Risk Assessment Of Ischemic Cardiovascular Disease In Rural Naxi Population Across Plateau Areas

Objective:To explore the exposure of cardiovascular disease risk factors in rural Naxi population aged 35 to 75 in Trans-plateau Regions,assess the risk of ischemic cardiovascular disease（ICVD）in the next 10 years,and to investigate the differences of cardiovascular risk assessment models in evaluation of 10-year cardiovascular risk assessment,so as to provide a scientific basis for the prevention of cardiovascular diseases in rural Naxi population across the plateau.Methods:With random sampling method,rural Naxi population aged 35-75 years old from 8villages in the trans-plateau region of Yunnan Province was selected as the research object.The data of questionnaire surveys,physical examinations and laboratory examinations were collected.The Chinese ICVD 10-year risk assessment form and Framingham 10-year risk assessment form was applied to predict the 10-year risk of ICVD and perform statistical analysis.Results:（1）A total of 381 Naxi people were included in the study.The exposure rates of hypertension,diabetes,smoking,dyslipidemia,overweight or obesity were 48.8%,4.7%,24.7%,57.7%,29.1% respectively.The prevalence of hypertension in the high-altitude plateau area was higher than that in the middle-altitude plateau area,and the prevalence of diabetes was lower than that in the middle-altitude plateau area.（2）In this survey,29.1%,33.6%,and 21.5% of the population have 1,2,or ≥3 risk factors,respectively,and as the age increases,the higher the proportion of risk factors aggregation.The proportion of males with 2 or more than 3 risk factors was higher than that of females,and the difference was statistically significant（P<0.01）.（3）In this survey,the 10-year incidence scoring method of Chinese ICVD showed that the proportion of low-risk（≤10%）,intermediate（≤20% and ≥10%）and high（>20%）risk of cardiovascular disease in 10 years are 82.9%,9.7% and 7.3%.The Framingham10-year incidence scoring method shows that in the next 10 years,the proportion of people at low（≤10%）,intermediate（≤20% and ≥10%）and high（>20%）risk of cardiovascular disease are 41.2%,31.2% and 27.6%.The Kappa value of the consistency test of the prediction results of the two methods is 0.179.（4）Chinese ICVD 10-year incidence scoring method calculates that the total median absolute risk of 10-year ICVD incidence in men [2.9%（P25,P75: 2.1%,7.3%）] is significantly higher than that of women [1.8%（P25,P75: 0.8%）,6.8%)].The Framingham 10-year incidence score method calculates that the total median absolute risk of ICVD incidence in men at 10 years [14.65%（P25,P75: 9.85%,27.11%）] is significantly higher than that of women [9.47%（P25,P75: 5.65%,19.22%）].In the two scoring methods,the 10-year ICVD risk of men and women has a trend of increasing with age,and the difference in absolute risk of different age groups is statistically significant（P <0.01）.Conclusion:The 35-75-years-old rural Naxi population in the trans-altitude area is at high risk of cardiovascular disease in the next 10 years.The prediction results of the two risk scores are poorly consistent,and the Framingham 10-year risk assessment method may overestimate the risk of cardiovascular disease in rural Naxi population in the next 10 years.