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To evaluate the impact of cerebrovascular death on the life expectancy of Chinese residents in recent years and explore the difference in the subgroups.Life expectancy and cause-elimination life expectancy were calculated by standard life table techniques using the adjusted mortality data from the Death Surveillance Data Sets in 2005 and 2010 provided by the National Disease Surveillance System. Decomposition method was used to quantitatively evaluate the impact of cerebrovascular disease.The life expectancy of Chinese residents was 73.23 years old in 2010. The loss of life expectancy caused by cerebrovascular death was 2.26 years in 2010, with about 97% of that came from the elimination of deaths in the residents aged over 40 years old. Compared with 2005, the reduction of cerebrovascular deaths contributed to a total of 0.04 years increase in the life expectancy of Chinese residents in 2010, with 0.45 years for urban residents. However, for the rural residents, cerebrovascular death increased and caused 0.12 years decrease of life expectancy.The impact of cerebrovascular death on the life expectancy of Chinese residents is still great. Significant difference is showed between the urban and rural areas with reduction in the urban but increase in the rural. The life expectancy is likely to be further increased by reducing cerebrovascular death in the Chinese residents aged over 40 years old.

To explore the 15-years change in fasting TG level and the accumulative incidence of type 2 diabetes mellitus (T2DM) from 1992 to 2007, and to assess the association between the change in TG level and the accumulative onset risk of T2DM.A total of 11 387 subjects aged 35 - 64 years were recruited from 6 provinces in China in the baseline survey in 1992, and were followed-up for cardiovascular disease till 2007. In 2007, 9184 subjects were successfully followed-up and 5966 subjects entered into the second examination. Totally 5408 participants, who were free of diabetes at baseline and had complete information for both check ups, were included in this analysis. Fasting TG levels were categorized into three groups:1.70 mmol/L, 1.70 - 2.25 mmol/L and ≥ 2.26 mmol/L. The association between 15-years change in TG level and the accumulative onset risk of T2DM was assessed by logistic regression analysis.In 1992, the mean level of TG was 1.49 mmol/L in male and 1.26 mmol/L in female. During the 15 years, TG levels increased by 0.25 mmol/L and 0.53 mmol/L in male and female, respectively. The prevalence of elevated TG (1.70 mmol/L) increased from 23.4% in 1992 to 39.0% in 2007. The 15-year accumulative incidence of diabetes was 13.9% in male and 11.8% in female. The incidence rates were 10.5%, 16.2% and 26.6% for TG levels of1.70 mmol/L, 1.70 - 2.25 mmol/L and ≥ 2.26 mmol/L, respectively. Multivariate logistic regression analysis showed that the baseline TG level was significantly associated with the onset risk of diabetes after adjustment for other cardiovascular risk factors. At any given baseline TG level, the onset risk of diabetes increased with the TG levels in the second examination in 2007. After adjusting other risk factors, participants with the highest categories of both baseline and follow-up TG levels had 2.1 folds higher accumulative onset risk of diabetes (RR = 3.39, 95%CI 2.49 - 4.61) than those with the lowest categories of both baseline and follow-up TG levels.Baseline TG level is independently associated with diabetes onset risk, and the change of TG level in a 15-year interval predicts the onset risk of diabetes beyond the baseline TG level.

To examine the current status of the use of aspirin among outpatients with established coronary heart disease (CHD) in China.Sixty-four hospitals across 31 provinces of China, including 32 secondary hospitals and 32 tertiary hospitals were selected for a baseline survey. Fifty outpatients with history of acute coronary syndrome (ACS) were recruited consecutively in each hospital. Information of these patients was collected and the situation of aspirin use among the patients was analyzed.There totally 2781 CHD outpatients were recruited with complete data. Mean age of the patients was 65 +/- 10. Sixty-nine percent of the patients was males and 31% was females. The utilization rate of aspirin before this clinical visit was 83.6%. There were significant difference among regions and hospitals. The utilization rate of aspirin was 64.2% and 97.8% respectively in the two provinces with the lowest use rate and the highest use rate. Use rates of aspirin in CHD outpatients varied from 29.4% to 98%among 64 hospitals. The male CHD patients had higher use rate than the female patients did (85.1% vs. 80.4%, P0.01). There also was notable difference in prescribed dose of aspirin among regions and hospitals. An analysis of multiple logistic regression model revealed that gender, age, monthly income, history of PCI and onset time of the previous ACS event were independently associated with the utilization status of aspirin in these outpatients.The overall utilization rate of aspirin in CHD outpatients reached to 83.6%, but remarkable differences in aspirin use existed among regions, hospitals and patients with different characteristics in current clinical practice in China.

To evaluate the association between serum HDL-C and the risk of cardiovascular diseases (CHD) in subjects aged 35-64 years.A prospective study was carried out in 11 provinces from 1992 to 2002. The association of baseline HDL-C level and cardiovascular disease occurrence was analyzed in 30384 subjects aged 35-64 years using Cox multivariate proportional hazards regression.(1) Compared with the group of HDL-Cor = 1.56 mmol/L, multivariate-adjusted relative risk of ischemic cardiovascular disease (ICVD), including CHD and ischemic stroke increased continuously with decreased HDL-C level. (2) HDL-C level had different impact on different types of CVD. Positive association was observed between HDL-C level and the risk of ischemic stroke, but the relationship between HDL-C level and the risk of hemorrhagic stroke was indefinite. Compared with the group with HDL-Cor = 1.56 mmol/L, the risk of CHD of the group with HDL-Cor =1.03 mmol/L increased by 45% (RR = 1.45, P0.05) and that of ischemic stroke increased by 53% (RR = 1.53, P0.01). (3) 6.4% of ICVD, 7.2% of the acute CHD and 7.3% of the acute stroke was attributable to low serum high density lipoprotein cholesterol.Starting from HDL-Cor = 1.56 mmol/L, the risk of ICVD increases continuously with decreased HDL-C level. Comprehensive intervention for multiple risk factor clustering should be strengthened to reduce theoverall risk of CVD.

To analyse the trends and distributions of case-fatality within 28 days after stroke in the population aged 35 - 74 in Beijing from 1984 to 2000 and to explore the possible influencing factors for case-fatality.In Sino-MONICA Project, acute stroke events were registered in a standardized way in men and women aged 35 - 74 years in Beijing from 1984 to 2000. Death even was defined as death within 28 days after stroke onset. From January 1 1984 to December 31 2000, 13,556 patients were registered, and 3905 died within 28 days of stroke onset.(1) The overall case-fatality within 28 days after stroke was 28.8% from 1984 to 2000, and the case-fatality were 63.2% for cerebral infarction (CI) and 34.8% for cerebral haemorrhage (CH) respectively. (2) The case-fatality for stroke declined 1.51% (P0.01) in men and 1.83% (P0.01) in women annually during 1984 to 2000, and the decline rate for CH and CI were 1.48% and 0.51% per year respectively. (3) The case-fatality ratio between men and women was 1:1.13 (P0.01). The case fatality for stroke was higher in rural area (38.7%) than in urban area (26.3%) (P0.01), and higher for recurrent stroke (36.1%) than for initial stroke (25.2%) (P0.01).The overall 28-day case-fatality after stroke onset decreased continually in the population aged 35 - 74 in Beijing during 1984 to 2000. The biggest contribution was from the decline of case-fatality of cerebral haemorrhage of stroke. In order to decrease the incidence of stroke, promoting the quality of health care and secondary prevention for stroke will be necessary, especially in rural area.

To evaluate the effect of lowering the fasting plasma glucose (FPG) cutoff point for the criterion of impaired fasting glucose (IFG) in the 2003 ADA guideline on the prevalence of IFG and risk of ischemic cardiovascular diseases (ICVD) associated with IFG in Chinese population.A prospective study was carried out in 11 provinces from 1992 to 2003. The baseline survey was conducted according to the WHO-MONICA protocol for risk factor surveys. These subjects have been followed-up for coronary heart disease (CHD) and stroke since the baseline survey. The association between baseline FPG and ICVD (CHD and ischemic stroke) events in 30 378 subjects aged 35 - 64 years in the 10-year follow-up period was analyzed.(1) Lowering the criterion for diagnosing IFG to 5.55 mmol/L increased the prevalence of IFG from 6.9% to 21.6% in Chinese population aged 35 - 64 years. (2) As compared with the group of FPG less than 5.55 mmol/L, the prevalence of other traditional CVD risk factors increased in the FPG level of 5.55 - 6.05, 6.11 - 6.94 and 6.99 mmol/L or above. (3) Univariate analysis method showed that the 10-year accumulated incidence and relative risk for ICVD increased with the elevated baseline level of FPG. (4) After adjusting for age and other ICVD risk factors (including hypertension, lipid disorder, smoking and obesity) FPG level of 5.55 - 6.05 mmol/L showed an independently predictive value for ICVD in men (RR = 1.302, 95% CI = 1.021 - 1.660), but not in women (RR = 1.255, 95% CI = 0.887 - 1.776). Hypertension, low HDL-C, smoking (men) and central obesity (women) were more strongly associated with ICVD than glucose status.The newly defined IFG criterion (FPG 5.55 - 6.94 mmol/L) increased the prevalence of IFG by more than 2 times in Chinese population aged 35 - 64 years. The 10-year accumulated incidence and relative risk for ICVD increased with the elevated baseline level of FPG. The predictive value of hyperglycemia for ICVD was weaker than that of other traditional risk factors. Comprehensive intervention for multiple risk factors clustering should be strengthened to reduce the overall risk of CVD.

To describe the changing trend of serum total cholesterol (TC) in Beijing population aged 25 - 64 years old from 1984 to 1999 and to explore the distributions of hypercholesterolemia in different subgroups.From 1984 to 1999, five independent cardiovascular diseases (CVD) risk factors surveys with the same protocol were conducted in Beijing population aged 25 - 64 years. Stratified-random sampling was used.(1) In the period from 1984 to 1999, the mean level of TC increased 1.058 mmol/L (25.1%) in Beijing population aged 25 - 64. The mean level of TC showed increase trends in different genders and age groups, with the greatest increase of 0.998 mmol/L (25.9%) being in the 25 - 34 age group. The mean level of TC was higher in urban subjects than in rural subjects, whereas the increment of TC level was higher in the rural subjects (32.8%) than in urban subjects (26.3%). (2) The prevalence of hypercholesterolemia increased from 6.1% in 1984 to 29.9% in 1999, with 23.8% of the increase during the 15 years. Among different subgroups, both the lowest prevalence of hypercholesterolemia and the greatest increase of hypercholesterolemia prevalence were shown in men aged 25 - 34 years old, with a 16.4 fold increase in 15 years.The increase trends of mean TC level and hypercholesterolemia prevalence were observed in Beijing population during 1984 - 1999, especially in rural subjects and men aged 25 - 34 years old.

To explore the association of cardiovascular disease (CVD) risk factors and its impact on the 10-year prevalence of carotid atherosclerosis.Two surveys for CVD risk factors were carried out in a population consisting of 1323 subjects in Beijing in both 1992 and 2002 and a direct measurement of carotid arteries with B-mode ultrasound imaging were performed in 2002. Intima-media thickness (IMT) and plaque of carotid arteries were regarded as the indicators of carotid atherosclerosis and main CVD risk factors were treated as the impact factors.(1) 10-year prevalence of carotid atherosclerosis continually increased with elevated baseline risk factors levels. Age, smoking, hypertension and hypercholesterolemia were found to be independently associated with carotid atherosclerosis. (2) 10-year prevalence of carotid atherosclerosis increased with the elevated number of risk factors clustering in individuals. (3) The prevalence of IMT and plaque were 67.1% and 42.6% in subjects with CVD risk factors in both 1992 and 2002 surveys with Odds Ratios being 1.7 and 3.1 times as those without risk factors.Traditional CVD risk factors exert impact on CVD and carotid atherosclerosis with different degrees and carotid atherosclerosis can be regarded as an early evaluation indicator for risk of atherosclerotic diseases.

To provide epidemiological data for the revision of The National Guideline for Prevention and Treatment of Hypertension through the analysis of the association between blood pressure (BP) and the risk of cardiovascular diseases (CVD) in a cohort aged 35-64 years.A prospective study was carried out in 11 provinces from 1992 to 2002. The association between BP and CVD (CHD and stroke) was analyzed in 31728 subjects aged 35 - 64 years.(1) Compared with BP110/75 mmHg, the risk of CVD increased 1 time (RR=2.09), 2 times (RR=3.23), and 10 times (RR=11.81) when BP was 120-129/80-84 mmHg, 140-149/90-94 mmHg, andor = 180/110 mm Hg, respectively. (2) The risk of acute CHD for subjects with stage 2 hypertension was 2.3 times of those with optimal BP, whereas the risk of ischemic stroke and hemorrhagic stroke was 4.9 times and 11.7 times, respectively. (3) 36.1% of all CVDs, 44.0% of the acute stroke and 23.7% of the acute CHD were attributable to hypertension. (4) In each BP level, the 10-year risk of CVD increased with the increased number of other risk factors.The risk of CVD increases with BP continuously from BP of 110/75 mmHg. Therefore, the cutpoint of the diagnostic criteria for hypertension is arbitrary. Comprehensive intervention for multiple risk factor clustering should be strengthened to reduce the overall risk of CVD.