| Objectives To analyze the prevalence of CVD high-risk individuals in Hebei Province from 2017 to 2018,to understand the changes in dietary,lifestyle,physical examination and laboratory indexes after two-year follow-up interventions among CVD high-risk individuals,and to construct a comprehensive evaluation model to compare the intervention effects among different populations to provide a reference basis for the prevention and treatment of CVD in Hebei Province.Methods From 2017 to 2018,the multistage stratified cluster sampling method was used to take the work into consideration,and 42663 residents from six regions of Hebei Province were selected to participate in the early screening of cardiovascular high-risk individuals,and 10479 residents from the systematically adjudicated screening results were selected as the subjects.They were offered a two-year health intervention through lifestyle guidance,primary and secondary prevention of CVD and follow-up surveys in 2019 and2020.The changes in dietary profiles,lifestyle,physical examination indexes,and laboratory indexes of the investigated subjects in 3 survey studies before intervention,1year after intervention,and 2 years after intervention were compared.Principal component analysis was used to construct a comprehensive evaluation model of intervention effects,and the comprehensive intervention effects were compared among different characteristic populations.Results 1 The detection rate of high-risk individuals for CVD in Hebei Province from2017 to 2018 was 24.56%.Multivariate Logistic regression analysis showed that male gender(OR=1.08),70~75 age groups(OR=1.11),rural residence(OR=1.10),junior college and above education(OR=1.54),smoking(OR=1.23),drinking alcohol(OR=1.32),hypertension(OR=6.15),diabetes(OR=1.30)and dyslipidemia(OR=4.61)were associated with a high risk of cardiovascular risk(P<0.05).2 Loss to follow-up was 23.85% in those at high cardiovascular risk during a two-year follow-up.Multivariate Logistic regression analysis showed that male gender(OR=1.12)and rural residence(OR=3.64)were positively correlated with loss of follow-up(P<0.05),and the 50~59 age groups(OR=0.65),60~69 age groups(OR=0.56),secondary school(OR=0.65)and junior college and above(OR=0.82)were negatively correlated with loss of follow-up(P<0.05).3 The results of Cochran’s Q test showed statistically significant differences(P<0.05)in the frequency of regular dietary consumption among study subjects across the 3 followup surveys;The results of pairwise comparisons by Dunn’s method(with Bonferroni correction)showed that the frequency of regular consumption of omnivores,eggs and products,fresh fruits,soy products,and dairy products and their products increased from year to year after the intervention,and the differences were all statistically significant(adjusted P<0.05).4 The results of Cochran’s Q test showed statistically significant differences(P<0.05)in the proportion of study subjects’ lifestyle behaviors across the 3 follow-up surveys;The results of pairwise comparisons by Dunn’s method(with Bonferroni correction)showed that the proportion of people who smoked and consumed alcohol decreased from year to year after the intervention,and the differences were all statistically significant(adjusted P<0.05).5 The results of one-way repeated measures ANOVA showed statistically significant differences(P<0.05)between the means of the physical examinations and laboratory parameters of the study subjects among the 3 follow-up surveys;Pairwise comparisons by Bonferroni method showed that the means of SBP,DBP,BMI,TC,and LDL-C decreased year by year after intervention,and the differences were all statistically significant(adjusted P<0.05).6 A model for the comprehensive evaluation of intervention effects was constructed based on 12 indicators by principal component analysis,with principal component 1 representing clinical indicators,principal component 2 representing dietary indicators,principal component 3representing lifestyle indicators,and principal component 4 representing cholesterol indicators.7 Intervention effect the results of the comprehensive score of the comprehensive evaluation model showed that the 35~59 age groups was older than the60~75 age groups,the Han group was larger than non Han Chinese,the urban was larger than rural,the secondary school and above educated individuals were larger than primary school and below,and the results of the F-test showed that the differences were statistically significant(P<0.05).Conclusions 1 The prevalence rate of high-risk cardiovascular disease in Hebei is24.56%.Men,70~75 age groups,rural residents,junior college or above,smoking,drinking,hypertension,diabetes and dyslipidemia are associated with high risk of cardiovascular disease.2 During the two-year follow-up,the loss rate is 23.85%.Men and rural residents are positively correlated with the loss of follow-up.3 After 2 years of body-based intervention,the dietary situation and bad lifestyle of the subjects are improved,and the blood pressure,blood glucose,blood lipid,cholesterol,waist circumference and body mass index of the subjects are reduced.4 The results of the comprehensive evaluation of intervention effects based on principal component analysis show that the comprehensive intervention effects are better in the 35~59 age groups,urban residents,Han Chinese,and those with secondary school education and above.Figure1;Table16;Reference 106... |
PDF Full Text Request