Analysis of epidemiological characteristics of risk factors for cardiovascular diseases and malignant tumors based on the Shanghai community elderly cohort

doi:10.3969/j.issn.1674-8115.2024.05.010

Journal of Shanghai Jiao Tong University (Medical Science) ›› 2024, Vol. 44 ›› Issue (5): 617-625.doi: 10.3969/j.issn.1674-8115.2024.05.010

• Public health • Previous Articles

Analysis of epidemiological characteristics of risk factors for cardiovascular diseases and malignant tumors based on the Shanghai community elderly cohort

LI Ping¹^,²(), JIANG Huiru², YE Mengyue³, WANG Yayu¹^,², CHEN Xiaoyu⁴, YUAN Ancai², XU Wenjie⁵, DAI Huimin⁶, CHEN Xi⁷, YAN Xiaoxiang⁸, TU Shengxian², ZHENG Yuanqi⁷, ZHANG Wei²^,⁹(), PU Jun²()

^1.School of Public Health, Bengbu Medical University, Bengbu 233030, China
^2.Department of Cardiology, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200127, China
^3.Physical Examination Center, Ningbo Hangzhou Bay Hospital, Zhejiang Province, Ningbo 315336, China
^4.Center for Clinical Investigation, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200127, China
^5.Department of Traditional Chinese Medicine, Heqing Community Health Service Center of Pudong New Area, Shanghai 201201, China
^6.Department of General Practice, Weifang Community Health Service Center of Pudong New Area, Shanghai 200122, China
^7.Department of Cardiology, Sanming First Hospital, Fujian Province, Sanming 365000, China
^8.Department of Cardiovascular Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
^9.Department of Epidemiology, Shanghai Cancer Institute, Shanghai 200032, China.

Received:2023-09-27 Accepted:2024-03-01 Online:2024-05-28 Published:2024-05-28
Contact: ZHANG Wei,PU Jun E-mail:lp239600@163.com;zhangwei050080@renji.com;punjun310@hotmail.com
Supported by:
Professional Technical Service Platform Project of Shanghai(22DZ2292400);Emerging Interdisciplinary Research Project of Shanghai Municipal Health Commission(2022JC013);Project of Shanghai Health Commission Key Research Center(2023ZZ02021);Key Clinical Specialty of Shanghai Municipal Health Commission(SHSLCZDZK06204);Key Discipline Construction Project of Shanghai Three-year Action Plan to Strengthen Public Health System Construction (2023—2025)(GWVI-11.1-26);Innovative Research Team of High-level Local Universities in Shanghai(SHSMU-ZDCX-2021-0700);Health Science and Technology Research Project of Pudong New Area Health Commission(PW2023E-02);Discipline Leader Training Program of Health System in Pudong New area(PWRd2022-06);Discipline Construction of Pudong New Area Health Commission(PWYq2020-03);Jointly Funded Projects of Science and Technology Plan in Sanming City(2022-S-56)

Abstract

Abstract:

Objective ·To analyze the epidemiological characteristics of risk factors for cardiovascular diseases and malignant tumors based on the Shanghai community elderly cohort. Methods ·The study subjects were selected from the Shanghai community elderly cohort established from February to August 2019, with a total of 17 948 people. The study subjects were divided into 4 groups according to self-reported presence or absence of tumors and/or cardiovascular diseases during the baseline survey: tumor-free and non-cardiovascular disease group, single cardiovascular disease group, single tumor group and tumor cardiovascular disease co-occurrence group. The differences among the four groups of subjects were collected and compared in terms of demographic characteristics and physiological indicators, daily living habits (smoking, drinking tea, drinking coffee, drinking carbonated drink, drinking alcohol, sedentary time, physical activity level and sleep quality), past medical history, psychological status (depression and anxiety) and dietary compliance. Results ·Among the study subjects, 60.1% of tumor patients were complicated with cardiovascular diseases. The differences among the four groups of subjects in age, gender, educational level, pre-retirement occupation, waist circumference, hip circumference and body mass index were statistically significant (all P<0.05). Compared with the tumor-free and non-cardiovascular disease group, the single cardiovascular disease group, single tumor group and tumor cardiovascular disease co-occurrence group all exhibited lower proportions of smoking and high physical activity levels (all P<0.05), and higher proportion of sedentary time exceeding 4 h/d and poor sleep quality (all P<0.05); the proportion of subjects with past medical histories including hyperlipidemia, peripheral vascular disease, endocrine system disease, respiratory system disease, urinary system disease and digestive system disease of the single cardiovascular disease group and the tumor cardiovascular disease co-occurrence group was higher (all P<0.05), and the proportion of subjects with depression and anxiety was also higher (all P<0.05). Furthermore, compared with the tumor-free and non-cardiovascular disease group, the single cardiovascular disease group had lower compliance rates of poultry, fish, fruit and liquid milk (all P<0.05). Among the four groups, only the compliance rate of vegetable intake exceeded 50%, while the compliance rates of poultry, fish, fruit, liquid milk and tubers were all below 20%. Conclusion ·In the elderly population of Shanghai communities, over half of malignant tumor patients are concomitant with cardiovascular diseases. Unhealthy daily habits are prevalent among those with cardiovascular diseases, tumors and tumor-cardiovascular disease co-occurrence. The intake of many foods in the elderly of the community do not reach the levels recommended by Chinese Dietary Guidelines.

Key words: malignant tumor, cardiovascular disease, risk factor, epidemiological characteristics, cohort

CLC Number:

R181.2

LI Ping, JIANG Huiru, YE Mengyue, WANG Yayu, CHEN Xiaoyu, YUAN Ancai, XU Wenjie, DAI Huimin, CHEN Xi, YAN Xiaoxiang, TU Shengxian, ZHENG Yuanqi, ZHANG Wei, PU Jun. Analysis of epidemiological characteristics of risk factors for cardiovascular diseases and malignant tumors based on the Shanghai community elderly cohort[J]. Journal of Shanghai Jiao Tong University (Medical Science), 2024, 44(5): 617-625.

Figures/Tables 4

TrendMD

References 29

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Characteristic	Tumor-free and non-cardiovascular disease group (n=6 222)	Single cardiovascular disease group (n=10 523)	Single tumor group (n=480)	Tumor cardiovascular disease co-occurrence group (n=723)	F/χ² value	P value
Age/year	66.9±5.8	69.0±6.2^②	68.2±6.4^②	69.9±6.5^②	175.135	0.000
Gender/n(%)					31.431	0.000
Male	2 898 (46.6)	4 880 (46.4)	230 (47.9)	260 (36.0)^②
Female	3 324 (53.4)	5 643 (53.6)	250 (52.1)	463 (64.0)^②
Educational level/n(%)					126.112	0.000
Primary school and below	1 840 (29.6)	3 931 (37.4)^②	137 (28.5)	265 (36.7)^②
Middle school/high school	4 030 (64.8)	6 076 (57.7)^②	305 (63.5)	405 (56.0)^②
College and above	352 (5.7)	516 (4.9)^②	38 (7.9)^②	53 (7.3)
Pre-retirement occupation/n(%)^①					31.485	0.008
Worker	2 095 (33.7)	3 352 (31.9)^②	183 (38.1)^②	233 (32.2)
Farmer	3 364 (54.1)	5 904 (56.1)^②	230 (47.9)^②	384 (53.1)
Technology professional/medical professional/teacher	275 (4.4)	434 (4.1)	28 (5.8)	47 (6.5)^②
Administrative staff	322 (5.2)	564 (5.4)	26 (5.4)	44 (6.1)
Individual business enterprise	91 (1.5)	143 (1.4)	9 (1.9)	9 (1.2)
Others	75 (1.2)	123 (1.2)	4 (0.8)	6 (0.8)
Waist circumference/n(%)^①					520.279	0.000
Normal	4 356 (76.0)	5 814 (58.9)^②	343 (79.6)	381 (57.7)^②
Central obesity	1 378 (24.0)	4 053 (41.1)^②	88 (20.4)	279 (42.3)^②
Hip circumference/cm^①	91.4±6.6	93.8±7.1^②	90.9±6.7	93.9±7.3^②	165.209	0.000
BMI/(kg·m^-2)^①	23.7±3.1	25.3±3.4^②	23.1±3.2^②	25.1±3.4^②	339.084	0.000

Characteristic	Tumor-free and non-cardiovascular disease group (n=6 222)	Single cardiovascular disease group (n=10 523)	Single tumor group (n=480)	Tumor cardiovascular disease co-occurrence group (n=723)	F/χ² value	P value
Age/year	66.9±5.8	69.0±6.2^②	68.2±6.4^②	69.9±6.5^②	175.135	0.000
Gender/n(%)					31.431	0.000
Male	2 898 (46.6)	4 880 (46.4)	230 (47.9)	260 (36.0)^②
Female	3 324 (53.4)	5 643 (53.6)	250 (52.1)	463 (64.0)^②
Educational level/n(%)					126.112	0.000
Primary school and below	1 840 (29.6)	3 931 (37.4)^②	137 (28.5)	265 (36.7)^②
Middle school/high school	4 030 (64.8)	6 076 (57.7)^②	305 (63.5)	405 (56.0)^②
College and above	352 (5.7)	516 (4.9)^②	38 (7.9)^②	53 (7.3)
Pre-retirement occupation/n(%)^①					31.485	0.008
Worker	2 095 (33.7)	3 352 (31.9)^②	183 (38.1)^②	233 (32.2)
Farmer	3 364 (54.1)	5 904 (56.1)^②	230 (47.9)^②	384 (53.1)
Technology professional/medical professional/teacher	275 (4.4)	434 (4.1)	28 (5.8)	47 (6.5)^②
Administrative staff	322 (5.2)	564 (5.4)	26 (5.4)	44 (6.1)
Individual business enterprise	91 (1.5)	143 (1.4)	9 (1.9)	9 (1.2)
Others	75 (1.2)	123 (1.2)	4 (0.8)	6 (0.8)
Waist circumference/n(%)^①					520.279	0.000
Normal	4 356 (76.0)	5 814 (58.9)^②	343 (79.6)	381 (57.7)^②
Central obesity	1 378 (24.0)	4 053 (41.1)^②	88 (20.4)	279 (42.3)^②
Hip circumference/cm^①	91.4±6.6	93.8±7.1^②	90.9±6.7	93.9±7.3^②	165.209	0.000
BMI/(kg·m^-2)^①	23.7±3.1	25.3±3.4^②	23.1±3.2^②	25.1±3.4^②	339.084	0.000

Daily living habit	Tumor-free and non-cardiovascular disease group (n=6 222)	Single cardiovascular disease group (n=10 523)	Single tumor group (n=480)	Tumor cardiovascular disease co-occurrence group (n=723)	χ² value	P value
Smoking/n(%)^①					130.142	0.000
No	4 576 (73.5)	8 140 (77.4)^②	417 (86.9)^②	646 (89.4)^②
Yes	1 646 (26.5)	2 380 (22.6)^②	63 (13.1)^②	77 (10.6)^②
Drinking tea/n(%)^①					12.517	0.006
No	4 578 (73.6)	7 824 (74.4)	378 (78.8)^②	566 (78.3)^②
Yes	1 641 (26.4)	2 695 (25.6)	102 (21.2)^②	157 (21.7)^②
Drinking coffee/n(%)^①					1.017	0.797
No	5 809 (93.4)	9 853 (93.7)	444 (92.7)	677 (93.6)
Yes	411 (6.6)	668 (6.3)	35 (7.3)	46 (6.4)
Drinking carbonated drink/n(%)^①					8.407	0.033
No	6 180 (99.4)	10 453 (99.4)	470 (98.1) ^②	717 (99.3)
Yes	39 (0.6)	67 (0.6)	9 (1.9) ^②	5 (0.7)
Drinking alcohol/n(%)					1.143	0.767
No	5 195 (83.5)	8 767 (83.3)	397 (82.7)	593 (82.0)
Yes	1 027 (16.5)	1 756 (16.7)	83 (17.3)	130 (18.0)
Sedentary time/n(%)^①					69.673	0.000
≤2 h/d	3 392 (54.6)	5 230 (49.8) ^②	238 (49.7)^②	317 (43.9)^②
3‒4 h/d	2 255 (36.3)	4 060 (38.6) ^②	184 (38.4)	296 (41.0)^②
>4 h/d	562 (9.1)	1 216 (11.6) ^②	57 (11.9)^②	109 (15.1)^②
Physical activity level/n(%)					46.650	0.000
Low level	300 (4.8)	618 (5.9)^②	29 (6.0)	64 (8.9)^②
Middle level	1 973 (31.7)	3 592 (34.1)^②	176 (36.7)^②	265 (36.7)^②
High level	3949 (63.5)	6 313 (60.0)^②	275 (57.3)^②	394 (54.5)^②
Sleep quality/n(%)^①					27.736	0.000
Good	5 172 (83.3)	8 495 (80.9)^②	381 (79.5)^②	553 (76.8)^②
Poor	1 038 (16.7)	2 011 (19.1)^②	98 (20.5)^②	167 (23.2)^②

Daily living habit	Tumor-free and non-cardiovascular disease group (n=6 222)	Single cardiovascular disease group (n=10 523)	Single tumor group (n=480)	Tumor cardiovascular disease co-occurrence group (n=723)	χ² value	P value
Smoking/n(%)^①					130.142	0.000
No	4 576 (73.5)	8 140 (77.4)^②	417 (86.9)^②	646 (89.4)^②
Yes	1 646 (26.5)	2 380 (22.6)^②	63 (13.1)^②	77 (10.6)^②
Drinking tea/n(%)^①					12.517	0.006
No	4 578 (73.6)	7 824 (74.4)	378 (78.8)^②	566 (78.3)^②
Yes	1 641 (26.4)	2 695 (25.6)	102 (21.2)^②	157 (21.7)^②
Drinking coffee/n(%)^①					1.017	0.797
No	5 809 (93.4)	9 853 (93.7)	444 (92.7)	677 (93.6)
Yes	411 (6.6)	668 (6.3)	35 (7.3)	46 (6.4)
Drinking carbonated drink/n(%)^①					8.407	0.033
No	6 180 (99.4)	10 453 (99.4)	470 (98.1) ^②	717 (99.3)
Yes	39 (0.6)	67 (0.6)	9 (1.9) ^②	5 (0.7)
Drinking alcohol/n(%)					1.143	0.767
No	5 195 (83.5)	8 767 (83.3)	397 (82.7)	593 (82.0)
Yes	1 027 (16.5)	1 756 (16.7)	83 (17.3)	130 (18.0)
Sedentary time/n(%)^①					69.673	0.000
≤2 h/d	3 392 (54.6)	5 230 (49.8) ^②	238 (49.7)^②	317 (43.9)^②
3‒4 h/d	2 255 (36.3)	4 060 (38.6) ^②	184 (38.4)	296 (41.0)^②
>4 h/d	562 (9.1)	1 216 (11.6) ^②	57 (11.9)^②	109 (15.1)^②
Physical activity level/n(%)					46.650	0.000
Low level	300 (4.8)	618 (5.9)^②	29 (6.0)	64 (8.9)^②
Middle level	1 973 (31.7)	3 592 (34.1)^②	176 (36.7)^②	265 (36.7)^②
High level	3949 (63.5)	6 313 (60.0)^②	275 (57.3)^②	394 (54.5)^②
Sleep quality/n(%)^①					27.736	0.000
Good	5 172 (83.3)	8 495 (80.9)^②	381 (79.5)^②	553 (76.8)^②
Poor	1 038 (16.7)	2 011 (19.1)^②	98 (20.5)^②	167 (23.2)^②

Item	Tumor-free and non-cardiovascular disease group (n=6 222)	Single cardiovascular disease group (n=10 523)	Single tumor group (n=480)	Tumor cardiovascular disease co-occurrence group (n=723)	χ² value	P value
Hyperlipidemia/n(%)					274.126	0.000
No	5 838 (93.8)	9 042 (85.9)^②	443 (92.3)	600 (83.0)^②
Yes	384 (6.2)	1 481 (14.1)^②	37 (7.7)	123 (17.0)^②
Peripheral vascular disease/n(%)^①					69.969	0.000
No	6 139 (98.8)	10 181 (96.8)^②	472 (98.7)	697 (96.5)^②
Yes	74 (1.2)	333 (3.2)^②	6 (1.3)	25 (3.5)^②
Endocrine system disease/n(%)^①					490.889	0.000
No	5 160 (83.2)	7 282 (69.3)^②	397 (82.9)	430 (59.5)^②
Yes	1 045 (16.8)	3 226 (30.7)^②	82 (17.1)	293 (40.5)^②
Respiratory system disease/n(%)^①					25.046	0.000
No	5 876 (94.7)	9 862 (93.9)^②	445 (93.1)	651 (90.2)^②
Yes	329 (5.3)	639 (6.1)^②	33 (6.9)	71 (9.8)^②
Urinary system disease/n(%)^①					34.050	0.000
No	5 980 (96.4)	9 940 (94.6)^②	455 (95.2)	671 (93.1)^②
Yes	225 (3.6)	568 (5.4)^②	23 (4.8)	50 (6.9)^②
Digestive system disease/n(%)^①					81.699	0.000
No	4 778 (77.1)	7 478 (71.2)^②	358 (75.1)	485 (67.4)^②
Yes	1 421 (22.9)	3 021 (28.8)^②	119 (24.9)	235 (32.6)^②
Depression symptom/n(%)					40.660	0.000
No	6 025 (96.8)	10 024 (95.3)^②	459 (95.6)	670 (92.7)^②
Yes	197 (3.2)	499 (4.7)^②	21 (4.4)	53 (7.3)^②
Anxiety symptom/n(%)					27.224	0.000
No	6 106 (98.1)	10 196 (96.9)^②	465 (96.9)	695 (96.1)^②
Yes	116 (1.9)	327 (3.1)^②	15 (3.1)	28 (3.9)^②

Analysis of epidemiological characteristics of risk factors for cardiovascular diseases and malignant tumors based on the Shanghai community elderly cohort

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Dietary compliance status	Tumor-free and non-cardiovascular disease group (n=6 222)	Single cardiovascular disease group (n=10 523)	Single tumor group (n=480)	Tumor cardiovascular disease co-occurrence group (n=723)	χ² value	P value
Vegetable intake/n(%)^①					6.881	0.076
<300 g/d	1 906 (31.4)	3 042 (29.7)^②	149 (32.2)	205 (29.1)
≥300 g/d	4 156 (68.6)	7 208 (70.3)^②	314 (67.8)	500 (70.9)
Poultry intake/n(%)^①					23.615	0.005
0 g/week	121 (2.0)	199 (1.9)	10 (2.1)	17 (2.4)
<300 g/week	4 578 (74.9)	8 046 (77.7)^②	357 (76.1)	540 (75.8)
300‒500 g/week	946 (15.5)	1 468 (14.2)^②	73 (15.6)	111 (15.6)
>500 g/week	470 (7.7)	639 (6.2)^②	29 (6.2)	44 (6.2)
Fish intake/n(%)^①					28.426	0.000
0 g/week	147 (2.4)	288 (2.8)	20 (4.3)^②	14 (2.0)
<300 g/week	4 985 (81.7)	8 615 (83.4)^②	392 (83.6)	606 (85.6)^②
300‒500 g/week	692 (11.3)	1 050 (10.2)^②	45 (9.6)	67 (9.5)
>500 g/week	279 (4.6)	378 (3.7)^②	12 (2.6)^②	21 (3.0)^②
Fruit intake/n(%)^①					0.000	0.000
0 g/d	585 (9.6)	1 155 (11.2)^②	29 (6.2)^②	55 (7.8)
<200 g/d	5 135 (84.3)	8 625 (83.6)	397 (84.8)	613 (86.7)
200‒350 g/d	340 (5.6)	477 (4.6)^②	38 (8.1)^②	33 (4.7)
>350 g/d	33 (0.5)	59 (0.6)	4 (0.9)	6 (0.8)
Liquid milk intake/n(%)^①					28.235	0.000
0 g/d	2 197 (36.0)	4 096 (39.5)^②	181 (38.3)	242 (34.1)
<300 g/d	3 618 (59.2)	5 854 (56.5)^②	269 (57.0)	436 (61.4)
≥300 g/d	294 (4.8)	418 (4.0)^②	22 (4.7)	32 (4.5)
Tubers intake/n(%)^①					0.000	0.000
0 g/d	1 019 (16.7)	1 891 (18.3)^②	69 (14.7)	116 (16.3)
<50 g/d	4 914 (80.6)	8 212 (79.4)	385 (82.1)	575 (80.9)
50‒100 g/d	141 (2.3)	204 (2.0)	14 (3.0)	16 (2.3)
>100 g/d	25 (0.4)	30 (0.3)	1 (0.2)	4 (0.6)

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