Geographic Variations in the Prevalence, Awareness, Treatment, and Control of Dyslipidemia among Chinese Adults in 2018-2019: A Cross-sectional Study.

Objective: To investigate the spatial patterns of the prevalence, awareness, treatment, and control rates of dyslipidemia at the provincial level in China. Methods: A national and provincial representative cross-sectional survey was conducted among 178,558 Chinese adults in 31 provinces in mainland China in 2018-2019, using a multi-stage, stratified, cluster-randomized sampling design. Subjects, as households, were selected, followed by a home visit to collect information. Both descriptive and linear regression procedures were applied in the analyses. Results: The overall prevalence of dyslipidemia was 35.6%, and wide geographic variations of prevalence, treatment, and control rates of dyslipidemia were identified among 178,558 eligible participants with a mean age of 55.1 ± 13.8 years. The highest-lowest difference regarding the provincial level prevalence rates were 19.7% vs. 2.1% for high low-density lipoprotein cholesterol, 16.7% vs. 2.5% for high total cholesterol, 35.9% vs. 5.4% for high triglycerides, and 31.4% vs. 10.5% for low high-density lipoprotein cholesterol. The treatment rate of dyslipidemia was correlated with the socio-demographic index ( P < 0.001), urbanization rate ( P = 0.01), and affordable basic technologies and essential medicines ( P < 0.001). Conclusion: Prevailing dyslipidemia among the Chinese population and its wide geographic variations in prevalence, treatment, and control suggest that China needs both integrated and localized public health strategies across provinces to improve lipid management.

Hemodynamic characteristics in preeclampsia women during cesarean delivery after spinal anesthesia with ropivacaine.

BACKGROUND: Very few studies have been published on the hemodynamic changes associated with spinal anesthesia induced with ropivacaine during cesarean deliveries in preeclamptic women. AIM: To record and analyze hemodynamic data in women with preeclampsia undergoing cesarean delivery after spinal anesthesia induced with ropivacaine. METHODS: Ten eligible women with preeclampsia were enrolled in this prospective observational study. Spinal anesthesia was performed with 2.4 mL of 0.5% ropivacaine. Hemodynamic changes were then analyzed at multiple time points. The hemodynamic responses to vasopressor interventions and uterotonic agents, as well as maternal and neonatal outcomes were also recorded. RESULTS: Stable hemodynamic trends were observed in this study. Cardiac output (CO) and stroke volume increased mildly during surgery. In contrast, mean arterial pressure and systemic vascular resistance showed a moderate decrease from induction until the end of surgery. Central venous pressure dramatically increased after delivery. Oxytocin administration was associated with the most significant hemodynamic fluctuations during surgery, namely, an increase in CO and heart rate. Phenylephrine intervention was only required in three patients, and caused an increase in mean arterial pressure and systemic vascular resistance along with a decrease in heart rate, stroke volume, and CO. No maternal and neonatal complications were observed during this study, except transient episodes of hypotension. CONCLUSION: Spinal anesthesia for caesarian delivery with ropivacaine in women with preeclampsia is linked to modest hemodynamic changes of no clinical significance in this study. Careful cardiovascular monitoring is still recommended, particularly after the delivery of the fetus or the use of oxytocin.

Prediction of 10-year Atherosclerotic Cardiovascular Disease Risk among Adults Aged 40-79 Years in China: a Nationally Representative Survey.

OBJECTIVE: To establish the distribution of 10-year atherosclerotic cardiovascular disease (ASCVD) risk among Chinese adults. METHODS: We estimated the 10-year ASCVD risk by applying the 2013 American College of Cardiology/ American Heart Association pooled cohort equations (PCEs) to the data obtained from the 2010 China Chronic Disease and Risk Factor Surveillance that involved 61,541 participants (representing 520,158,652 Chinese adults) aged 40-79 years. We also compared the ASCVD risk with the 10-year ischemic cardiovascular disease (ICVD) risk, which was calculated using the simplified scoring tables recommended by the Chinese Guidelines for Prevention of Cardiovascular Diseases (Chinese model). RESULTS: Based on the PCEs, the average 10-year ASCVD risk among adults without self-reported stroke or myocardial infraction was 12.5%. Approximately 247 million (47.4%) and 107 million (20.6%) adults had ⋝ 7.5% and > 20% 10-year ASCVD risks, respectively. The 10-year ASCVD risk > 20% was higher among men, less educated individuals, smokers, drinkers, and physically inactive individuals than among their counterparts. Overall, 29.0% of adults categorized using the Chinese model were overclassified with the PCEs. CONCLUSION: Our results define the distribution of 10-year ASCVD risk among Chinese adults. The 10-year ASCVD risk predicted by the PCEs was higher than the ICVD risk predicted by the Chinese model.

Vegetable and Fruit Consumption among Chinese Adults and Associated Factors: A Nationally Representative Study of 170,847 Adults.

OBJECTIVE: This study examined vegetable and fruit (VF) consumption rate and its associated factors among Chinese adults. METHODS: Nationally representative data from the 2013 China Chronic Disease Surveillance survey were used. Dietary intake data, including VF consumption during the last 12 months, were collected. All analyses were weighted to obtain nationally representative estimates. Associations between VF consumption and other factors (e.g., meal frequency and physical activity) were examined through logistic regression analysis. RESULTS: The average fruit consumption was 102.3 g/day (95% CI: 97.0-107.6) and the average vegetable consumption was 350.6 g/day (95% CI: 339.3-361.8). Over half (53.2%, 95% CI: 50.9-55.4) of Chinese adults met the VF consumption of 400 g/day recommended by the World Health Organization (WHO). Rural residents had a higher prevalence of low VF consumption rate than urban residents [49.20% (95% CI: 46.2%-52.2%) vs. 44.0% (95% CI: 41.7%-46.3%) P < 0.01]. Old age (OR = 1.01, 95% CI: 1.00-1.01), low educational level, low income, minority ethnicity (OR = 1.41, 95% CI: 1.15-1.74), underweight (OR = 1.17, 95% CI: 1.03-1.33), single marital status (OR = 1.20, 95% CI: 1.08-1.33), low health literacy, irregular breakfast (OR = 1.20, 95% CI: 1.04-1.38) or lunch (OR = 1.58, 95% CI: 1.26-1.99) habits, and no leisure-time physical activity were associated with low VF consumption. CONCLUSION: Only half of Chinese adults met the VF consumption recommended by the WHO. Low socio-economic status, irregular diet, and poor health literacy were likely associated with low VF consumption. National efforts and programs are needed to promote VF consumption.

Smoking and Its Relation to Metabolic Status among Chinese Adults: Analysis of a Nationwide Survey

OBJECTIVE: To update the estimated prevalence rates of smoking and examine major metabolic diseases associated with smoking status in Chinese adults. METHODS: Using a complex, multistage, probability sampling design, we recruited a nationally representative sample of 98,658 Chinese adults aged ⋝18 years in 2010. Information on current, former, never, and passive smoking status was obtained using a standard questionnaire. All estimates were weighted to represent the overall Chinese adult population. RESULTS: The estimated proportion of current smokers was 28.3% for Chinese adults aged ⋝18 years. The corresponding values of former and passive smokers were 5.1% and 21.4%, respectively. Additionally, former smokers were found to have a less favorable metabolic risk profile among all categories of smoking status in both men and women. The prevalence of metabolic diseases such as diabetes and hypertension also increased with a greater number of smoking pack-years in men. CONCLUSION: The prevalences of current smoking and passive smoking remain high in Chinese adults.

Prevalence of Major Cardiovascular Risk Factors and Cardiovascular Disease in Women in China: Surveillance Efforts.

In this study, we aimed to assess the relationship of socioeconomic status and acculturation with cardiovascular disease (CVD) risk profiles and CVD and examine the CVD risk factors associated with CVD. We used data from the 2010 China Chronic Disease and Risk Factor Surveillance surveys, which consisted of a nationally representative sample of women. The following prevalence was found: myocardial infarction (MI): 0.4%; stroke: 0.5%; abnormal cholesterolemia: 44.9%; overweight or obesity: 32.2%; hypertension: 31.7%; diabetes: 9.0%; and smoking: 2.5%. In total, 30.9% of Chinese women had no risk factors, but 13.3% had ⋝3 associated risk factors. In multivariate-adjusted models, hypertension, diabetes, overweight or obese, and smoking were all directly associated with MI; For stroke, associations were positive with hypertension, abnormal cholesterolemia, diabetes, and overweight or obesity. Therefore, it can be concluded that CVD risk factors are common among Chinese women aged ⋝18 years.

Self-rated health and health-related quality of life among Chinese residents, China, 2010.

BACKGROUND: Self-rated health (SRH) and health-related quality of life (HRQOL) are two outcome measures used to assess health status. However, little is known about population-based SRH and HRQOL in China. METHODS: Data from the 2010 China Chronic Disease and Risk Factor Surveillance, a nationally representative sample of 98,658 adults (≥18-year-old) residing in China, were analyzed. SRH was assessed by asking "Would you say that, in general, your health is very good, good, general, poor, or very poor?" HRQOL was assessed by asking "For about how many days during the past 30 days was your health not good due to physical illnesses, injuries, or mental unhealthy?". RESULTS: Overall, 6.3 % of participants rated their health as poor or very poor. The prevalence of poor/very poor health increased with advancing age ranging from 2.0 % in the 18-24 year-olds to 14.9 % in those ≥75 years-old, while it decreased with education levels from 13.0 % in illiterates/those with some primary school education to 2.2 % in college graduates or above. Additionally, women were more likely than men to rate their health as poor or very poor (7.2 % vs. 5.4 %). The reported rate of poor/very poor health was higher in western region residents compared to those in the east (7.4 % vs. 5.3 %). The mean numbers of self-reported physically unhealthy days, injury-caused unhealthy days, or mentally unhealthy days during the past 30 days were 1.48, 0.20, and 0.54, respectively. Older adults had more physically unhealthy days than the younger ones ranging from 2.92 days in those ≥ 75 year-old to 0.95 days in 18-24 year-olds. Women had more physically unhealthy days and mentally unhealthy days than men (1.72 vs. 1.23; 0.62 vs. 0.46, respectively). The highest mean number of physically unhealthy days (2.32) was reported by illiterates or those with some primary school education. The highest mean number of mentally unhealthy days (0.86) reported by college graduates or above. CONCLUSIONS: Substantial variations existed in SRH and HRQOL among age groups, gender groups, education groups, and across regions in China. Considering these disparities will be important when developing health policies and allocating resources.

Hypertension Screening and Follow-up Management by Primary Health Care System among Chinese Population Aged 35 Years and Above.

OBJECTIVE: To describe hypertension screening and follow-up management among Chinese population aged 35 years and above within the primary health care system. METHODS: Data from 2010 China Chronic Disease and Risk Factor Surveillance System were used. We investigated previous hypertension diagnosis, screening, and follow-up assessments within the primary health care system. The prevalence of self-reported and criterion-based hypertension, screening rates, demographic and socioeconomic characteristics associated with screening, and patterns of follow-up assessments were recorded. The SAS software system was used for statistical analyses. RESULTS: About 17.1% reported a previous hypertension diagnosis. The rate difference between the two measures of prevalence was 27.2%. Among those without self-reported hypertension, 27.7% reported never visiting a clinic during the past 1 year and 60.4% of those attending a clinic reported ever being screened. Younger age group was associated with lower screening proportion; odds ratios of 35-, 45-, 55-, and ⋝65 years were 1.7 (95% CI: 1.5-1.9), 1.5 (95% CI: 1.3-1.7), 1.3 (95% CI: 1.2-1.4), and 1.0, respectively. About 35.1% of the patients had undergone follow-up assessments four or more times during the past 1 year. CONCLUSION: Majority of the Chinese population aged 35 years and above, particularly the less educated, elderly population, and rural residents were unaware of that they were suffering from hypertension. Most patients did not receive enough management services by the primary health care system. Thus, strengthening both the screening and follow-up management is needed.

[A cross-sectional study of the association of movement disorders, constipation and sleep disturbances among elderly in China].

OBJECTIVE: To investigate the current status and association between movement disorders, constipation and sleep disturbances in the elderly population of China. METHODS: A total of 42 353 subjects aged over 60 years old from Chinese Chronic Non-communicable Disease & Risk Factor Surveillance (2010) was selected in our study. The information on movement disorders, constipation and sleep disturbances was collected by standardized questionnaire interview. The prevalence and association of self-reported movement disorders, constipation and sleep disturbances was measured according to different gender, age groups and regions. RESULTS: The study was conducted among 42 353 old adults, including 21 893 males (51.7%) and 20 460 females (48.3%); 17 917 from urban areas (42.3%) and 24 436 from rural areas (57.7%); and the proportion of elderly from eastern, central and western regions were 37.9% (16 031 subjects), 29.1% (12 345 subjects) and 33.0% (13 977 subjects) respectively. After weighted complex analysis, the data showed that among the elderly population over 60 years old in China, the self-reported rates of movement disorders, constipation and sleep disturbances were all age-related, rising up with the age increasing. The rates of 60-64 age group were 2.8% (95%CI:1.9%-3.7%), 3.6% (95%CI:3.1%-4.1%) and 12.4% (95%CI:11.0%-13.8%);and in ≥ 80 age group, the rates were 13.2% (95%CI:10.2%-16.1%), 8.8% (95%CI:7.1%-10.6%) and 19.1% (95%CI:16.3%-21.9%). The self-reported rate of movement disorders was 5.7% (95%CI: 4.5%-7.0%); the prevalence of constipation was 5.1% (95%CI: 4.4%-5.7%), which was higher among women (5.8%, 95%CI: 5.0%-6.6%) than it among men (4.3%, 95%CI: 3.7%-4.8%) (χ(2) = 23.40, P < 0.05), and higher among subjects from urban areas (6.0%, 95%CI: 5.1%-7.0%) than from rural areas (4.6%, 95%CI: 3.8%-5.4%) (χ(2) = 5.62, P < 0.05); the prevalence of self-reported sleep disturbances was 14.2% (95%CI: 12.7%-15.8%), higher in women (17.4%, 95%CI: 15.4%-19.3%) than in men (11.0%, 95%CI: 9.7%-12.2%) (χ(2) = 172.05, P < 0.05); the prevalence of movement disorders in people with constipation (16.3%, 95%CI: 12.7%-19.9%) was much higher than it in people without constipation (5.2%, 95%CI: 4.0%-6.3%) (χ(2) = 242.73, P < 0.05); and the prevalence of movement disorders in people with sleep disturbances (13.0%, 95%CI: 10.6%-15.4%) was much higher than it in people without sleep disturbances (4.5%, 95%CI: 3.5%-5.5%) (χ(2) = 688.80, P < 0.05).Logistic regression analysis showed that constipation and sleep disturbances would increase the risk of movement disorders, with the OR (95%CI) at 2.93 (2.57-3.33) and 2.73 (2.48-3.02), respectively. CONCLUSION: The present study showed that self-reported rates of movement disorders, constipation and sleep disturbances all rose up with age increasing in the elderly. The movement disorders was associated with constipation and sleep disturbances.

[Relationship between prevalent features of central obesity and clustering of cardiometabolic diseases among Chinese elder people].

OBJECTIVE: To study the relationship between prevalence of central obesity and clustering of cardiometabolic diseases among Chinese elder people over 60 years old. METHODS: A complex multistage stratified sampling survey on chronic diseases was conducted in 162 surveillance points, 31 provinces, China in 2010 by China CDC. The survey included face-to-face interview, physical measurement (body height, weight, waist circumference (WC) and blood pressure) and laboratory test (blood sugar, blood lipid and hemoglobin A1C), to collect the information about the prevalence of the risk factors as smoking, drinking, diet and physical activities and the prevalence of hypertension, diabetes and dyslipidemia. The survey selected 19 966 subjects who were over 60 years old. Central obesity was defined as WC ≥ 85 cm in males or ≥ 80 cm in females. The prevalence of central obesity among the elder people over 60 years old in different districts and populations was calculated; and the proportion of cardiometabolic diseases in groups of different WC was then analyzed. RESULTS: The prevalence of central obesity among elderly population over 60 years old was 48.6% (95%CI:46.1%-51.2%), including 39.7% (95%CI:37.2%-42.2%) males and 57.3% (95%CI:54.5%-60.1%) females. The proportion of females was higher than that of males (χ(2) = 474.63, P < 0.01). The higher the education level, the higher the prevalence of central obesity among elderly men. There was no significant association among females. The higher the family income, the higher the prevalence of central obesity. The prevalence of central obesity was 59.2% in urban area, which was much higher than that in rural area (43.5%) (χ(2) = 50.06, P < 0.01). The proportion of hypertension, diabetes and clustering of cardiometabolic disease was separately 18.8% (95%CI:16.1%-21.5%) , 66.2% (95%CI:63.0%-69.4%) and 47.5% (95%CI:44.1%-50.8%) among elderly men with WC between 85 and 89 cm, and separately 24.0% (95%CI:21.2%-26.8%), 78.2% (95%CI:75.6%-80.8%) and 64.0% (95%CI:60.3%-67.6%) among elderly men with WC ≥ 90 cm; which were both higher than those among elderly men with WC < 85 cm (separately 13.4% (95%CI:11.5%-15.3%) , 58.3% ( 95%CI:55.5%-60.1%) and 30.8% (95%CI:28.7%-32.9%) ). The proportion of hypertension, diabetes and clustering of cardiometabolic disease was 20.1% (95%CI:17.4%-22.7%) , 68.6% (95%CI:65.5%-71.8%) and 48.1% (95%CI:44.6%-51.6%) among elderly women with WC between 80 and 84 cm, and separately 31.7% (95%CI:28.9%-34.4%) , 81.0% (95%CI:78.5%-83.5%) and 61.8% (95%CI:58.9%-64.8%) among elderly women with WC ≥ 85 cm; which were both higher than those among elderly women with WC < 80 cm (separately 12.8% (95%CI:10.8%-14.8%) , 60.1% (95%CI:57.1%-63.0%) and 30.4% (95%CI:27.3%-33.5%)). CONCLUSION: Nearly half of the Chinese elder people were central obese. The proportion of cardiometabolic diseases among central obesity was significantly higher than that among non-obese population. We should pay more concern about them in the future prevention and control of chronic diseases.

[Disease burden on diabetes in China, 2010].

OBJECTIVE: To estimate the disease burden of diabetes in China, 2010. METHODS: We calculated the disability adjusted life years (DALYs) of diabetes, using data from both the Mortality Surveillance in National Disease Surveillance Points System and the China Chronic Disease Surveillance (2010). We also examined the differences of DALYs by gender, age, urban/rural areas and geographical locations. RESULTS: The overall disease burden of diabetes was 19.12 DALYs per 1000 population. Men (18.30 DALYs per 1000) had a higher DALY rate than in women (19.97 DALYs per 1000). We observed an upside-down "U" relationship between DALY rate and age. Residents aged 15 - 79 years bore most part of disease burden and the burden peaked among population at age from 45 to 60 years (30.39 DALYs per 1000). There was a higher DALY rate seen in the population from the urban areas (17.83 DALYs per 1000) than those from the rural areas (17.03 DALYs per 1000). In order, the burden showed a decrease from the eastern region (22.28 DALYs per 1000), middle region (19.62 DALYs per 1000) to the western region (13.54 DALYs per 1000), in the country. CONCLUSION: China is currently carrying considerable burden caused by diabetes among the population of labor force while inequity of burden was seen among different geographical regions within China.

Dietary sodium intake: knowledge, attitudes and practices in Shandong Province, China, 2011.

OBJECTIVE: To investigate the knowledge, attitudes and practices (KAP) for dietary sodium intake among adult residents of Shandong Province, China. METHODS: In 2011, we conducted a cross sectional survey among a representative sample of 15,350 adults aged 18 to 69 years using a standardized questionnaire to assess their KAP for sodium. Variation in the KAPs by gender, and residence location were compared using the Chi-square tests. Predictors for the 'intention to' and 'currently taking action to' reduce sodium intake were determined by multivariate logistic regression with adjustment for confounding factors. RESULTS: KAPs for dietary sodium intake among urban residents was generally more favorable than among rural residents. Women were likely to have more favorable KAPs than men. About four fifth of subjects reported that they favored a low sodium diets. However, 31% reported that consumption of less sodium results in less physical strength. Overall, 70% indicated their intention to reduce sodium intake, although only 39 % reported that they had taken action to reduce sodium. Multiple logistic regression analyses indicated that favorable actions to dietary sodium reduction were more likely to occur among those who were aware of the link between sodium and hypertension, and less likely among those who had unfavorable attitudes towards dietary sodium reduction. CONCLUSION: Increasing knowledge levels about the benefits of sodium reduction will be a key success factor for effective sodium reduction initiatives and is linked to favorable behavioral change. Emphasis should be placed on the rural area.

[The study of management of hypertensive people aged 35 and over in communities in China].

OBJECTIVE: To investigate the community-based management status of hypertensive patients aged 35 or over in China and provide basic data for evaluation by investigating the hypertensive patients managed in communities. METHODS: The subjects in this study were recruited from the individuals of the 2010 China Non-communicable and Chronic Diseases. In September 2011, flow-up survey and a cross-section analysis has been done during the same people interviewed in 2010. Clustering sampling method was used to select 11 977 samples aged 35 or over and diagnosed by doctors from community level or above hospitals to be interviewed. A face to face questionnaire survey was carried out to collect information on general demographic characteristics, the treatment and control of blood pressure and risk factors of the hypertensive patients of community management.Sample was weighted according to complex sampling scheme and post-stratification to represent the population of Chinese hypertensive patients aged 35 or over and the rates with 95% confidence intervals (CI) were calculated for the subgroups according to different characteristics. The Rao-scott χ(2) test was performed to test for the differences of the rates of the subgroups. RESULTS: In the survey, there were 11 977 patients aged 35 or over diagnosed as hypertension by doctors, and among them, a total of 5120 hypertensive patients had been under management in communities. After being weighted the rate of management of hypertensive patients in communities was 43.99% (95%CI:38.17%-49.81%). There was a significant difference in the proportion of patients receiving management services when comparing different age groups (χ(2) = 21.98, P < 0.01) and sex (χ(2) = 4.18, P < 0.05), the rate of management among the patients aged 65 or over was 46.97% (95%CI:40.44%-53.50%), while among the patients aged 35 to 44 was only 37.72% (31.78%-43.65%). The rate of management was higher among females (45.37%, 95%CI:39.24%-51.50%) than males (42.50%, 95%CI:36.71%-48.30%). The overall rate of standardized management of hypertensive patients managed in communities was 35.30% (95%CI:31.78%-38.81%). The research also found differences in the proportions of patients receiving standardized management services when comparing different age groups (χ(2) = 28.66, P < 0.05), gender (χ(2) = 235.85, P < 0.01), and regions (χ(2) = 9.29, P < 0.05). The rate of receiving standardized management services among the patients aged 65 or over was 40.52% (95%CI:36.21%-44.82%), while among the patients aged 35 to 44 was only 26.18% (95%CI:20.07%-32.29%), the rate was lower among males (16.78%, 95%CI:14.13%-19.42%) than females(51.29%, 95%CI:46.41%-56.16%) , the rate of patients living in urban areas (38.53%, 95%CI:34.34%-42.72%) was higher than patients living in rural areas (33.36%, 95%CI:28.17%-38.55%) . The differences of the treatment rates of hypertensive patients managed in communities were found among different age groups (χ(2) = 26.39, P < 0.01), gender (χ(2) = 13.91, P < 0.01), and regions (χ(2) = 4.27, P < 0.05), the rate of treatment was 94.67% (93.41%-95.93%) among the patients aged 65 or over , while 86.47% (95%CI:81.05%-91.89%) among patients aged 35 to 44, the rate of treatment was higher among females (94.35%, 95%CI:93.15%-95.55%) than among males (90.84%, 95%CI:88.99%-92.70%), and it was also higher among patients living in urban regions (94.17%, 95%CI:92.62%-95.71%) than among patients living in rural regions (91.86%, 95%CI:90.20%-93.52%). The rate of control of hypertensive patients managed in communities was 33.13% (95%CI:29.50%-36.76%) and the rate was higher among the subjects living in the urban areas (45.09%, 95%CI:38.73%-51.45%) than in rural areas (25.96%, 95%CI:21.63%-30.30%) (χ(2) = 22.40, P < 0.01). CONCLUSION: Results from our study showed that community management of hypertension had been popularized across the country. And it could significantly improve the program on the treatment and control of hypertension at the community level in China.

[Self-rated health status among Chinese residents, China, 2010].

OBJECTIVE: To investigate the self-rated health status among Chinese residents in 2010. METHODS: Data was from the Non-communicable Disease & Risk Factor Surveillance in China, 2010. A total of 98 638 adults aged ≥ 18 years were included in the study. Self-rated health was assessed by four questions: (1) Would you assess your health status as very good or good, general (not good/not poor), poor or very poor? (2) How many days was your health not good for physical illness during the past 30 days? (3) How many days was your health not good for injury during the past 30 days? (4) How many days was your health not good for mental illness, which include stress and problem with emotions depression during the past 30 days? After being weighed according to complex sampling scheme and post-stratification, the sample was used to estimate the prevalence of self-rated health. The Rao-scott χ(2) test with different samples was adopted for comparison among groups. RESULTS: In total, 57.5% (95%CI:55.5%-59.5%) of the participants rated their health as being either very good or good, 36.2% (95%CI:34.5%-37.8%) as general, and only 6.3% (95%CI:5.7%-6.9%) as poor or very poor; In different age groups and gender, the differences were statistically significant (χ(2) values were 1179.88, 85.36, both P values were < 0.05) . The reported rate of poor or very poor health increased significantly with advancing age ranging from 2.0% (95%CI:1.5%-2.4%)in 18-24 year-old group to 14.9% (95%CI:12.6%-17.2%) in ≥ 75 year-old group; Females were more likely than males to rate their health as poor or very poor , respectively (7.2%; 95%CI 6.5%-7.9% and 5.4%; 95%CI:4.9%-5.9%). During the past 30 days 18.5% (95%CI:17.1%-19.8%) of the participants was not in good health for physical illness. The reported rate of physical illness increased significantly with advancing age (χ(2) = 211.99, P < 0.01), and it was the lowest in 25-34 year-old group (15.4%; 95%CI:13.7%-17.0%), and the highest in ≥ 75 year-old group (28.3%; 95%CI:24.9%-31.6%) . It was statistically higher among females (21.1%; 95%CI:19.5%-22.6%) compared to males (15.9%; 95%CI:14.6%-17.3%) (χ(2) = 231.81, P < 0.01); the reported rates of physical illness were 17.4% (95%CI:15.3%-19.5%) among residents in the east region, 17.2% (95%CI:14.7%-19.6%) in the middle region, and 21.5% (95%CI:18.7%-24.4%) in the western region(χ(2) = 6.75, P < 0.01). During the past 30 days 2.7% (95%CI:2.3%-3.2%) of the participants was not in good health for injure. The reported rate of injure decreased significantly with advancing age (χ(2) = 25.54, P < 0.01), and it was the highest in 18-24 year-old group (3.8%; 95%CI:2.6%-5.0%), and the lowest in 35-44 year-old group (2.3%; 95%CI:1.8%-2.7%) . It was statistically higher among males (3.0%; 95%CI:2.4%-3.5%) compared to females (2.5%; 95%CI:2.1%-2.9%) (χ(2) = 8.89 P < 0.01) ; the reported rates of injure were 2.3% (95%CI:1.9%-2.7%) among residents in the east region , 2.1% (1.7%-2.4%) in the middle region, and 4.1% (95%CI:2.6%-5.6%) in the west region (χ(2) = 16.26, P < 0.01). During the past 30 days 10.0% (95%CI:8.8%-11.3%) of the participants was not in good health for mental illness. The reported rate of mental illness decreased significantly with advancing age (χ(2) = 92.14 P < 0.01), and it was the highest in 18-24 year-old group (12.9%; 95%CI: 10.6%-15.2%), and the lowest in ≥ 75 year-old group (5.7%; 95%CI: 4.4%-7.0%) .It was statistically higher among females (10.8%; 95%CI:9.5%-12.1%) than males (9.2%; 95%CI:7.9%-10.5%) (χ(2) = 21.59, P < 0.01). CONCLUSION: The self-rated health status among Chinese residents was good in 2010. Substantial variation exists in self-rated health status across age groups, between genders, and across regions. Considering these disparities will be important for developing health policy and allocating resources.

[The status of awareness, treatment and control of hypertension in adult population in Shandong province in 2011].

OBJECTIVE: To identify the status of awareness, treatment and control of hypertension in adult population in Shandong province in China. METHODS: A total of 15 350 representative subjects aged 18 to 69 in Shandong province were selected with multistage stratified and clustered sampling design. Questionnaire investigation and physical examination including measurement of blood pressure, height and weight, were taken for all of them. The prevalence was estimated by weighted SURVEYFREQ model. RESULTS: In Shandong province, 34.5% of the hypertensive patients were aware of their high blood pressure (31.1% in male, 38.5% in female), 27.5% of them were taking antihypertensive medications (24.1% in male, 31.7% in female), and 14.9% of them (13.7% in male, 16.4% in female) were under control for their blood pressure (<140/90 mm Hg). CONCLUSION: The rates of awareness, treatment and control of hypertension in adult hypertensive population in Shandong province, China were low, and it is urgently needed to take steps for intervention and control for hypertension prevention, particularly in rural areas.

[Prevalence and characteristic of overweight and obesity among adults in China, 2010].

OBJECTIVE: To study the prevalence and characteristics of overweight and obesity among Chinese adults aged 18 and above, in year 2010. METHODS: A total of 98 271 adults aged 18 and above, who were sampled from 162 surveillance points of 31 provinces of China mainland, were enrolled in the study. Weight and height of each subject were measured, and then body mass index (BMI) was calculated. Overweight was defined as 24 kg/m² ≤ BMI < 28 kg/m², while obesity was defined as BMI ≥ 28 kg/m². After complex weighting, the prevalence of overweight and obesity among total population and specified rates among different populations by gender and districts and age were calculated. RESULTS: Prevalence rate of overweight among Chinese adults was 30.6%, separately at 31.5% and 29.7% among males and females (χ² = 16.05, P < 0.01); 27.1%, 37.2% and 32.3% in groups of population aged 18 - 44, 45 - 59 and over 60 year-old, respectively (χ² = 482.00, P < 0.01); separately at 33.9% and 29.1% in urban and rural areas (χ² = 21.14, P < 0.01); 32.0%, 31.1% and 28.0% in eastern, central and western regions, respectively (χ² = 8.72, P < 0.05). Prevalence rate of obesity among Chinese adults was 12.0%, separately at 11.9% and 12.1% among males and females (χ² = 0.33, P > 0.05); and 10.6%, 14.7% and 12.6% in groups of populations aged 18 - 44, 45 - 59 and over 60 year-old, respectively (χ² = 111.25, P < 0.01); separately at 14.2% and 11.0% in urban and rural areas (χ² = 12.11, P < 0.01); and 13.5%, 11.9% and 9.9% in eastern, central and western regions, respectively (χ² = 10.05, P < 0.01). The total prevalence rate of overweight and obesity among Chinese adults was 42.6%. It appeared that the total prevalence rate of overweight and obesity among urban populations (48.1%) were higher than rural populations (40.1%) (χ² = 20.37, P < 0.01); while the total rate showed a gradual decreasing trend from eastern (45.5%) to central (43.0%) and western (37.9%) regions (χ ²= 10.46, P < 0.01). CONCLUSION: The prevalence of overweight and obesity were comparatively high among Chinese adults aged 18 and above in year 2010, and significant differences could be found among gender, age, urban or rural areas and eastern, central or western districts.

[Awareness rate, treatment rate and control rate of dyslipidemia in Chinese adults, 2010].

OBJECTIVE: To explore the awareness, treatment and control rates of dyslipidemia among Chinese adults aged over 18 in 2010, and to analyze the prevalent features. METHODS: 97 409 subjects aged over 18 were recruited from 162 monitoring sites around 31 provinces in China mainland in 2010, applying multi-stage stratified cluster random sampling method. Information about subjects' history of dyslipidemia, treatment and control were collected by face-to-face interview; and each subject's fasting venous blood was drawn in the morning before having food, to test total cholesterol (TC), triglyceride (TG), high density lipoprotein-cholesterol (HDL-C) and low density lipoprotein-cholesterol (LDL-C). In total, 51 818 cases of dyslipidemia ever or now, including 2235 subjects who once suffered from dyslipidemia but had their blood lipid controlled to normal, were screened out. And the awareness, treatment and control rates were calculated by complex weighting. RESULTS: The awareness rate of dyslipidemia among Chinese adults was 10.93%, while the stratified rates were 6.00%, 16.75% and 18.74% in the groups of subjects aged 18 - 44, 45 - 59 and over 60 years old, respectively (χ² = 1293.02, P < 0.01); 10.32% and 11.71% among males and females, respectively (χ² = 18.67, P < 0.01); 16.59% and 8.17% in groups from urban and rural areas, respectively (χ² = 618.38, P < 0.01); and 12.22%, 11.75% and 8.26% in groups from eastern, central and western China, respectively (χ² = 117.04, P < 0.01). The treatment rate of dyslipidemia was 6.84% among Chinese adults, while the stratified rates were 3.55%, 10.73% and 12.05% in the groups of subjects aged 18 - 44, 45 - 59 and over 60 years old, respectively (χ² = 858.72, P < 0.01); 6.37% and 7.43% among males and females, respectively (χ² = 16.69, P < 0.01); 10.17% and 5.21% in groups from urban and rural areas, respectively (χ² = 327.51, P < 0.01); and 7.33%, 7.52% and 5.41% in groups from eastern, central and western China, respectively (χ² = 50.71, P < 0.01). The control rate of dyslipidemia was 3.53% among total subjects, while whose stratified rates were 1.64%, 5.49% and 6.94% in the groups of subjects aged 18 - 44, 45 - 59 and over 60 years old, respectively (χ² = 554.12, P < 0.01); 2.57% and 4.75% among males and females, respectively (χ² = 131.04, P < 0.01); 5.23% and 2.70% in groups from urban and rural areas, respectively (χ² = 165.13, P < 0.01) ; and 4.21%, 3.89% and 2.17% in groups from eastern, central and western China, respectively (χ² = 91.45, P < 0.01). CONCLUSION: The awareness, treatment and control rates of dyslipidemia have been comparatively low among Chinese adults, especially among the population who were young, or who were from rural area or western China.

[Survey of dietary intake of Chinese adults in 2010].

OBJECTIVE: To analyze the status of dietary intake of Chinese adults in 2010. METHODS: In 2010, China Chronic Disease Surveillance was carried out in 31 provinces and Xinjiang Production and Construction Corps. The survey was undertaken in 162 surveillance sites in the national disease surveillance points system by stratified multi-stage cluster random sampling. The participants were local residents (living in the area for more than 6 months) aged 18 years and above in the surveillance sites. A semi-quantitative food frequency questionnaire was used to measure the dietary intake for 97 187 urban and rural adults aged 18 years and above. After complex weighting for the sample, the average daily consumption for major food was analyzed for different genders and regions. RESULTS: After complex weighting, the median of cereal, rice and wheat flour intake for Chinese adults was 375.0 g. The median of livestock meat intake was 57.1 g with western areas (85.7 g) much higher than eastern (57.1 g) and central areas (46.2 g) (χ² = 2054.82, P < 0.01). The median of poultry intake was 7.1 g, eastern areas (10.0 g) higher than western and central areas (both 6.7 g) (χ² = 1210.86, P < 0.01). The median of seafood intake was 14.3 g, eastern (15.0 g) much higher than central (14.3 g) and western areas (7.1 g) (χ² = 5603.37, P < 0.01). The median of daily intake for eggs was 21.4 g, western (14.3 g) lower than eastern and central areas (both 21.4 g) (χ² = 1699.11, P < 0.01). The median of dairy product intake was 42.9 g, eastern (57.1 g) higher than western and central areas (both 35.7 g) (χ² = 196.35, P < 0.01). Overall, 52.8% of urban and rural residents did not meet recommended amount of fruit and vegetable intake. The rate of inadequate intake of fruit and vegetable was higher in rural (55.7%) than urban areas (46.1%, χ² = 929.43, P < 0.01). CONCLUSION: The adult intake of cereal category foods tended to decline in 2010, and the intakes of vegetable and fruits, fishery products as well as dairy products were evidently deficient and regionally varied.

[The levels and distribution of the serum lipids in Chinese adults, 2010].

OBJECTIVE: To study the levels of blood lipid among Chinese adults in 2010 and analyze the epidemiological features. METHODS: Fasting serum levels of total cholesterol (TC), triglyceride (TG), high density lipoprotein-cholesterol (HDL-C) and low density lipoprotein-cholesterol (LDL-C) were determined for 90 395 subjects aged 18 and over who were selected by multi stage cluster random sampling method from 162 surveillance sites of 31 provinces of China mainland in 2010. After complex weighting, the differences of levels of serum total TC, TG, HDL-C and LDL-C were analyzed in different age, gender and geographic regions. RESULTS: After complex weighting, the levels of serum TC in Chinese adults was (4.04 ± 1.08) mmol/L, with (3.86 ± 1.03), (4.29 ± 1.11) and (4.33 ± 1.09) mmol/L in the groups of 18 - 44, 45 - 59 and over 60 years old (F = 177.56, P < 0.01), respectively. The level of serum TC was (4.06 ± 1.09) mmol/L and (4.03 ± 1.07) mmol/L in males and females (F = 2.38, P > 0.05), respectively; (4.08 ± 1.13) mmol/L and (4.03 ± 1.06) mmol/L in urban and rural areas (F = 0.51, P > 0.05), respectively, and (4.13 ± 1.11), (4.03 ± 1.01) and (3.93 ± 1.11) mmol/L in areas of east, middle and west respectively (F = 2.56, P > 0.05). The levels of serum TG was (1.33 ± 1.28) mmol/L, with(1.26 ± 1.24), (1.48 ± 1.46) and (1.35 ± 1.05) mmol/L in the groups of 18 - 44, 45 - 59 and over 60 years old (F = 85.98, P < 0.01), respectively. The level of serum TG was (1.45 ± 1.48) mmol/L and (1.21 ± 1.01) mmol/L in males and females (F = 172.01, P < 0.01), respectively, (1.34 ± 1.26) mmol/L and (1.33 ± 1.28) mmol/L in urban and rural areas (F = 0.16, P > 0.05), respectively, and(1.30 ± 1.25), (1.35 ± 1.23) and (1.35 ± 1.36) mmol/L in areas of east, middle and west (F = 0.69, P > 0.05) respectively. The levels of serum HDL-C was (1.11 ± 0.31) mmol/L, with (1.09 ± 0.30), (1.13 ± 0.33) and (1.14 ± 0.33) mmol/L in the groups of 18 - 44, 45 - 59 and over 60 years old (F = 27.81, P < 0.01), respectively. The level of serum HDL-C was (1.08 ± 0.32) mmol/L and (1.14 ± 0.30) mmol/L in males and females (F = 178.66, P < 0.01), respectively, (1.11 ± 0.31) mmol/L and (1.11 ± 0.32) mmol/L in urban and rural areas (F = 0.09, P > 0.05), respectively, and (1.12 ± 0.32), (1.12 ± 0.31) and (1.09 ± 0.32) mmol/L in areas of east, middle and west (F = 1.06, P > 0.05) respectively. The levels of serum LDL-C was (2.27 ± 0.78) mmol/L, with (2.15 ± 0.74), (2.42 ± 0.80) and (2.46 ± 0.81) mmol/L in the groups of 18 - 44, 45 - 59 and over 60 years old (F = 129.84, P < 0.01), respectively. The level of serum LDL-C was (2.30 ± 0.78) mmol/L and (2.24 ± 0.78) mmol/L in males and females (F = 25.06, P < 0.01), respectively, (2.33 ± 0.82) mmol/L and (2.24 ± 0.76) mmol/L in urban and rural areas (F = 3.48, P > 0.05), respectively, and (2.35 ± 0.80), (2.25 ± 0.74) and (2.17 ± 0.77) mmol/L in areas of east, middle and west (F = 4.58, P < 0.05) respectively. CONCLUSION: The levels of serum lipid of middle aged male, female after menopause and people living in eastern region were higher than other Chinese adults. Effective measures should be taken earlier to control serum lipid levels.

[Leisure-time physical activity and sedentary behaviors among Chinese adults in 2010].

OBJECTIVE: To understand the prevalence of participation in leisure-time physical activity, and sedentary behaviors among Chinese adults. METHODS: Data from Chinese Chronic Disease Surveillance (2010) was used. Among adults aged 18 years old and over, the information on frequency and duration of occupational activity, house chores, commuting and leisure time activity was collected by an interview with Global Physical Activity Questionnaire (GPAQ). The time spent on watching TV, reading, using computers or playing games after work was also surveyed. This present study only analyzed the percentage of participating in leisure time moderate or vigorous intensity physical activity at least 10 minutes three days per week and the time spent on TV, reading, using computer and playing games during after hours among Chinese adults of 98 649 subjects. RESULTS: 11.9% (95%CI: 10.5% - 13.3%) of all adults took part in leisure time moderate or vigorous intensity physical activity at least 10 minutes for three days per week, with-group the percentage highest among age-group 18 - 24 (15.6%, 95%CI: 10.5% - 13.3%) and lowest among age 25 - 34 (9.9%, 95%CI: 8.0% - 11.7%) and 75 years old and over (9.9%, 95%CI: 8.2% - 11.6%) (P < 0.01). The age related change showed a double-peak curve. The percentage was higher in male (13.1%, 95%CI: 11.6% - 14.6%) than in female (10.6%, 95%CI: 9.3% - 12.0%) (P < 0.01). Among the populations engaged in diverse occupations, the lowest percentage was detected among those in farming, forestry, husbandry and fishing (4.2%, 95%CI: 3.4% - 4.9%). Higher percentage was found among the residents lived in urban areas (19.9%, 95%CI: 17.4% - 22.5%) than in rural areas (8.2%, 95%CI: 6.7% - 9.8%) (P < 0.01), and higher in the east area (14.8%, 95%CI: 11.9% - 17.6%) compared to that in central (9.7%, 95%CI: 8.1% - 11.3%) or in west areas (10.3%, 95%CI: 8.4% - 12.3%) in China (P < 0.01). Furthermore, (2.7 ± 2.0) hours per day was spent in sedentary behaviors, such as watching TV, reading, using computers or playing games during after hours. Those aged 18 - 24 years-old spent most time (3.8 ± 2.6) hours per day in sedentary behaviors and the time reduced with age (P < 0.01). More time on Sedentary behaviors were taken by male (2.9 ± 2.1 hours per day) than by female ((2.6 ± 1.9) hours per day) (P < 0.01), with more hours spent in urban ((3.3 ± 2.2) hours per day) than that in rural ((2.5 ± 1.9) hours per day) (P < 0.01). No difference was detected among the residents lived in east ((2.9 ± 2.1) hours per day), central ((2.7 ± 2.0) hours per day) and west area ((2.6 ± 2.0) hours per day) (P > 0.05). CONCLUSION: The percentage of taking part in moderate and vigorous activity during leisure time was generally low. Average time spent in after hours sedentary behaviors was long.