Interpretation of the Annual Report on Cardiovascular Health and Diseases in China 2022

Abstract

The Chinese edition of the Annual Report on Cardiovascular Health and Diseases in China 2022 has been published.[1] We present herein an interpretation of this report. 1. Influencing factors on cardiovascular health 1.1. Tobacco use China is the largest consumer and injured state of tobacco products in the world. A systematic analysis from the Global Burden of Disease (GBD) study 2019 indicated that the number of deaths attributable to tobacco smoking in China increased by 57.9% during 1990–2019, from 1.5 to 2.4 million. Cigarette smoking and second-hand smoke exposure are the major preventable risk factors for total mortality in Chinese adults. The multivariate-adjusted relative risk (RR) of death was 1.23 (95% confidence interval (CI): 1.18–1.27) and the population attributable fraction (PAF) risk was 7.9% for cigarette smoking. Data from China Adult Tobacco Survey demonstrated that the prevalence of current smoking among people aged ≥15 years was 26.6% in 2018, which was decreased in comparison with the estimates in 2010 and 2015. The prevalence was 50.5% among males and 2.1% among females. Global Youth Tobacco Survey showed that in 2021, the prevalence of ever-cigarette smokers was 16.7% and that of current smokers was 4.7% among secondary school students. In 2018, the prevalence of non-current smokers aged ≥15 years who were exposed to second-hand smoke was 68.1% in China, and the proportion of non-current smokers who saw someone smoking indoors was 71.9%. The proportion of Chinese people who currently use e-cigarettes was 0.9%, and the rate of smoking abstinence was 20.1% among Chinese smokers aged ≥15 years in 2018. China Health Literacy Survey was conducted in 2018 among 84,839 participants aged 20–69 years from 31 provincial administrative units across China. Among the general population, the prevalence of tobacco dependence was 13.1%. Among current smokers, it was 49.7%. In China, 183.5 million adults were tobacco dependent in 2018, and 177.5 million of them were men. A total of 461,047 adults aged 30–79 years in the China Kadoorie Biobank (CKB) cohort were followed up for a median of 11.2 years. Results showed that tobacco smoking played a crucial role in all transitions from healthy to first cardiometabolic disease, and subsequently to cardiometabolic multi-morbidity. The rate of smoking abstinence was 20.1% among Chinese smokers aged ≥15 years in 2018. Among the individuals who had tried smoking cessation in the past 12 months, more than half of them gave up smoking because of their health issues. The top 3 reasons for quitting attempt were concern about the adverse impact of smoking on health (38.7%), suffering from a disturbing illness (26.6%) and opposition from family members (14.9%) [Figure 1].Figure 1:: The main reasons for smoking quit attempt in the past 12 months in 2018.1.2. Dietary nutrition The status of dietary nutrition among Chinese residents has been improved on the whole. Data from the China Nutrition and Health Surveillance 2015–2017 indicated that the average energy intake per reference person per day was 2,007.4 kcal. It was adequate for energy and intake of macronutrients, including carbohydrate, protein, and total fat. The trend in average daily energy intake decreased in the Chinese population. The proportion of energy intake from protein changed little, but that from carbohydrates declined apparently. The contribution of fat-to-energy intake increased and exceeded the Chinese Dietary Guidelines recommendation (20%–30%) since 2012 [Figure 2]. The proportion of energy intake from fat in rural areas was 33.2% during 2015–2017, which exceeded the recommended upper limit of 30% for the first time.Figure 2:: Trend in percentage of energy intake from carbohydrate, protein, and fat among Chinese residents from 1982 to 2015.In general, the trend in dietary structure among Chinese residents during 1982–2015 was characterized as decreased intake of cereals and vegetables and increased intake of animal foods with pork dominating. Intake of fruits, eggs, seafood, dairy products, and soybeans remained at a low level [Figure 3]. Daily intake of cooking increased and that of cooking of them were the [Figure Trend in dietary structure among Chinese residents from 1982 to Trend in of cooking and among Chinese residents from 1982 to of intake from 1990–2019, the increased from to and animal intake increased from to in China [Figure in animal and during prevalence of intake as per day per was among Chinese aged years during Chinese aged the average intake in 2018 increased by with that in The prevalence of as per in the was among and that of as an average daily intake for males and for was which was decreased by in comparison with that in In a the Chinese major Chinese and It had energy from fat by increased energy intake from protein by and increased energy from carbohydrates by dietary intake from to intake increased from to and intake increased from to a the in the of in the from to the of the was (95% to with the the was (95% to The per was China per It that the was in in Chinese adults with and in Youth more than in and more than in from and across 31 provincial administrative units in China. of indicated that with the prevalence in from showed an in the proportion of of to in the and but in school In of the in and school the that of daily to of daily and for years and for In the prevalence of daily on in the of and on was and on it increased to and of the Chinese Survey on and Health were conducted from to and Chinese in and aged years [Figure Results showed that the prevalence of health status and decreased on the whole. The among years were of health status and among Chinese in and from to of aged years in the China Health and Nutrition Survey indicated that from to the prevalence of among the participants increased by The declined by and the on increased by China Disease and Nutrition Surveillance was a that was conducted in across 31 provincial administrative units in China. In the prevalence of among residents aged years was It increased with the in 2010 but remained low in China. for the population aged the prevalence of was in the aged years [Figure of among Chinese adults aged years in 2015. from indicated that the total among Chinese adults from to during to the decreased by in and a was in females. China Disease and Nutrition Surveillance showed that the of adults aged years in 2018 was which was to that in but than that in 2010 A study the by the Health in on prevalence for and on individuals aged years. The of mortality by in China was to to million deaths than Chinese residents cardiovascular from the study were followed up for an average of years. total was with a risk of The risk for the top of total was by for death in total was with a risk of The of the was and of for and Data from the cohort showed that a was with a a and fat. In a was with a a and more fat. of and were with and The trend of and among Chinese residents is on the [Figure on the Surveillance of Nutrition and Health of Chinese indicated that the prevalence of and in were and for aged and 7.9% for aged years. on the from China Disease and Surveillance 2018, were and for adults aged in the prevalence of and among Chinese residents and is that by the prevalence of and in adults to the Chinese in and aged years to the Chinese and in aged years to the the number of people with and and has in China. In 2018, of Chinese residents aged years their in the past Data from the study indicated that in the deaths were in China. The mortality to was per population, and of deaths to In the Biobank participants aged years were during and were followed up for an average of years. In with an of was with mortality for A study the of and aged years from cohort Health and Health in China. from to was with a than for for mortality in among individuals who a at factors A of showed that among with in China, the prevalence of was (95% and that of from to The study showed that the prevalence of in China was among with first which was than that among a of it was than that in the risk of was in the Chinese residents A of on the and indicated that the prevalence of among was It was in China than in A total of participants of were in the China Health and with of with had an risk of and mortality with to the of Chinese adults aged 30–79 years in the analysis of the the prevalence of major was a median of of was in participants with major with was more in the residents Cardiovascular risk factors Data from of in and that the prevalence of among the Chinese residents aged ≥15 years was and a general trend on the prevalence of in China. of Chinese of ≥15 ≥15 ≥15 China Health and Nutrition Survey Survey on the of Nutrition and Diseases of Chinese 2012 China Survey China Health and Nutrition Survey China Disease and Surveillance 2018 to China Survey the prevalence of among Chinese residents aged years was and the prevalence was during It was that million of the Chinese population had The prevalence of was and the prevalence was It was that million of the Chinese adults had China Disease and Surveillance was conducted in of 31 provincial administrative units across China in 2018. A was to residents aged and participants were in the The prevalence of was (95% A cohort study Chinese adults aged years from of increased from per during to per during Data from indicated that the prevalence of among Chinese adults aged years increased from in to in 2015. The and of among Chinese adults aged years in were and 2]. and of from in China. rate rate rate ≥15 China Health and Nutrition Survey Survey on the of Nutrition and Diseases of Chinese 2012 China Nutrition and Health Surveillance and of among Chinese population 11.2 China Survey China of China Health and Nutrition Survey China Disease and Surveillance 2018 of A study was in from provincial administrative units across China during Results showed that for of increased by study adults with risk of had a of and had and followed them up for an average of years. 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Results from China and Cardiovascular Health during and a in provincial administrative units across China during showed that the prevalence of by Chinese and of at the first the prevalence of 3 in in China and Cardiovascular Health and in to the from of the prevalence among Chinese in areas from in to in 2015. for the largest of and the prevalence increased from to years. is the risk for in and of on the and Data of Chinese and aged years were from Chinese Survey on and Health The risk for because of increased from in to in The population attributable risk for because of and was than that for [Figure in the for because of and in Chinese during attributable to the of participants aged years for analysis in the China Nutrition and Diseases Surveillance in the of total and were than in Disease that China had of the in but of in 2018, as as aged years were in the and Data of participants in and participants in indicated that the and in among and were all increased with the estimates of years Data from China Survey of Disease and on the of Nutrition and Diseases of Chinese showed that the prevalence of as the of including and among Chinese adults aged years increased from in to in and China of a prevalence of among the population aged years. Results from the China Disease and Surveillance China Nutrition and Diseases Surveillance China and and China showed that low and were major of among Chinese residents [Figure of of among Chinese adults. China Nutrition and Diseases China Disease and China of China and Cardiovascular and Health was conducted among and aged years in The prevalence of as and was to the of in of the of was by in China. risk exposure level for remained the risk for followed by risk exposure The risk for first of was in China to the by Chinese for the of in Results showed that for of the total had risk of and of them Among participants with risk of and were with In for of the total had risk of of were with and 26.6% The rate was among who were to 2018, the for Cardiovascular Disease in China with who had a of from Among were in in In the aged the was of them and had A cohort of participants from study in China were followed up for a median of years. 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The prevalence of among them was to prevalence of was as in and in on the of from the Chinese population in adults with from in China. were to a of from to with the participants in the had a median in of years and a of years in In the risk was by in in cardiovascular in in cardiovascular and in The of and was in the than in the A was conducted and 2010 including adults aged years from provincial administrative units in China. The prevalence of was the number of with in China was to about million. The prevalence of rate was and that of as a to was A total of adults aged years were in the of China Health and The prevalence of as an rate was (95% and increased with for aged for for for and for aged China Disease Annual Data Report indicated that the with of all in in China. 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A trend of mortality to exposure has been since to a that on the and health of an of in China and attributable deaths in and A study the of and in China on and The and attributable deaths in were to by (95% and (95% and of China the and of and the of areas for and of of areas had been in 31 provincial administrative units across China, of all and The and for and of Diseases in China was by the of the of the of China in It that the of areas in was to of the and which has been an of the and of in the the of areas is the of and from individuals to the population. The of areas for and of in of was in the number of healthy units as healthy healthy healthy healthy healthy healthy healthy and the increased by from to The healthy units and improved the of risk factors for among The prevalence of and decreased by and been in the years. 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It who in in China and 2018. Results showed that the mortality declined from in to in 2018. The in was The prevalence of to on and secondary increased In 2021, were to with in China in which increased by in comparison with the in [Figure The average number of was per The proportion of who were with for increased from 2019 to 2021, with the estimates of and for the 3 The mortality of has at a low level since It was in 2021, as that in of from to in China. to the mortality of showed an to Health it was among and among rural for and of all [Figure The mortality of was the of death in areas and the in rural It was in than in and in rural areas than in Trend of mortality of in and rural residents in China from to 2019 indicated that in the rate of in China was per It was for for and for to the of decreased by the of increased by that of and decreased by and 3]. 3 and of and percentage from to 2019 in China. 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