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Author Spotlight: Assessing the Cardiovascular Profile of Patients with Metabolic Syndrome
Published on: September 27, 2024
Prevalence and Mortality of Cardiovascular-Kidney-Metabolic Syndrome in China: A Nationwide Population-Based Study
Congyi Zheng1, Anping Cai2, Muyi Sun3
1Division of Prevention and Community Health, National Center for Cardiovascular Disease, Fuwai Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China.
Insights
Cardiovascular-kidney-metabolic (CKM) syndrome is prevalent in China, with advanced stages significantly increasing mortality risk. Addressing CKM syndrome requires urgent, comprehensive management strategies to combat this growing epidemic.
Area of Science:
- Epidemiology
- Public Health
- Cardiology
- Nephrology
- Metabolic Disorders
Background:
- Cardiovascular-kidney-metabolic (CKM) syndrome is an emerging health framework to assess CKM health.
- Data on the prevalence and mortality burden of CKM syndrome in China is limited.
- Understanding CKM syndrome's impact in China is crucial for public health planning.
Purpose of the Study:
- To determine the prevalence of different Cardiovascular-kidney-metabolic (CKM) syndrome stages in China.
- To evaluate the association between CKM stages and all-cause, cardiovascular (CV), and non-CV mortality.
- To quantify the mortality burden attributable to CKM stages in the Chinese adult population.
Main Methods:
- Utilized data from 33,685 nationally representative adults in the China Hypertension Survey (2012-2015).
- Calculated weighted prevalence for each CKM stage (0-4).
- Employed Cox regression analysis to assess mortality risks and population attributable fractions (PAFs) for CKM stages.
Main Results:
- Prevalence: Stage 0 (18.8%), Stage 1 (15.5%), Stage 2 (42.1%), Stage 3 (14.7%), Stage 4 (8.9%). Advanced stages (3-4) accounted for 23.6%.
- Mortality Risk: Compared to Stage 0, adjusted Hazard Ratios (HRs) for all-cause death increased with stage: Stage 2 (1.36), Stage 3 (2.47), Stage 4 (4.00). Similar trends observed for CV and non-CV mortality (P-trend < 0.001).
- Mortality Burden: Population Attributable Fractions (PAFs) for all-cause death increased with stage: Stage 2 (13.4%), Stage 3 (18.6%), Stage 4 (22.0%).
Conclusions:
- A significant proportion of Chinese adults exhibit poor Cardiovascular-kidney-metabolic (CKM) health.
- Advanced CKM stages are strongly associated with increased all-cause, cardiovascular, and non-cardiovascular mortality.
- Urgent implementation of integrated management strategies is necessary to address the widespread CKM syndrome epidemic in China.
Background:
Cardiovascular-kidney-metabolic (CKM) syndrome is a novel staging framework used to evaluate CKM health. The burden of CKM syndrome in China is relatively unknown, and such data may inform future health priority.
Objectives:
The purpose of this study was to assess the prevalence and mortality risk across CKM stages.
Methods:
Nationally representative populations (n = 33,685) were included from the China Hypertension Survey. The weighted prevalence of each CKM stage was calculated. All-cause, cardiovascular (CV), and non-CV death associated with CKM stages were analyzed using Cox regression analysis. Population attributable fraction (PAF) was calculated to estimate the mortality burden related to each CKM stage.
Results:
Between 2012 and 2015, 18.8% of Chinese adults met criteria for stage 0, 15.5% for stage 1, 42.1% for stage 2, 14.7% for stage 3, and 8.9% for stage 4, with advanced stage (stages 3-4) was 23.6%. After 5-year follow-up, compared with stage 0, adjusted HR for all-cause death in stage 1 was 0.77 (95% CI: 0.51-1.15), stage 2 was 1.36 (95% CI: 1.04-1.77), stage 3 was 2.47 (95% CI: 1.91-3.19), and stage 4 was 4.00 (95% CI: 3.07-5.22). Similarly, adjusted HRs for CV death and non-CV death progressively increased from stage 2 to 4 (both P-trend values < 0.001). For all-cause, CV, and non-CV death, PAFs increased with advancing CKM stages. For instance, for all-cause death, PAFs caused by stages 2, 3, and 4 were 13.4%, 18.6%, and 22.0%.
Conclusions:
Poor CKM health is widespread in China, underscoring the urgent need for collaborative and comprehensive management strategies to tackle CKM syndrome epidemic.
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