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Spatiotemporal Variations in Ischemic Heart Disease Mortality and related risk factors in China between 2010 and 2015: A Multilevel Analysis
Lijun Wang
Chinese Center for Disease Control and Prevention
Corresponding Author
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View the published version at BMC Public Health.
Background: To explore the relationship between geographical differences of mortality and related risk factors in ischemic heart disease (IHD) in China.
Methods: Data were collected from the nationally representative China Mortality Surveillance System to calculate annual IHD mortality counts (2010-2015). Descriptive analysis was used to analyze the IHD mortality among Chinese population from 2010 to 2015. Negative binomial regression was used to investigate potential spatiotemporal variation and correlations with age, gender, urbanization, and region.
Results: The overall IHD mortality was 221.17/100,000, accounting for 1.51 million deaths in 2015. The standardized IHD mortality rate increased by 5.51% from 2010 to 2015 among people aged 40 years and older. Multilevel analysis indicated significant differences in gender, regional effects, and age. High urbanization rate (risk ratio [RR] = 0.728, 95% confidence interval [CI] = (0.631, 0.840)) and average high-density lipoprotein (HDL) (RR=0.741, 95%CI: 0.616,0.891) were negatively associated with IHD mortality. IHD mortality was significantly higher in populations with a low rate of medical insurance coverage (RR= 1.218, 95%CI: 1.007, 1.473), as well as the average body mass index (BMI) (RR= 1.436, 95%CI: 1.135, 1.817) and systolic blood pressure (SBP) (RR= 1.310, 95%CI: 1.019, 1.684). While the relationship with current smoking rate, excessive intake of red meat, insufficient vegetable or fruits intake didn’t show the statistical significance. The negative correlation between the average sedentary time and IHD mortality was not conclusive due to the possible deviation of the data.
Conclusions: The mortality of IHD showed an upward trend for people aged 40 years and older in China during 2010-2015, which should be paid attention to. Therefore, some risk factors should be controlled, such as SBP, overweight/obesity. HDL is a protective factor, as well as higher urbanization rate, family income level, and medical insurance coverage.
Keywords
Ischemic Heart Disease, Risk Factor, Multilevel Statistical Model
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CURRENT STATUS: Published
Version 3
Posted 17 Dec, 2020
No comments provided
Review #1 received
Received 23 Nov, 2020
Review #2 received
Received 07 Nov, 2020
Reviewer #2 agreed
On 06 Nov, 2020
Reviewer #1 agreed
On 29 Oct, 2020
Editor assigned
On 27 Oct, 2020
Reviewers invited
Invitations sent on 27 Oct, 2020
Submission checks complete
On 26 Oct, 2020
Editor invited
On 26 Oct, 2020
No comments provided
Editorial decision: Major revision
On 26 Sep, 2020
Review #2 received
Received 12 Sep, 2020
Reviewer #2 agreed
On 20 Aug, 2020
Review #1 received
Received 16 Aug, 2020
Reviewer #1 agreed
On 29 Jul, 2020
Reviewers invited
Invitations sent on 26 Jul, 2020
Editor assigned
On 20 Jul, 2020
Submission checks complete
On 19 Jul, 2020
Editor invited
On 19 Jul, 2020
First submitted
On 14 Jul, 2020
Metrics
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PDF Downloads: ...
HTML Views: ...
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This preprint is under consideration at BMC Public Health. A preprint is a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Research article
Spatiotemporal Variations in Ischemic Heart Disease Mortality and related risk factors in China between 2010 and 2015: A Multilevel Analysis
Lijun Wang
Chinese Center for Disease Control and Prevention
Corresponding Author
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Published
Version 3
Posted 17 Dec, 2020
No comments provided
Review #1 received
Received 23 Nov, 2020
Review #2 received
Received 07 Nov, 2020
Reviewer #2 agreed
On 06 Nov, 2020
Reviewer #1 agreed
On 29 Oct, 2020
Editor assigned
On 27 Oct, 2020
Reviewers invited
Invitations sent on 27 Oct, 2020
Submission checks complete
On 26 Oct, 2020
Editor invited
On 26 Oct, 2020
No comments provided
Editorial decision: Major revision
On 26 Sep, 2020
Review #2 received
Received 12 Sep, 2020
Reviewer #2 agreed
On 20 Aug, 2020
Review #1 received
Received 16 Aug, 2020
Reviewer #1 agreed
On 29 Jul, 2020
Reviewers invited
Invitations sent on 26 Jul, 2020
Editor assigned
On 20 Jul, 2020
Submission checks complete
On 19 Jul, 2020
Editor invited
On 19 Jul, 2020
First submitted
On 14 Jul, 2020
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
License:
This work is licensed under a CC BY 4.0 License. Read Full License
View the published version at BMC Public Health.
Background: To explore the relationship between geographical differences of mortality and related risk factors in ischemic heart disease (IHD) in China.
Methods: Data were collected from the nationally representative China Mortality Surveillance System to calculate annual IHD mortality counts (2010-2015). Descriptive analysis was used to analyze the IHD mortality among Chinese population from 2010 to 2015. Negative binomial regression was used to investigate potential spatiotemporal variation and correlations with age, gender, urbanization, and region.
Results: The overall IHD mortality was 221.17/100,000, accounting for 1.51 million deaths in 2015. The standardized IHD mortality rate increased by 5.51% from 2010 to 2015 among people aged 40 years and older. Multilevel analysis indicated significant differences in gender, regional effects, and age. High urbanization rate (risk ratio [RR] = 0.728, 95% confidence interval [CI] = (0.631, 0.840)) and average high-density lipoprotein (HDL) (RR=0.741, 95%CI: 0.616,0.891) were negatively associated with IHD mortality. IHD mortality was significantly higher in populations with a low rate of medical insurance coverage (RR= 1.218, 95%CI: 1.007, 1.473), as well as the average body mass index (BMI) (RR= 1.436, 95%CI: 1.135, 1.817) and systolic blood pressure (SBP) (RR= 1.310, 95%CI: 1.019, 1.684). While the relationship with current smoking rate, excessive intake of red meat, insufficient vegetable or fruits intake didn’t show the statistical significance. The negative correlation between the average sedentary time and IHD mortality was not conclusive due to the possible deviation of the data.
Conclusions: The mortality of IHD showed an upward trend for people aged 40 years and older in China during 2010-2015, which should be paid attention to. Therefore, some risk factors should be controlled, such as SBP, overweight/obesity. HDL is a protective factor, as well as higher urbanization rate, family income level, and medical insurance coverage.
Figure 1
Figure 1