Affiliation:
1. Department of Big Data in Health Science, School of Public Health, Zhejiang University, Hangzhou, China
2. Center for Biostatistics, Bioinformatics, and Big Data, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
3. Department of Biostatistics, Epidemiology and Environmental Health Sciences, Jiann-Ping Hsu College of Public Health, Georgia Southern University, Statesboro, GA, USA
Abstract
The burden of premature atherosclerotic cardiovascular disease (ASCVD) has increased rapidly in China. Using the China Health and Nutrition Survey (CHNS) data, we assessed the risk factors of premature ASCVD (age of diagnosis: <55 years for men and <65 years for women). Propensity score matching was used to reduce selection bias. Multivariable Cox proportional-hazards analyses indicated that factors associated with increased risk of premature ASCVD included hypertension (adjusted hazard ratio [HRadj.] = 1.68, 95% confidence interval [CI] = [1.14, 2.48]), obesity (HRadj. = 1.64, 95% CI = [1.03, 2.61]), and high carbohydrate intake (HRadj. = 1.46, 95% CI = [1.03, 2.08]). Conversely, participants with medical insurance (HRadj. = 0.42, 95% CI = [0.28, 0.61]), high urbanization index (HRadj. = 0.53, 95% CI = [0.33, 0.85]), and high household income (HRadj. = 0.48, 95% CI = [0.33, 0.71]) had lower risk of premature ASCVD. When comparing premature vs non-premature ASCVD participants, those who were obese (HRadj. = 2.08, 95% CI = [1.14, 3.80]) or living in more urbanized areas had higher hazards of early onset (HRadj. = 2.29, 95% CI = [1.33, 3.94]).
Subject
Public Health, Environmental and Occupational Health