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. 2022 Feb 15;2(1):87-100.
doi: 10.1016/j.jacasi.2021.09.007. eCollection 2022 Feb.

Status of Cardiovascular Health in Chinese Children and Adolescents: A Cross-Sectional Study in China

Yanna Zhu  1 , Pengfei Guo  1 , Zhiyong Zou  2 , Xiuhong Li  1 , Muqing Cao  1 , Jun Ma  2 , Jin Jing  1
Affiliations

Status of Cardiovascular Health in Chinese Children and Adolescents: A Cross-Sectional Study in China

Yanna Zhu et al. JACC Asia. .

Abstract

Background: The American Heart Association defined "ideal cardiovascular health (CVH)" in pediatric populations to promote primordial prevention in cardiovascular diseases. Little is known about CVH and associated sociodemographic factors among Chinese children and adolescents.

Objectives: This study aimed to evaluate CVH and the associations with sociodemographic characteristics in Chinese children and adolescents.

Methods: This cross-sectional study analyzed baseline data of 15,583 participants aged 7 to 17 years from a Chinese national intervention program against obesity (2013-2014). CVH status was estimated according to 4 health behaviors (nonsmoking, body mass index, physical activity, and diet) and 3 health factors (total cholesterol, blood pressure, and fasting plasma glucose), using revised American Heart Association criteria. Multinomial logistic regression was used to assess the association between sociodemographic characteristics and the number of ideal CVH metrics.

Results: The prevalence of ideal CVH status was 1.7% (males: 1.9%; females: 1.6%) in the study population. The prevalence of ideal CVH behaviors and ideal health factors was 3.1% (males 3.3%; females: 3.0%) and 53.6% (males: 52.4%; females: 54.9%), respectively. Ideal fasting plasma glucose was the most prevalent component (males: 94.4%; females: 97.4%), whereas ideal physical activity (males: 34.6%; females: 23.9%) and diet (males: 28.3%; females: 30.1%) were the least prevalent. Female sex, younger age, undeveloped economy, residence in the southern region, and no family history of cardiovascular diseases were associated with more ideal CVH metrics.

Conclusions: Ideal CVH status in Chinese children and adolescents is alarmingly rare. Physical activity and diet are key to promotion of CVH. Effective interventions are needed to promote CVH and reduce health disparities in early life.

Keywords: AHA, American Heart Association; BMI, body mass index; BP, blood pressure; CVD, cardiovascular disease; CVH, cardiovascular health; China; FPG, fasting plasma glucose; TC, total cholesterol; adolescent; cardiovascular disease; child; epidemiology; pediatric obesity.

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Conflict of interest statement

This project was funded by the Special Research Grant for Non-profit Public Service of the Ministry of Health of China (Grant No.201202010), the Guangdong Provincial Natural Science Foundation (Grant No. 2017A030313844 and Grant No. 2021A1515010439), and the Research fund for medical science (Grant No. 2019B030335001). The funders had no role in study design, data collection and analysis, decision to publish, or manuscript preparation. No relationships with industry were involved in this study. The authors have reported that they have no relationships relevant to the contents of this paper to disclose.

Figures

None
Graphical abstract
Central Illustration
Central Illustration
Status of Cardiovascular Health Metrics in Chinese Children and Adolescents In this nationwide school-based cross-sectional study: 1) ideal cardiovascular health status (having 7 ideal health metrics) was alarmingly rare in Chinese children and adolescents; and 2) ideal physical activity (≥60 minutes of moderate or vigorous activity every day) and ideal dietary intake (having recommended amounts of 4-5 diet components) were the least prevalent metrics.
Figure 1
Figure 1
Ideal CVH Behaviors and Factors According to Age and Sex Proportions of participants with ideal cardiovascular health (CVH) status (7 ideal health metrics), ideal health behavior status (4 ideal health behavior metrics), and ideal health factor status (3 ideal health factor metrics) according to age in the total population (A), male subjects (B), and female subjects (C).
See this image and copyright information in PMC

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