。个人层面的特征是通过面对面访谈获得的。使用具有对数链接函数的广义线性混合模型计算患病率比（rr）和95%置信区间（95% ci），以探讨村级SES与个体社会、人口统计学和心血管危险因素与卒中或冠心病的关系。方差用中位率比（MRR）和区间率比（IRR）表示。结果在卒中患病率（MRR = 1.70, 95% CI: 1.42 - 1.94, P < 0.05）和冠心病患病率（MRR = 1.59, 95% CI: 1.35 - 1.78, P < 0.05）上，村庄差异显著，仅村庄收入就分别占卒中和冠心病村间差异的10%和13.5%。高收入村庄卒中（RR = 1.69, 95% CI: 1.09 - 2.62）和冠心病（RR = 1.63, 95% CI: 1.13 - 2.34）的风险均高于低收入村庄。在个体水平的危险因素中，高血压与卒中患病率的相关性（RR = 2.33, 95% CI: 1.93 - 1.80）高于冠心病（RR = 1.58, 95% CI: 1.38 - 1.82），而肥胖仅与冠心病相关（RR = 1.43, 95% CI: 1.23 - 1.66）。此外，年龄与收入之间存在交互作用；60岁以下高收入村庄居民冠心病患病率较高（RR = 1.58, 95% CI: 1.15 ~ 2.18），但卒中患病率较低。结论中国农村的血管风险存在差异，收入越高的村庄终生卒中和冠心病患病率越高。对于冠心病，高收入村庄的年轻居民的邻里效应更强。研究结果可能对针对高危人群的公共卫生干预措施产生影响。
Background Lower neighborhood-level socioeconomic status (SES) is associated with an increased risk of vascular disease in developed countries. Aims This study aims to identify village- and individual-level determinants of stroke and coronary heart disease (CHD) in a rural Chinese population. Methods We analyzed data from a population-based survey of 14 424 rural Chinese adults aged over 40 years from 54 villages. Primary outcomes were stroke and coronary heart disease (CHD) prevalence. Village-level SES was determined from the Chinese government's official statistical yearbook. Individual-level characteristics were obtained by in-person interviews. Prevalence rate ratios (RRs) and 95% confidence intervals (95% CIs) were calculated using generalized linear mixed models with log-link function to explore associations of village-level SES and individual social, demographic, and cardiovascular risk factors with stroke or CHD. Variance was expressed using the median rate ratio (MRR) and interval rate ratio (IRR). Results Village accounted for significant variability in the prevalence of stroke (MRR = 1·70; 95% CI: 1·42–1·94; P < 0·05) and CHD (MRR = 1·59; 95% CI: 1·35–1·78, P < 0·05), with village-level income alone accounting for 10% and 13·5% of between-village variation in stroke and CHD, respectively. High-income villages were at higher risk of both stroke (RR = 1·69, 95% CI: 1·09–2·62) and CHD (RR = 1·63, 95% CI: 1·13–2·34) than lower-income villages. Among individual-level risk factors, hypertension was associated with a higher prevalence of stroke (RR = 2·33, 95% CI: 1·93–2·80) than CHD (RR = 1·58, 95% CI: 1·38–1·82), whereas obesity was only associated with CHD (RR = 1·43, 95% CI: 1·23–1·66). In addition, there was an interaction between age and income; residents of higher-income villages below age 60 had a higher prevalence of CHD (RR = 1·58, 95% CI: 1·15–2·18) but not stroke. Conclusions There were differences in vascular risk across rural villages in China, with higher lifetime stroke and CHD prevalence in higher-income villages. For CHD, neighborhood effects were stronger among younger residents of high-income villages. The results may have implications for public health interventions targeting populations at risk.
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影响因子：
7.7
作者：
Li Y;He Y;Qi L;Jaddoe VW;Feskens EJ;Yang X;Ma G;Hu FB
通讯作者：
Hu FB
影响因子：
6.3
作者：
Roux, AVD;Borrell, LN;Schultz, R
通讯作者：
Schultz, R
影响因子：
9.9
作者：
Kapral, Moira K.;Fang, Jiming;Anderson, Geoffrey M.
通讯作者：
Anderson, Geoffrey M.
DOI：
10.1136/bmj.b4567
发表时间：
2009-11-24
期刊：
BMJ (Clinical research ed.)
影响因子：
--
作者：
Strazzullo P;D'Elia L;Kandala NB;Cappuccio FP
通讯作者：
Cappuccio FP
影响因子：
4.9
作者：
Li, Yanping;Jaddoe, Vincent W.;Ma, Guansheng
通讯作者：
Ma, Guansheng