A Cohort Study On The Risk Factors Of Coronary Heart Disease In Middle-aged And Old People In Rural Areas Of Jilin Province

Objectives:To investigate the risk factors of coronary heart disease(CHD)in the rural areas of Jilin province,and to further analyze the interaction of the relevant risk factors on the morbidity of coronary heart disease and provide the basics for the prevention and management of coronary heart disease.Methods:A total of 1228 middle-aged and elderly people was collected from the rural areas of Jilin Province by random cluster sampling.The questionnaire survey(including social demographic characteristics,general living habits survey and past medical history),physical examination and blood samples tests were performed.After obtaining the basic survey data follow up annually.The incidence of coronary heart disease was observed during the follow-up period.SPSS 24.0 was used for statistical analysis.The normal data were analyzed by x ± s and t test.The comparison between groups was analyzed by ?2 test.Single factor and multivariate analysis were used to analyze the Cox proportional hazards regression model.In multi-factor analysis,the model adjustment was carried out with forward Wald method.Results:1.The total follow-up of this study was 9574.7 years,with an average follow-up of 7.8 years.During the follow-up period,61 people were newly diagnosed with coronary heart disease,the incidence density was 6.37 / 1000 person-years.2.The single factor Cox regression analysis results showed that cigarette smoking,high social psychological stress,body mass index(BMI),waist hip ratio(WHR),total cholesterol(TC),triglyceride(TG),low density lipoprotein cholesterol(LDL-C)and high-density lipoprotein cholesterol(HDL-C)to be significantly associated with the onset of coronary heart disease(P < 0.05).3.After adjusting the factors of gender,ethnicity,educational level,drinkinghistory,BMI and WHR which are significantly associated with smoking,the risk of coronary heart disease in smoking group was 3.249 times higher than non-smoking group(P<0.001).Compared with the unadjusted Hazard ratio,smoking group increased the risk of coronary heart disease.4.After adjusting the factors of marital status,ethnicity and diabetes history which are significantly associated with psychosocial stress,the risk of coronary heart disease in high psychosocial stress group was 5.079 times higher than healthy group(P= 0.001).Compared with the unadjusted Hazard ratio,the risk of coronary heart disease in high psychosocial stress group is unchanged.5.After adjusting the factors of gender,nationality,smoking history,hypertension and diabetes,WHR,TC,TG,LDL-C and HDL-C which are significantly associated with BMI,the risk of coronary heart disease in 24?BMI<28 kg / m2and?28 kg / m2 group was 2.601 and 2.515 times higher than BMI<24 group(P<0.05).Compared with the unadjusted Hazard ratio,the risk of coronary heart disease in24?BMI<28 kg / m2 and BMI?28 kg / m2 group is lower.6.After adjusting the factors of age,sex,national history,smoking,drinking,hypertension,and diabetes,BMI,TC,TG,LDL-C and HDL-C,which are significantly associated with WHR,the risk of coronary heart disease in WHR“Male?0.9,Female?0.85” group was 1.342 times higher than WHR “Male<0.9,Female<0.85”(P> 0.05).7.After adjusting the factors of age,sex,history of diabetes,BMI,WHR,TG,LDL-C and HDL-C,which are significantly associated with TC,the risk of coronary heart disease in TC ? 6.2 mmol/L group was 1.783 times higher than TC<5.2mmol/L group(P> 0.05).8.After adjusting the factors of nationality,culture,history of hypertension and diabetes,BMI,WHR,TC,LDL-C and HDL-C,which are significantly associated TG,the risk of coronary heart disease in TG1.7~2.3 mmol/L and TG?2.3 mmol/L group was 2.851 and 3.501 times higher than TG<1.7 mmol/L group(P<0.001).Compared with the unadjusted Hazard ratio,the risk of coronary heart disease in TG1.7~2.3mmol/L and TG?2.3 mmol/L group is lower.9.After adjusting the factors of age,sex,whether in leisure sports activities,history of hypertension and diabetes,BMI,WHR,TC and TG,which are significantly associated LDL-C,the risk of coronary heart disease in LDL-C?4.1 mmol/L groupwas 1.527 times higher than LDL-C<3.4 mmol/L group(P> 0.05).10.After adjusting the factors of BMI,WHR,TC and TG which are significantly associated HDL-C,the risk of coronary heart disease in HDL-C?1.0 mmol/L group was 0.541 times higher than HDL-C<1.0 mmol/L group(P < 0.05).Compared with the unadjusted Hazard ratio,the risk of coronary heart disease in HDL-C?1.0 mmol/L group increased.Conclusion:1.The incidence of coronary heart disease was 6.37 / 1000 person-years.2.Smoking affected by BMI is a risk factor for coronary heart disease in middle-aged and elderly people in rural areas of Jilin Province.With the increase of BMI,the risk of coronary heart disease in smokers increased.3.High social psychological stress is a risk factor of coronary heart disease for middle-aged and elderly people in rural areas of Jilin province.4.BMI ?24 kg / m2 was the risk factor of coronary heart disease in rural areas of Jilin province.Affected by sex,smoking,history of diabetes mellitus and triglyceride(TG),the risk of coronary heart disease of BMI?24 kg / m2 population was reduced.5.TG ?1.7 mmol/L is a risk factor of the onset of coronary heart disease for the middle-aged and elderly people in rural areas of Jilin Province.Affected by national,social psychological pressure and BMI,the risk of coronary heart disease of TG ? 1.7mmol /L population is decreased.6.HDL-C ? 1.0 mmol/L was the protective factor of coronary heart disease for the middle-aged and elderly people in rural areas of Jilin province.Influenced by BMI and TG,the risk of coronary heart disease increased in the HDL-C?1.0 mmol/L population.