National Center for Chronic and Noncommunicable Disease Control and Prevention

Beijing, China

National Center for Chronic and Noncommunicable Disease Control and Prevention

Beijing, China

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Bi Y.,Shanghai JiaoTong University | Jiang Y.,National Center for Chronic and Noncommunicable Disease Control and Prevention | He J.,Tulane University | Xu Y.,Shanghai JiaoTong University | And 13 more authors.
Journal of the American College of Cardiology | Year: 2015

Background Cardiovascular disease has become the leading cause of death in China. Objectives The goal of this study was to evaluate the current status of cardiovascular health in Chinese adults. Methods Cardiovascular health data were collected from a nationally representative sample of 96,121 Chinese adults age ≥20 years in 2010. Ideal cardiovascular health was defined according to the American Heart Association's 2020 Strategic Impact Goals as follows: the simultaneous presence of 4 favorable health behaviors (ideal smoking status, ideal body mass index, physical activity at goal, and healthy dietary habits) and 4 favorable health factors (ideal smoking status, untreated total cholesterol <200 mg/dl, untreated blood pressure <120/<80 mm Hg, and untreated fasting plasma glucose <100 mg/dl) in the absence of a history of cardiovascular disease. Results The estimated percentage of ideal cardiovascular health was 0.2% in the general adult population in China (0.1% in men and 0.4% in women). An estimated 0.7% (0.4% in men and 1.0% in women) of Chinese adults had all 4 ideal health behaviors, and 13.5% (5.0% in men and 22.3% in women) had all 4 ideal health factors. Men most frequently had 3 to 4 ideal components, and women most commonly had 4 to 5 ideal components of the 7 cardiovascular health metrics. Ideal diet (1.6%) was the least common among all cardiovascular health metrics. Female sex and younger age were the 2 most common protective factors for cardiovascular health in Chinese adults. Conclusions The percentage of ideal cardiovascular health in Chinese adults is extremely low. Both population-wide and high-risk strategies should be implemented with great effort to promote cardiovascular health in China. © 2015 American College of Cardiology Foundation.


Mendis S.,World Health Organization | Johnston S.C.,University of California at San Francisco | Fan W.,National Center for Chronic and Noncommunicable Disease Control and Prevention | Oladapo O.,University of Ibadan | And 2 more authors.
Bulletin of the World Health Organization | Year: 2010

Objective To evaluate a simple cardiovascular risk management package for assessing and managing cardiovascular risk using hypertension as an entry point in primary care facilities in low-resource settings. Methods Two geographically distant regions in two countries (China and Nigeria) were selected and 10 pairs of primary care facilities in each region were randomly selected and matched. Regions were then randomly assigned to a control group, which received usual care, or to an intervention group, which applied the cardiovascular risk management package. Each facility enrolled 60 consecutive patients with hypertension. Intervention sites educated patients about risk factors at baseline and initiated treatment with hydrochlorothiazide at 4 months in patients at medium risk of a cardiovascular event, according to a standardized treatment algorithm. Systolic blood pressure change from baseline to 12 months was the primary outcome measure. Findings The study included 2397 patients with baseline hypertension: 1191 in 20 intervention facilities and 1206 in 20 control facilities. Systolic and diastolic blood pressure decreased more in intervention patients than in controls. However, at 12 months more than half of patients still had uncontrolled hypertension (systolic blood pressure > 140 mmHg and/or diastolic blood pressure > 90 mmHg). Behavioural risk factors had improved among intervention patients in Nigeria but not in China. Only about 2% of hypertensive patients required referral to the next level of care. Conclusion Even in low-resource settings, hypertensive patients can be effectively assessed and managed in primary care facilities.


Xu Y.,Shanghai JiaoTong University | Wang L.,National Center for Chronic and Noncommunicable Disease Control and Prevention | He J.,Tulane University | Bi Y.,Shanghai JiaoTong University | And 20 more authors.
JAMA - Journal of the American Medical Association | Year: 2013

IMPORTANCE: Noncommunicable chronic diseases have become the leading causes of mortality and disease burden worldwide. OBJECTIVE: To investigate the prevalence of diabetes and glycemic control in the Chinese adult population. DESIGN, SETTING, AND PARTICIPANTS: Using a complex, multistage, probability sampling design, we conducted a cross-sectional survey in a nationally representative sample of 98 658 Chinese adults in 2010. MAIN OUTCOMES AND MEASURES: Plasma glucose and hemoglobin A1c levels were measured after at least a 10-hour overnight fast among all study participants, and a 2-hour oral glucose tolerance test was conducted among participants without a self-reported history of diagnosed diabetes. Diabetes and prediabetes were defined according to the 2010 American Diabetes Association criteria; whereas, a hemoglobin A1c level of <7.0% was considered adequate glycemic control. RESULTS: The overall prevalence of diabetes was estimated to be 11.6% (95% CI, 11.3%-11.8%) in the Chinese adult population. The prevalence among men was 12.1% (95% CI, 11.7%-12.5%) and among women was 11.0% (95% CI, 10.7%-11.4%). The prevalence of previously diagnosed diabetes was estimated to be 3.5% (95% CI, 3.4%-3.6%) in the Chinese population: 3.6% (95% CI, 3.4%-3.8%) in men and 3.4% (95% CI, 3.2%-3.5%) in women. The prevalence of undiagnosed diabetes was 8.1% (95% CI, 7.9%-8.3%) in the Chinese population: 8.5% (95% CI, 8.2%-8.8%) in men and 7.7% (95% CI, 7.4%-8.0%) in women. In addition, the prevalence of prediabetes was estimated to be 50.1% (95% CI, 49.7%-50.6%) in Chinese adults: 52.1% (95% CI, 51.5%-52.7%) in men and 48.1% (95% CI, 47.6%-48.7%) in women. The prevalence of diabetes was higher in older age groups, in urban residents, and in persons living in economically developed regions. Among patients with diabetes, only 25.8% (95% CI, 24.9%-26.8%) received treatment for diabetes, and only 39.7% (95% CI, 37.6%-41.8%) of those treated had adequate glycemic control. CONCLUSIONS AND RELEVANCE: The estimated prevalence of diabetes among a representative sample of Chinese adults was 11.6% and the prevalence of prediabetes was 50.1%. Projections based on sample weighting suggest this may represent up to 113.9 million Chinese adults with diabetes and 493.4 million with prediabetes. These findings indicate the importance of diabetes as a public health problem in China.


Wang L.,National Center for Chronic and Noncommunicable Disease Control and Prevention | Zhou M.,National Center for Chronic and Noncommunicable Disease Control and Prevention | Astell-Burt T.,University of Western Sydney | Astell-Burt T.,University of St. Andrews | And 8 more authors.
Diabetes Care | Year: 2015

RESEARCH DESIGN AND METHODS: Self-report and biomedical data were collected from98,058 adults aged ‡18 years (90.5% response) from 162 areas spanning mainland China. Diabetes status was assessed using American Diabetes Association criteria. Among those with diabetes, detection was defined by prior diagnosis. Choropleth maps were used to visually assess geographical variation in each outcome at the provincial level. The odds of each outcome were assessed usingmultilevel logistic regression, with adjustment for person- and area-level characteristics.RESULTS: Geographic visualization at the provincial level indicated widespread variation in diabetes prevalence and detection across China. Regional prevalence adjusted for age, sex, and urban/rural socioeconomic circumstances (SECs) ranged from 8.3% (95% CI 7.2%, 9.7%) in the northeast to 12.7% (11.1%, 14.6%) in the north. A clear negative gradient in diabetes prevalence was observed from13.1%(12.0%, 14.4%) in the urban high-SEC to 8.7% (7.8%, 9.6%) in rural low-SEC counties/districts. Adjusting for health literacy and other person-level characteristics only partially attenuated these geographic variations. Only one-third of participants living with diabetes had been previously diagnosed, but this also varied substantively by geography. Regional detection adjusted for age, sex, and urban/rural SEC, for example, spanned from 40.4% (34.9%, 46.3%) in the north to 15.6% (11.7%, 20.5%) in the southwest. Compared with detection of 40.8% (37.3%, 44.4%) in urban high-SEC counties, detection was poorest among rural low-SEC counties at just 20.5% (17.7%, 23.7%). Person-level characteristics did not fully account for these geographic variations in diabetes detection.CONCLUSIONS: Strategies for addressing diabetes risk and improving detection require geographical targeting. © 2015 by the American Diabetes Association.OBJECTIVE: To investigate the geographic variation in diabetes prevalence and detection in China.


He G.,Hong Kong University of Science and Technology | Fan M.,Ball State University | Zhou M.,National Center for Chronic and Noncommunicable Disease Control and Prevention
Journal of Environmental Economics and Management | Year: 2016

By exploiting exogenous variations in air quality during the 2008 Beijing Olympic Games, we estimate the effect of air pollution on mortality in China. We find that a 10 percent decrease in PM10 concentrations reduces the monthly standardized all-cause mortality rate by 8 percent. Men and women are equally susceptible to air pollution risks. The age groups for which the air pollution effects are greatest are children under 10 years old and the elderly. © 2016 Elsevier Inc.


Jiang Y.,National Center for Chronic and Noncommunicable Disease Control and Prevention
Zhonghua yu fang yi xue za zhi [Chinese journal of preventive medicine] | Year: 2010

OBJECTIVE: To describe the epidemiologic characteristics of cerebrovascular disease (CVD) mortality in China from 2004 to 2005. METHODS: The data came from 2004-2005, the third national mortality retrospective sampling survey which collected the death cause information and covered 31 province-level regions and 160 surveillance spots in the interior of China. Total 142 660 482 person years were investigated. Based on the data, the crude death rates of ages, genders and diseases were calculated. Years of potential life lost (YPLL) were also calculated. Standardized death rates were calculated from census data in 2000 and each five-year was counted as an age group. RESULTS: The total number of residents died of CVD between 2004 and 2005 was 194 932 (male 108 414, female 86 518, urban 63 397, rural 131 535) in survey districts. The crude death rates of CVD were 136.6 per 100 000 and the standardized death rate was 120.1 per 100 000. The crude death rates of CVD were 148.6 per 100 000 in male and 124.1 per 100 000 in female; the standardized death rates were 144.2 and 98.2, respectively. The crude death rates of CVD were 132.4 per 100 000 in urban area and 138.8 per 100 000 in rural area; the standardized death rates were 107.3 and 127.6 per 100 000 population, respectively. With age increasing, the crude death rates of CVD showed a fast growth trend. The crude death rates of group aged 35 - 39, 55 - 59, 85 and above were 10.6 (1352/12 712 639), 177.6 (10 599/5 967 274) and 4051.4 (25 430/627 688) per 100 000 respectively. Intracerebral hemorrhage accounting for 50.4% (98 324 cases) of CVD deaths, followed by cerebral infarction, accounting for 24.8% (48 305 cases). The total cases of stroke, hemorrhagic stroke, ischemic stroke and not-specified stroke were 167 147, 105 766, 48 305 and 13 076, respectively, and the crude death rates were 117.2, 74.7, 33.9 and 11.3 per 100 000, respectively. The YPLL of Chinese people was 535.5 person years per 100 000. CONCLUSION: The mortality of CVD in male was higher than that in female; the mortality of CVD in urban area was higher than that in rural area. As the age increasing, the mortality of CVD appeared a rapid increment. Intracerebral hemorrhage was the main cause of CVD death.


Jiang W.,National Center for Chronic and Noncommunicable Disease Control and Prevention
Zhonghua liu xing bing xue za zhi = Zhonghua liuxingbingxue zazhi | Year: 2010

To study the preventive strategies through analyzing the poisoning cases from the National Injury Surveillance System (NISS), from 2006 to 2008. Data of poisoning cases was descriptively analyzed from Chinese NISS, from 2006 to 2008. The proportion of poisoning cases to all injuries cases from NISS were 2.57%, 2.48% and 2.52% from 2006 to 2008, which ranked sixth in all the injuries causes. Most people being poisoned had junior middle school education and most of them were agriculture/animal husbandry/fishery/water producers or commercial/service personnel. Most of the poisoning incidents were happened at home, always occurred in leisure time - around 8 PM, every day. The common types of poisoning were alcohol, clinical drugs, pesticide and carbon monoxide. Unintentional injuries were the main causes. Self-harm/suicidal cases in the rural areas were more than in the urban areas, with women more than men. The main type of self-harm/suicide related poisoning cases were through drugs or pesticide. ≥ 65, 15 - 29 and 30 - 44 year-olds were most commonly seen. Alcoholism was the primary type of poisoning injuries which is the highest in young adults (15 - 29 years and 30 - 44 years). It's important to promote civilized drinking habits and limit access to alcohol for youth. Self-harm/suicide had close relationship with clinical drugs and pesticide. The key points to prevent pesticide and clinical drugs poisoning were safe storage of pesticides, universal security of pesticide, and the supervision on drug producing and marketing. Children and the elderly were the high risk people for carbon monoxide poisoning. Monitoring and intervention must be strengthened.


Jiang Y.,National Center for Chronic and Noncommunicable Disease Control and Prevention
Zhonghua yu fang yi xue za zhi [Chinese journal of preventive medicine] | Year: 2013

OBJECTIVE: To study the relationship between prevalence of central obesity and clustering of cardiometabolic diseases among Chinese elder people over 60 years old.METHODS: A complex multistage stratified sampling survey on chronic diseases was conducted in 162 surveillance points, 31 provinces, China in 2010 by China CDC. The survey included face-to-face interview, physical measurement (body height, weight, waist circumference (WC) and blood pressure) and laboratory test (blood sugar, blood lipid and hemoglobin A1C), to collect the information about the prevalence of the risk factors as smoking, drinking, diet and physical activities and the prevalence of hypertension, diabetes and dyslipidemia. The survey selected 19 966 subjects who were over 60 years old. Central obesity was defined as WC ≥ 85 cm in males or ≥ 80 cm in females. The prevalence of central obesity among the elder people over 60 years old in different districts and populations was calculated; and the proportion of cardiometabolic diseases in groups of different WC was then analyzed.RESULTS: The prevalence of central obesity among elderly population over 60 years old was 48.6% (95%CI:46.1%-51.2%), including 39.7% (95%CI:37.2%-42.2%) males and 57.3% (95%CI:54.5%-60.1%) females. The proportion of females was higher than that of males (χ(2) = 474.63, P < 0.01). The higher the education level, the higher the prevalence of central obesity among elderly men. There was no significant association among females. The higher the family income, the higher the prevalence of central obesity. The prevalence of central obesity was 59.2% in urban area, which was much higher than that in rural area (43.5%) (χ(2) = 50.06, P < 0.01). The proportion of hypertension, diabetes and clustering of cardiometabolic disease was separately 18.8% (95%CI:16.1%-21.5%) , 66.2% (95%CI:63.0%-69.4%) and 47.5% (95%CI:44.1%-50.8%) among elderly men with WC between 85 and 89 cm, and separately 24.0% (95%CI:21.2%-26.8%), 78.2% (95%CI:75.6%-80.8%) and 64.0% (95%CI:60.3%-67.6%) among elderly men with WC ≥ 90 cm; which were both higher than those among elderly men with WC < 85 cm (separately 13.4% (95%CI:11.5%-15.3%) , 58.3% ( 95%CI:55.5%-60.1%) and 30.8% (95%CI:28.7%-32.9%) ). The proportion of hypertension, diabetes and clustering of cardiometabolic disease was 20.1% (95%CI:17.4%-22.7%) , 68.6% (95%CI:65.5%-71.8%) and 48.1% (95%CI:44.6%-51.6%) among elderly women with WC between 80 and 84 cm, and separately 31.7% (95%CI:28.9%-34.4%) , 81.0% (95%CI:78.5%-83.5%) and 61.8% (95%CI:58.9%-64.8%) among elderly women with WC ≥ 85 cm; which were both higher than those among elderly women with WC < 80 cm (separately 12.8% (95%CI:10.8%-14.8%) , 60.1% (95%CI:57.1%-63.0%) and 30.4% (95%CI:27.3%-33.5%)).CONCLUSION: Nearly half of the Chinese elder people were central obese. The proportion of cardiometabolic diseases among central obesity was significantly higher than that among non-obese population. We should pay more concern about them in the future prevention and control of chronic diseases.


Yin P.,National Center for Chronic and Noncommunicable Disease Control and Prevention | Zhang M.,National Center for Chronic and Noncommunicable Disease Control and Prevention | Li Y.,National Center for Chronic and Noncommunicable Disease Control and Prevention | Jiang Y.,National Center for Chronic and Noncommunicable Disease Control and Prevention | Zhao W.,National Center for Chronic and Noncommunicable Disease Control and Prevention
BMC Public Health | Year: 2011

Background: Socioeconomic status is likely an independent risk factor for Chronic Obstructive Pulmonary Disease (COPD), but little research has been done in China to study this association in a nationwide sample. Methods. We used data from the 2007 China Chronic Disease Risk Factor Surveillance of 49,363 Chinese men and women aged 15-69 years to examine the association between the prevalence of self-reported physician diagnosed COPD and socioeconomic status defined by both educational level and annual household income. Multivariable logistic regression modelling was performed with adjustement for potential confounders. Results: Both low educational attainment and low household income were independently associated with higher risk of physician-diagnosed COPD. Compared to subjects with high educational level, subjects with low educational level had a significantly increased risk of COPD (OR 1.67, 95%CI 1.32-2.13, p for trend< 0.001 for urban, OR 1.76, 95%CI 1.34-2.30, p for trend < 0.001 for rural) after adjusting for age, sex, smoking status, passive smoking and geographic regions. Similarly increased risk was observed for household income and COPD in urban (OR 1.64, 95%CI 1.28-2.09, P for trend< 0.001) but not rural areas. Among never smokers, low educational level and household income were still associated with a significant higher prevalence of COPD (OR 1.77, 95%CI 1.40-2.25, OR 1.31, 95%CI 1.05-1.62). Removal of those with asthma diagnosis did not alter the observed associations. Conclusions: Socioeconomic status is a risk factor for self-reported physician-diagnosed COPD independently of current or passive smoking. Prospective studies are needed in China to better understand the association between socioeconomic status and COPD. © 2011 Yin et al; licensee BioMed Central Ltd.


Wang L.,National Center for Chronic and Noncommunicable Disease Control and Prevention
BMC nephrology | Year: 2014

BACKGROUND: Microalbuminuria has been shown to be a risk factor for cardiovascular and renal disease in patients with hypertension and diabetes as well as in the general population. Urinary albumin excretion over 24 h is considered a 'gold standard' to detect microalbuminuria. Few studies have used 24-h urinary albumin excretion to analyze the prevalence of and related factors for microalbuminuira in a general Chinese population.METHODS: This study included 1980 adults aged 18-69 years from the Shandong-Ministry of Health Action on Salt and Hypertension (SMASH) Project 2011 survey. Blood pressure, height, weight and waist circumference were measured, and a venous blood and timed 24-h urine samples were collected from each participant. Linear and logistic regression analyses were used to test associations between established cardiovascular risk factors and microalbuminuria.RESULTS: The median (25th-75th percentile) of 24-h urinary albumin excretion was 6.1 mg/d (4.5-8.7 mg/d) for all adults, 6.0 mg/d (4.4-8.5 mg/d) for men and 6.2 mg/d (4.6-8.9 mg/d) for women. The overall prevalence of microalbuminuria was 4.1% (95% confidence interval [CI]: 3.2-5.0%), 3.7% (95% CI: 2.9-4.5%) for men and 4.6% (95% CI: 3.7-5.5%) for women. Microalbuminuria was present in 8.1% (95% CI: 6.9-9.3%) of individuals with hypertension, 11.4% (95% CI: 10.0-12.8%) of those with diabetes and 15.6% (95% CI: 14.0-17.2%) of those with both. Multiple logistic regression analysis indicated that systolic blood pressure (odds ratio [OR] 1.02; 95% CI: 1.01-1.03) and fasting blood glucose (OR 1.19; 95% CI: 1.05-1.35) were the independent risk factors for microalbuminuria.CONCLUSIONS: Adults in the general population of Shandong Province have a moderate prevalence of microalbuminuria. Those with hypertension and diabetes are at high risk of having microalbuminuria, suggesting the need for screening and early intervention for microalbuminuria among these individuals.

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