The Survey And Research Of Carotid Atherosclerosis And Its Risk Factors Among Cardiovascular High-risk Groups In Chang Sha City

Objective To investigate basic feature of Cardiovascular high-risk groups of changsha,analyzed carotid atherosclerotic(CAS) and its risk factors.Methods Based on 2013 stroke prevention and screening program of National health development planning commission,to select the more-than-40-year old(including 40 years) inhabitant(inhabited ≥half an year)from urban(Sifang Community)and rural(Tanyang Town) by cluster sampling method.The epidemiology research was implemented from Nov.2013 to Jan,2014.Collected relevant information by questionnaire, physical examination, laboratory examination.Screening out cardiovascular high-risk groups(coronary heart disease risk ≥20% over the next 10 years) by Freminham danger equation and observed the carotid atherosclerosis by carotid duplex ultrasound.Cardiovascular high-risk groups were analyzed into two groupsaccording to its domicile and geographic difference to analyze the difference of basic feature;Analyzed CAS and its rural-urban differences; Used single factor analysis and multiple factors logisticregression model to analyze risk factors of CAS in cardiovascular high-risk groups and its rural-urban differences.Results 1.Based on the census bureau of hunan province census data in 2013, according to the household registration information,conform to the age and residence,5228 reserch objectives were complete data in the research, urban2815,rural 2413,sample rate 92%,be in conformity with sample rate 85% of stroke prevention and screening program of National health development planning commission. 612 cardiovascular high-risk patients were selectd, he ratio of male to female was 1.23:1,mainly in male;the average age was 57.62±9.28 years,ratio of age(40-49 years, 50-59 years, 60-69 years, ≥70-years) were(22.06%) 、(33.99%) 、(34.64%) 、(9.31%), mainly in 60-69years;low、medium、higher educational level were respectively 44.61%、49.84%、5.56%,mainly in medium educational level;farmers 40.85%, non-agricultural occupation 59.15%, mainly in non-agricultural occupation;smoke 45.26.%, lack of exercise 24.35%, eating greasy 41.99%, fat 25.49%, diabetes 24.35%, high blood pressure 65.59%, hyperlipidemia 62.75%. 2.282 cases(46. 08%) from urban, the ratio of male to female was 1.27:1; 330 cases(53.92%) from rural, the ratio of male to female was 1.20:1. The average age of urban was 61.09±8.50 years, mainly was 60 to 69 years(50.35%), the average age of rural 54.65 ±8.90 years, mainly was 50 to 59 years old(40.61%). Smoke in urban and rural were 42.55% and 47.58%;fat in urban and rural were 28.27% and 22.73%; hyperlipemia in urban and rural were 61.35%、63.94%;the differenceswithout statisticallysignificant(P > 0.05).Urban populationmainly wasmedium educational level,was 70.92%,rural populationmainly was low educational level; Urban populationmainly was non-agricultural occupation,was 86.52%, rural populationmainly was famer,was 64.24%;lack of exercis in urban and rural were 29.79% and 19.70%,eating greasy were 34.75%and 48.18%,prevalence of diabetes29.79% and 19.70%,prevalence ofhypertension were 75.18% and 57.58%,all difference werestatistically significant(P<0.05). 3.The prevalence of CAS in cardiovascular risk groups was 36.27%, urban was 34.04%,rural was 38.18%,male was 36.98%,femal was 35.40%; urban male was32.28%, urban female was 36.29%; rural mela was 41.11%, rural female was 34.67%. The prevalence of CAS in different age groups(40-49 years.50-59 years,60-60 years, ≥70-years) were 28.15%,.35%,37.26% and 33.33%;the difference without statistically significant(P>0.05).The prevalence of CASin different cultural levels was statistically difference(P<0.05), cultural degree was higher, the prevalence of CAS was lower, the prevalence of CAS in low, medium and higher level of education were 42.12%, 32.46% and 23.53% respectively.The prevalence of CAS of Farmer and other non-agricultural vocational was 44.80% and 30.39%; The prevalence of CAS in eating greasy groups and non-eating greasy groups were 58.75% and 20%;the prevalence of CAS in physical inactivity groups and physical activity groups were 43.62% and 33.91%;the prevalence of CAS in smoker and non-smoker were 38.57% and 38.51%;The prevalence of CASin hypertension、diabetes、obesity、 hyperlipidemia were 39.05%, 29.53%, 50%, 38.02%;the prevalence of CAS in people without the diseasewere 30.95%, 38.44%, 31.58%, 33.33%;the difference without statistically significant(P>0.05). 4.Age of CAS crowd and non-CAS crowd among changsha cardiovascular high-risk groups were 57.87±8.57 years and 57.47± 9.67years;There were significant differences in low cultural degree, farmers, lack of exercise, dietary fat, hypertension, obesity between CAS crowd and non-CAS crowd(P<0.05 or P<0.01). Age of CAS crowd and non-CAS crowd in urban were 60.46 ± 8.53 years and 61.41 ±8.49 years. There were significant differences in lack of exercise, eating greasy, obesity between CAS crowd and non-CAS crowd(P<0.01). Age of CAS crowd and non-CAS crowd in rarul were±8.09 years and ± years. There were differences in low cultural degree, famer,dietary fat, hypertension, between CAS crowd and non-CAS crowd(P< 0.05 or P< 0.01). 5.Multivariate Logistic regression analysis for CAS patients showed:eating greasy, diabetes, lack of exercise, hypertension, farmers, hyperlipidemia were the risk factor for CAS. Multivariate Logistic regression analysis for urban CAS patients showed:hypertension and eating greasy were the main risk factor for CAS. Multivariate Logistic regression analysis for rarul CAS patients showed:eating greasy, hypertension, hyperlipidemia, farmers were the main risk factor for CAS.Conclusion1.male 、 60-69 years 、 medium cultural degree 、non-agricultural occupationof Changsharesidents have higher cardiovascular risk,people withhyperlipemia、hypertensionis more obvious.Cardiovascular high-risk groups in urban mainly arelack of exercise、diabetes、hypertensionaremore obvious than rural; cardiovascular high-risk groups in rural eating greasy are common. 2.The prevalence of carotid artery atherosclerosis diseases is 36.27% in cardiovascular high-risk groups of Changsha area,but no difference of prevalence between urban and rural. Groups with farming、 low cultural degree、 dietary fat, lack of exercise、hypertension,、hyperlipidemiaor obese have higher prevalence of carotid atherosclerosis. 3.The major risk factors of carotid artery atherosclerosis in cardiovascular high-risk groups of Changsha area are:eating greasy、lack of exercise、farming、hypertension or hyperlipidemia;people with hypertension or eating greasyofcardiovascular high-risk groupsin urban have significantly higher prevalence of carotid artery atherosclerosis;people with eating greasy、farming or combined with hypertension、hyperlipidemiaof cardiovascular high-risk groups in rural have significantly higher prevalence of carotid artery atherosclerosis.