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To investigate the status of the clustering of cardiovascular risk factors and hypertension control among hypertensive patients in the outpatient setting in China.This multi-center cross-sectional study was carried out from June to December 2009. Study patients were consecutively recruited from 46 hypertension outpatient clinics in 22 provinces, autonomous regions, and municipalities of China according to identical inclusion criteria. More than 100 consecutive patients should be recruited in each outpatient clinic, and 5206 hypertensive outpatients were included. The patients were examined by questionnaires, physical examinations, and biochemical analyses. Risk factors were defined according to the 2010 Chinese guidelines for the management of hypertension.In this patient cohort, dyslipidemia was found in 61.5% (3203/5206), obesity in 56.0% (2917/5206), and impaired glucose regulation in 27.8% (1449/5206) patients. The prevalence of smoking was 34.9% (910/2605) in male hypertensive patients, 88.9% (4630/5206) hypertensive patients had at least one of the above-mentioned four risk factors and 17.4% (906/5206) had three or more risk factors. Only 4.1% (211/5206) hypertensive outpatients were classified as low cardiovascular risk patients, 72.5% (3774/5206) hypertensive outpatients were classified as high or very high cardiovascular risk patients. The general blood pressure control rate was 44.3% (2304/5206), which was higher in the age group of ≥ 65 years than in those of 35-44 years [51.3% (818/1596) vs. 29.6% (160/541), P0.01], higher in low-risk patients than in high-risk patients [65.4% (138/211)vs. 41.9% (1581/3774), P0.01] and higher in patients under regular therapy ( ≥ 9 months per year) than in those of irregular therapy (6 months per year) [50.7% (1744/3442)vs. 30.0% (391/1305), P0.01].Clustering of cardiovascular risk factors, especially dyslipidemia and obesity, is common, and cardiovascular risk is high while blood pressure control rate is low among hypertensive outpatients in China.

To explore the impact of gender on lipoprotein-associated phospholipase A(2) (Lp-PLA(2)) activity and association with known cardiovascular risk factors.Participants in this study were recruited from Beijing sub-cohort from the Chinese Multi-provincial Cohort Study (CMCS) database. A total of 1471 participants with complete laboratory data were included in the study (688 male). Lp-PLA(2) activity was determined by colorimetric assay kit.Lp-PLA(2) activity level and correlation between Lp-PLA(2) activity and known risk factors were compared between men and women.(1) Lp-PLA(2) activity was higher in males than in females [(22.73 ± 8.52) nmol·min(-1)·ml(-1) vs.(20.01 ± 8.06) nmol·min(-1)·ml(-1), P0.01].(2) Age, waist circumference, systolic blood pressure, diastolic blood pressure and the prevalence of hypertension were higher in males than in females, while total cholesterol, low-density lipoprotein cholesterol (LDL-C) and high-density lipoprotein cholesterol (HDL-C) were higher in females than in males (P0.05 or P0.01).(3)Pearson correlation showed that Lp-PLA(2) activity was correlated with lipids ( total cholesterol, LDL-C, HDL-C, and triglyceride), blood pressure (systolic blood pressure and diastolic blood pressure), and adiposity associated parameters (waist circumference and body mass index) in males (all P0.01) and was correlated with lipid level (total cholesterol, LDL-C, HDL-C, and triglyceride) and age in females( P0.05 or P0.01). Correlations with variables associated with obesity or blood pressure in females were much weaker than those in males (in females, r = 0.02-0.08; in males, r = 0.10-0.16).(4)After adjustment for age, waist circumference, systolic blood pressure, glucose, LDL-C, HDL-C, triglyceride and high sensitivity C-reactive protein by multiple logistic regression model, Lp-PLA(2) activity was still significantly higher in males than in females (OR = 1.72, 95% confidence interval = 1.34-2.21, P0.01).Lp-PLA(2) activity and association with known cardiovascular risk factors differed in males and females. The gender difference in Lp-PLA(2) activity still presents after adjustment for known cardiovascular risk factors in this cohort.

To examine the distribution and trends of hospitalization rates for coronary heart disease (CHD) from 2007 to 2009 in Beijing.We calculated hospitalization rates for CHD using data from Beijing Hospital Discharge Information System. Information of census registered population in Beijing was obtained from Beijing Municipal Bureau of Statistics. CHD includes acute myocardial infarction, unstable angina and other forms of CHD. Age-standardized hospitalization rates for CHD per 100 000 population aged 25 years or more were calculated.During 2007 - 2009, a total of 248 049 patients aged 25 years or more hospitalized in Beijing with the primary discharge diagnosis of CHD were enrolled, of whom 73.7% were permanent registered Beijing citizens. The average hospitalization rate for CHD in 2007 - 2009 was 651.2/100 000 for the permanent residences in Beijing (741.2/100 000 in men, 560.9/100 000 in women). The highest average hospitalization rate (671.9/100 000) was seen in exurban area compared to other areas in Beijing. The average hospitalization rate for acute myocardial infarction, unstable angina, and other CHD was 126.4/100 000, 226.4/100 000 and 298.4/100 000, respectively. The hospitalization rate for CHD increased 18.1% from 2007 to 2009 (from 598.1/100 000 to 706.5/100 000). The same trend was seen in women (20.2%) and men (16.6%). The hospitalization rates of CHD in the urban, suburban, and exurban areas of Beijing all increased in the three years, and the greatest increase (36.6%) was found in exurban area. Hospitalization rates of acute myocardial infarction and unstable angina increased 24.5% and 55.3%, respectively, in the three years, while hospitalization rates of other CHD decreased 5.7%.The hospitalization rate of CHD is higher in men than in women in Beijing. The hospitalization rates for CHD increased from the observation period, especially in those living in exurban area. Awareness of the magnitudes and trends of CHD hospitalization rates is of great importance in evaluating the burden of cardiovascular disease, allocating and utilizing health care resources, and estimating the health insurance for Beijing.

To survey the incidence of acute coronary events and its trend in three years, and explore the distribution of the incidence across Beijing residents aged 25 years and more from 2007 to 2009.The present study incorporated and linked the routinely collected data from the Hospital Discharge Information System and Cause of Death Register System in Beijing, estimated the incidence of acute coronary events, and analyzed the distribution of the incidence across gender, age groups and regions. Acute coronary event was defined as non-fatal myocardial infarction and death from coronary heart disease. Numbers of residents by age, gender and area were obtained from the Beijing Statistics Bureau.A total of 68 390 acute coronary events were identified among permanent residents of Beijing aged 25 years and more from 2007 to 2009. The age-standardized incidence was 166.4 per 100 000 people in overall population, with 218.5 in males and 115.2 in females. The age-standardized incidence was 144.3, 154.7, and 195.8 per 100 000 people in urban, suburban, and exurban area, respectively. The incidence was the highest in Huairou district (263.8 per 100 000), while was the lowest in Haidian district (121.5 per 100 000). The age-standardized incidence was 158.4, 169.4, and 171.2 per 100 000 in 2007, 2008, and 2009, respectively. The age-standardized incidence increased by 8.1% in 2009 compared to 2007, increase in men (11.1%) was greater than in women (2.5%). The incidence increased significantly with age in each year. The incidence raised by 30.3% in 2009 compared to 2007 for men aged 35 - 44 years. In 2009, the incidence was 146.7, 155.9, and 207.4 per 100 000 people in urban, suburban, and exurban area, respectively. The rates increased by 3.2% in both urban and suburban areas, and 16.4% in exurban areas in 2009 compared to 2007.The incidence of acute coronary events increased from 2007 to 2009 among the permanent residents of Beijing aged 25 years and over, especially in young men, and people living in the exurban areas.

To observe the real world statins use for secondary prevention in patients with high risk 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 baseline survey. Fifty consecutive outpatients with established history of acute coronary syndrome were recruited in each hospital. Information of these patients including statins use was collected.A total of 2516 high risk CHD outpatients were involved in present report. Mean age of the patients was (65 ± 10) years and 69.4% patients were male. Fifty-seven point nine percent patients were treated with a statin at the time of interview and recommended low-density lipoprotein-cholesterol (LDL-C) target was achieved in 29.8% patients. Percent of statin use and achieving LDL-C goal was significantly higher in male outpatients than in female outpatients. Outpatients admitted in tertiary hospitals were more likely to have achieved their LDL-C targets than those admitted in secondary hospitals. Statin use was more often for patients in South China than patients in North China. The percentage reaching the optimal LDL-C treatment target was the highest in Central China (38.5%) and the lowest in Northeast China (18.5%). At this interview, 68.2% outpatients were prescribed statins and 24.1% prescribed doses of statins were sub-minimal.There was a gap between real world statin use and guideline recommendations for secondary prevention in high risk CHD patients in China.

To evaluate the prediction value of blood lipid levels on the newly-identified carotid plaque in middle-aged and elderly Chinese population.All study subjects were recruited from two cohorts from 2002 to 2007 [the People's Republic of China/United States of America collaborative study (USA-PRC study) and the Chinese multi-provincial cohort study (CMCS)]. The baseline examination including cardiovascular disease risk factors and B-mode ultrasound of carotid artery was performed in 2002 and the second examination was made in September to October, 2007. The relationship between baseline lipids and carotid plaque incidence was analyzed in a total of 2000 subjects aged 47 to 79 years (mean 63 years).(1) During these 5 years, the prevalence of carotid plaque increased from 30.3% to 62.2% and from 21.5% to 51.5% for men and women, respectively. The newly-identified carotid plaque incidence was 41.8% for men and 34.1% for women. (2) The incidence of artery plaque significantly increased in both sexes in proportion to increase of baseline total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), non-high-density lipoprotein cholesterol (non-HDL-C), and total to high-density cholesterol ratio (TC/HDL-C) levels (P0.05 or P0.01). (3) Cross-stratification analysis of LDL-C, triglyceride (TG) and HDL-C for carotid plaque incidence indicated the existence of conjoint effects between LDL-C and HDL-C, LDL and TG, as well as between TG and HDL-C, on the increased incidence of carotid plaque. (4) Multi-factorial analysis showed that higher LDL-C, non-HDL-C and TC/HDL-C were independent risk factors for development of new carotid plaque [OR = 1.44 (95%CI = 1.07 - 1.94), OR = 1.45 (95% CI = 1.08 - 1.96), OR = 1.59(95% CI = 1.14 - 2.23) in men;OR = 1.47 (95% CI = 1.13 - 1.92), OR = 1.35 (95% CI = 1.04 - 1.75), OR = 1.64 (95% CI = 1.20 - 2.23) in women].The prevalence of carotid plaque increased rapidly in this cohort between 2002 and 2007. Elevated LDL-C, non-HDL-C and TC/HDL-C levels were independent predictors of newly developed carotid plaque.

To evaluate the relationship between serum non-HDL-C and incidence of various cardiovascular disease (CVD) in Chinese population aged 35-64 years.This prospective study was performed from 1992 to 2004 in 11 provinces of China and the association between baseline non-HDL-C level with the risk of various CVD events was analyzed in 29 937 subjects aged 35-64 years using Cox multivariate proportional hazards regression. CVD events in this study including acute coronary events (ACE), ischemic stroke, hemorrhagic stroke and ischemic cardiovascular disease (ICVD).(1) Adjusted for age, gender, smoking status, diabetes, body mass index and blood pressure, the relative risk of ACE, ischemic stroke and ICVD in groups of non-HDL-C 3.37 - 4.13 mmol/L (130 - 159 mg/dl), 4.14 - 4.91 mmol/L (160 - 189 mg/dl) and ≥ 4.92 mmol/L (190 mg/dl) was 1.24 (0.91 - 1.70), 1.78 (1.25 - 2.53), 2.23 (1.48 - 3.35); 1.34 (1.07 - 1.68), 1.38 (1.04 - 1.83), 1.38 (0.97 - 1.94) and 1.37 (1.12 - 1.63), 1.52 (1.22 - 1.90), 1.70 (1.30 - 2.22), respectively. The risk of hemorrhagic stroke was declined obviously in group4.92 mmol/L (190 mg/dl). (2) The correlation between VLDL-C and ACE was the strongest in four CVD events when VLDL-C and LDL-C were joint analyzed, ICVD events ranked the second. The risk for ischemic stroke also borderline increased with increasing VLDL-C and LDL-C (P0.05).Increased non-HDL-C is associated with increased risk of suffering ACE, ischemic stroke and ICVD and VLDL-C plays a critical role in the development of ICVD events, especially ACS, in middle aged Chinese population.

To describe the distribution characteristics of carotid atherosclerosis and to analyze its association with cardiovascular risk factors in middle-aged and elderly Chinese.In 2007, the second cross-sectional examination for cardiovascular risk factors and B-mode ultrasound imaging on carotid arteries were performed in a Chinese population consisting of 2681 subjects aged 43-81 years old from two cohorts participants of the People's Republic of China/United States of America collaborative study (USA-PRC study) and the Chinese multi-provincial cohort study (CMCS). The association of cardiovascular risk factors with intima-media thickening (ITM) and plaque of carotid arteries was analyzed.(1) The mean intima-media thickening (Mean-IMT) of carotid artery was 0.68 mm, the maximal intima-media thickening (Max-IMT) was 1.07 mm. (2) The prevalence rate of carotid plaque was 60.3% in all subjects. As for the different sites of carotid arteries, the plaque prevalence rate at carotid bulb was 61.2% for male and 51.6% for female (chi2 = 23.44, P0.01), and at the internal carotid artery was 24.7% for male and 12.2% for female (chi2 = 69.57, P0.01), at the common carotid artery was 20.9% for male and 13.8% for female (chi2 = 23.18, P0.01). (3) After adjusting for age and other cardiovascular risk factors, the Mean-IMT and Max-IMT increased with elevated levels of systolic blood pressure, plasma glucose and low density lipoproteins cholesterol (LDL-C) (all P0.05). Hypertension, diabetes, smoking and high LDL-C (P0.05) were independent predict factors for the risk of carotid plaque.The carotid atherosclerosis was common in middle and older age Chinese and was positively associated with classical cardiovascular disease risk factors.

To survey the treatment status and clinical features of hospitalized patients with acute myocardial infarction (AMI) of 13 hospitals in Beijing in 2005.Uniform questionnaires were used to register AMI patients hospitalized from January 1 to December 31, 2005 in the 13 hospitals including traditional Chinese medicine (TCM) hospitals (n = 6) and western medicine hospitals (WM, n = 7) from Beijing. A total of 1663 AMI patients were registered (1366 cases in WM hospitals and 297 cases in TCM hospitals). An Access database was established and patient information was input, the clinical features and treatment status of hospitalized AMI patients were analyzed.The mean age was (63.9 +/- 12.8) years old [(62.8 +/- 12.8) years for WM Hospitals and (69.1 +/- 11.8) years for TCM hospitals, P0.05], male to female ratio was 2.4:1 (2.7:1 for WM hospitals and 1.6:1 for TCM hospitals, P0.05). The median time to hospital was 14 hours in TCM hospitals and 11 hours in WM hospitals (P0.05). Incidences of history of cerebrovascular disease, high blood pressure, diabetes, hyperlipidemia and complications such as in-patient arrhythmia, cardiac insufficiency, cardiogenic shock were significantly higher in TCM hospitals than in WM hospitals. The total mortality of 1663 AMI cases was 8.2% (15.8% in TCM hospitals vs. 6.6% in WM hospitals, P0.01). The reperfusion rate including emergency PCI and thrombolytic therapy rate was 31.3% in 13 hospitals (33.3% in WM hospitals vs. 21.9% in TCM hospitals, P0.05). Percent of guideline recommend drug use for AMI was as follows: aspirin 93.6%, ACEI and ARB 85.1%, beta-blocker 78.7%, low molecular weight heparin 85.4%, statins 74.7%.Reperfusion therapy and guideline recommended drugs were widely used although there was a need for further improvement. The hospitalized mortality showed a downward trend compared with results from five years ago, patients in TCM hospitals had an independent clinical features.

To observe the incidence of impaired glucose tolerance in hospitalized patients with essential hypertension without diabetes mellitus history and with normal fasting glucose.A total of 586 hospitalized patients with essential hypertension and without known diabetes mellitus (DM) and with normal fasting blood glucose (FBG5.6 mmol/L) were included in this epidemiologic cross-sectional survey and screening study and received oral glucose tolerance test (OGTT). Associations between postprandial blood sugar and age, gender, body mass index, blood pressure level, blood lipid level, carotid arterial sclerosis were analyzed.(1) Among 586 patients, the number of impaired glucose tolerance (IGT) was 159, the number of newly diagnosed DM was 41 and the prevalence rates of newly diagnosed DM and impaired glucose tolerance (IGT) were 7.0% and 27.1% respectively. (2) Incidence of carotid arterial sclerosis was 67.5% in patients with impaired glucose tolerance and 59.6% in patients with normal glucose tolerance (P0.05).Our results showed that incidence of newly diagnosed disturbed glucometabolic status is common among patients with essential hypertension without DM history and normal FBG. OGTT should be used as a routine procedure in these patients for the purpose of early intervention in hypertensive patients with abnormal glucometabolic status.

To evaluate the association between serum triglyceride (TG) and the cardiovascular diseases (CVD) risk in Chinese population.A total of 30, 378 men and women aged 35 - 64 years old were recruited in the Chinese-Chinese Multi-provincial Cohort Study (CMCS). The serum TG and other CVD risk factors were measured. All subjects were followed up annually or biannually for acute CVD events from 1992 to 2004. A Cox regression model was established to identify the association between TG and risk of CVD events.The accumulative incidence rate of acute coronary heart disease (CHD) events increased from 62.6/100 000 in the low TG groups to 168.4/100 000 in the high TG group divided by the quartile. TG was identified as an independent risk factor for CHD after adjustment for the confounding risk factors by a Cox regression model. Compared subjects with TG0.81 mmol/L, CHD risk increased 81% and 59% in subjects with TG 1.15 - 1.59 mmol/L and TG/= 1.60 mmol/L, respectively (all P0.05). There was no significant association between TG level and the risks of hemorrhagic and ischemic stroke events (P0.05).Serum TG is an independent risk factor for acute CHD events in Chinese population aged 35 - 64.

To evaluate the predictive value of the combined measurements of body mass index (BMI) and waist circumference (WC) for the risk of cardiometabolic diseases (including diabetes, hypertension, and dyslipidemia) and ischemic cardiovascular disease.A total of 30,378 Chinese people from 11 provinces were studied in this prospective study conducted from 1992 to 2003. Multivariable logistic and Cox regression were used respectively to determine the predictive value of WC for cardiometabolic diseases and ischemic cardiovascular disease within each BMI categories.(1) The prevalence of obesity were 10% defined by BMI. Among them, 76.4% had abdominal obesity defined by WC. The prevalence of abdominal obesity was 17.5% by WC categories, and 43.4% of them were classified as obesity by BMI. (2) The prevalence rates of cardiometabolic diseases were higher in individuals with elevated WC within each BMI category. (3) Compared with subjects with normal BMI and WC, the risk of ischemic cardiovascular disease increased by 38% (RR = 1.383, 95% CI 1.083 - 1.765) in overweight subjects with elevated WC and by 57% (RR = 1.570, 95% CI 1.226 - 2.010) in obese subjects with elevated WC.Combined measurements of BMI and WC provide a better prediction for the risk of cardiometabolic diseases and ischemic cardiovascular disease.

To evaluate the association between white blood cell count and the risk of cardiovascular diseases (CVD) in subjects aged 35 - 64 years.This prospective study was carried out in 11 provinces from 1992 to 2003. The association of baseline white blood cell count and cardiovascular disease occurrence was analyzed in 30 384 subjects aged 35 - 64 years using Cox multivariate proportional hazards regression.(1) Compared with the group of 4.0 - 4.9 x 10(9)/L, multivariate-adjusted relative risk of ischemic cardiovascular disease (ICVD, including coronary heart disease and ischemic stroke) increased continuously in proportion to increased white blood cell count. (2) White blood cell count had different impact on different types of CVD. Positive association was observed between white blood cell count and the risk of ischemic stroke, but the relationship between white blood cell count and the risk of hemorrhagic stroke was not significant. Compared with the referent group (4.0 - 4.9 x 10(9)/L), the risk of coronary heart disease of the group of white blood count9.0 x 10(9)/L increased by 70% (RR = 1.71, P0.05) and that of ischemic stroke increased by 80% (RR = 1.85, P0.01).The risk of ICVD and CVD increases continuously in proportion to increased white blood cell count, the white blood cell count might be used to predict future risk of CVD, especially risk for ICVD.

To establish cut offs and risk stratification of dyslipidemia in Chinese adults.Data from 2 widely cited studies: the PRC-US Collaborative Study of Cardiovascular and Cardiopulmonary Epidemiology and the China Multi-Provincial Cardiovascular Cohort Study, with a total of 40 719 Chinese adults, age 35 to 64 at baseline, about half men and half women, followed up for a total of 345 140.5 person years, were used to analyze the relationship between dyslipidemia and ischemic cardiovascular diseases (ICVD, including coronary heart events and ischemic stroke events) using a common data analysis protocol co-developed by the scientists from the 2 studies. The relative risk was estimated with the Cox proportional hazard model adjusting for other conventional cardiovascular risk factors. The 10-year absolute risk of ICVD for a 50 years-old person at different risk factor combinations was used to develop the risk stratification.(1) There was a continuous linear relationship between baseline TC (or LDL-C) and ICVD risk without a threshold; (2) The incidence (absolute risk) of ICVD was similar for LDL-C3.37 mmol/L (130 mg/dl) and for TC5.18 mmol/L (200 mg/dl); and similar for LDL-C4.14 mmol/L (160 mg/dl) and for TC6.22 mmol/L (240 mg/dl); (3) The absolute ICVD risk for TCor = 6.22 mmol/L (240 mg/dl) was slightly less but close to that for grade 1 hypertension; (4) ICVD risk increased as HDL-C decreased; (5) No significant association was found between baseline TG and subsequent ICVD; (6) At any TC level, the absolute ICVD risk for those having only hypertension was higher than that for those having 3 other risk factors.The cut offs for diagnosis of dyslipidemia in Chinese adults can refer to those used in relevant international guidelines: TC5.18 mmol/L (200 mg/dl) [or LDL-C3.37 mmol/L (130 mg/dl)] as normal, TC 5.18 - 6.19 mmol/L (200 - 239 mg/dl) [or LDL-C 3.37 - 4.12 mmol/L (130 - 159 mg/dl)] as borderline high, and TCor = 6.22 mmol/L (240 mg/dl) [or LDL-Cor = 4.14 mmol/L (160 mg/dl)] as high; HDL-C1.04 mmol/L (40 mg/dl) as low, 1.04 - 1.53 mmol/L (40 - 59 mg/dl) as normal andor = 1.55 mmol/L (60 mg/dl) as optimal. In risk stratification scheme, hypertension plays a role that equals to that of any other 3 risk factors.

To observe the risk factors characteristic of patients developing acute coronary syndrome, ischemic or hemorrhagic stroke in a Chinese population aged 35 - 64 (n = 30 378).This prospective study was carried out in 11 provinces in China from 1992 to 2003. The association between baseline risk factors and events in the 10-year follow-up period was analyzed.(1) A total of 809 events were recorded during the follow up period and 227 with acute coronary syndrome, 582 with stroke (ischemic 419, hemorrhagic 146, undefined 17) and the 10-year cumulative person-year incidence rates were 114/100,000, 209/100,000 and 73/100,000 for acute coronary syndrome, acute ischemic stroke and acute hemorrhagic stroke, respectively. (2) Rate of havingor = 1 modifiable risk factors was significantly higher in event group than that in subjects without events (89% vs. 64.7%, P0.01). (3) Sorted by intensity, the sequence of independently risk factors obtained from multivariate analysis for acute coronary syndrome were hypertension, smoking, hypercholesterolemia and low-HDL-C; for acute ischemic stroke event were hypertension, diabetes, low-HDL-C, smoking and obesity; for acute hemorrhagic stroke was hypertension.The morbidity for cardiovascular diseases is higher in Chinese population with various traditional risk factors than those without or having fewer traditional risk factors and there are various distinct independent risk factors pattern in patients with different cardiovascular diseases subtypes.

To evaluate the trends of cardiovascular disease (CVD) risk factors between 1992 and 2002 (10 years) in a cohort of Beijing.Two separate surveys were carried out for a cohort (2740 subjects) in 1992 and 2002 according to methods of the WHO MONICA project. Systolic blood pressure (SBP) and diastolic blood pressure (DBP), body mass index (BMI), waist circumference (WC) and hip circumference (HC), serum total cholesterol (TC), high density lipoprotein cholesterol (HDL-C), triglyceride (TG), glucose, prevalence of hypertension, rate of hypertension treatment and control were compared between 1992 and 2002.(1) Comparisons of the same age groups showed that CVD risk factors increased significantly during the 10 year period from 1992 to 2002. (2) Nineteen percent of the subjects with optimal BP in 1992 became hypertensive in 2002, and 45.3% of normal BP subjects in 1992 became hypertensive in 2002. (3) 43.8% of the subjects with normal blood lipid in 1992 became hyperlipidemia in 2002. (4) 37.0% of the subjects with normal BMI in 1992 became overweight in 2002, and 43.7% of subjects with normal WC in 1992 became high WC in 2002. (5) 14.6% of the subjects without metabolic syndrome in 1992 became with metabolic syndrome in 2002.The levels of CVD risk factors in this cohort increased significantly in a 10 year period from 1992 to 2002. Most of the risk factors were related to unhealthy life styles. To modify unhealthy life style and control the increasing rate of major risk factors are the key to reduce CVD incidence.