Abstract 14615: The Preventable Causes of Cardiovascular Diseases in China: Comparative Risk Assessment of Dietary, Lifestyle, and Metabolic Risk Factors

Background: fuelled by rapid urbanization and changes in dietary and lifestyle choices, cardiovascular disease (CVD) has emerged as the leading cause of death in China. Purposes: to estimate the CVD events that potentially contributed to 9 modifiable dietary, lifestyle, and metabolic risk factors in China. Methods: We used data on risk factor exposures in the Chinese population from nationally representative health surveys and CVD morbidity and mortality statistics from the China Health Statistical Yearbook and the National Population Census. We obtained the etiological effects of risk factors on CVD risk, by age, from systematic reviews and meta-analyses of epidemiological studies. We estimated the number of CVD events attributable to all non-optimal levels of each risk factor exposure, by urban/rural, age and sex. Results: Based on the exposure distribution estimated by 2009 China Health Nutrition Survey, the population attributable risk (PAR) on CVD events was 47.3% for high blood pressure, 23.2%, for physical inactivity, 18.5% for smoking, 13.5 for high BMI, 13.0% for high LDL cholesterol, 11.8% for high blood glucose, 11.1% for low dietary intakes of fruit and vegetable, 7.1% for high sodium intake and 3.5% for low PUFA intake, which was 78.0%, 18.8%, 20.9%, 21.9%, 8.2%, 16.1%, 12.0%, 20.3% and 2.0%, respectively, based on exposure distribution of 2002 China National Nutrition and Health Survey. In 2009, high blood pressure was responsible for 3.9 million CVD events, including 1.4 million CHD, 1.5 million ischemic strokes and 1 million hemorrhagic strokes. Large gender difference was found for PAR% of smoking (male 27.8%/female 6.5%). Conclusions: High blood pressure, smoking and physical inactivity, which all have effective interventions, are responsible for the largest number of CVD events in China. Other dietary, lifestyle, and metabolic risk factors for chronic diseases also cause a substantial number of CVD morbidity and mortality in China.