Prediction of 10-year Atherosclerotic Cardiovascular Disease Risk among Adults Aged 40-79 Years in China:a Nationally Representative Survey

Objective To establish the distribution of 10-year atherosclerotic cardiovascular disease （ASCVD） risk among Chinese adults. Methods We estimated the 10-year ASCVD risk by applying the 2013 American College of Cardiology/ American Heart Association pooled cohort equations （PCEs） to the data obtained from the 2010 China Chronic Disease and Risk Factor Surveillance that involved 61,541 participants （representing 520,158,652 Chinese adults） aged 40-79 years. We also compared the ASCVD risk with the 10-year ischemic cardiovascular disease （ICVD） risk, which was calculated using the simplified scoring tables recommended by the Chinese Guidelines for Prevention of Cardiovascular Diseases （Chinese model）. Results Based on the PCEs, the average 10-year ASCVD risk among adults without self-reported stroke or myocardial infraction was 12.5%. Approximately 247 million （47.4%） and 107 million （20.6%） adults had 〉 7.5% and 〉 20% 10-year ASCVD risks, respectively. The 10-year ASCVD risk 〉 20% was higher among men, less educated individuals, smokers, drinkers, and physically inactive individuals than among their counterparts. Overall, 29.0% of adults categorized using the Chinese model were overclassified with the PCEs. Conclusion Our results define the distribution of 10-year ASCVD risk among Chinese adults. The 10-year ASCVD risk predicted by the PCEs was higher than the ICVD risk predicted by the Chinese model.

Non-alcoholic steatohepatitis and the risk of myocardial infarction: Apopulation-based national study

BACKGROUNDNon-alcoholic fatty liver disease (NAFLD) is a systemic disease with bidirectionalrelationships with cardiovascular disease (CVD). Non-alcoholic steatohepatitis(NASH) is a more severe subtype of NAFLD. Patients with NASH exhibit moreintra and extrahepatic inflammation, procoagulant imbalances andproatherogenic lipid profiles. Whether NASH increases the risk of ischemic heartdisease is currently unclear.AIMTo investigate the relationship between acute myocardial infarction (MI) andNASH in a large cohort of subjects in the United States.METHODSWe reviewed data from a large commercial database (Explorys IBM) thataggregates electronic health records from 26 large nationwide healthcare systems.Using systemized nomenclature of clinical medical terms (SNOMED CT), weidentified adult with the diagnosis of NASH from 1999-2019. We includedpatients with the diagnosis of acute MI from 2018-2019. Comorbidities known tobe associated with NASH and MI such as obesity, diabetes mellitus,hyperlipidemia, smoking, male gender, and hypertension were collected.Univariable and multivariable analyses were performed to investigate whetherNASH is independently associated with the risk of MI.RESULTSOut of 55099280 patients, 43170 were diagnosed with NASH (0.08%) and 107000(0.194%) had a MI within 2018-2019. After adjusting for traditional risk factors,NASH conferred greater odds of MI odds ratio (OR) 1.5 [95% confidence interval(CI): 1.40-1.62]. Hyperlipidemia had the strongest association with MI OR 8.39(95%CI: 8.21-8.58) followed by hypertension OR 3.11 (95%CI: 3.05-3.17) andsmoking OR 2.83 (95%CI: 2.79-2.87). NASH had a similar association with MI asthe following traditional risk factors like age above 65 years OR 1.47 (95%CI: 1.45-1.49), male gender OR 1.53 (95%CI: 1.51-1.55) diabetes mellitus OR 1.89 (95%CI:1.86-1.91).CONCLUSIONMI appears to be a prevalent disease in NASH. Patients with NASH may needearly identification and aggressive cardiovascular risk modification.

Ten year risk assessment of ischemic cardiovascular disease and intervention analysis among middle-aged residents with moderate risk and above in a Shanghai-based community

Objective: The exposure conditions with regard to 10-year ischemic cardiovascular disease (ICVD) risk among residents aged 45-59 years treated in Hudong Community Health Service Center were surveyed to provide an objective basis for further studies on the relation between risk factors and ICVD events. Methods: The survey was conducted from October 2013 to March 2014 with use of the princi-ple of cluster sampling. Our investigation involved questionnaire and laboratory tests. All residents were evaluated according to the table of National 10-Year Risk Assessment for ICVD to forecast the 10-year risk. The community intervention methods were medication and lifestyle intervention based on the relevant guidelines. Results: The body mass index and smoking rate were significantly higher in men than in women. The 10-year ICVD risk was 6.1% for moderate risk or above. We performed intervention in such residents for 1 year, with the result that the blood pressure and total cholesterol levels were significantly decreased (P<0.05). Conclusion: It is imperative that early prediction and intervention be conducted for the resi-dents with risk factors. After the intervention, we found that the risk declined in 79.41% of the residents with moderate risk and or above and that the 10-year ICVD risk score decreased.