Background

The previous studies have examined the connection between cardiometabolic danger factors as well as cardiovascular disease (CVD) but the evidence for the atributable impact of individual and combination risk factors of cardiometabolic origin to CVD as well as mortality remains sporadic. Our aim was to explore and quantify the relationships and the population attributable fraction (PAF) of risk factors with CVD as well as all cause mortality and to calculate how much CVD free lives lost due with the existence of risk factors.

Methods

22 thousand 5 hundred and 66 people with a 35 age group and no CVD were included between October 2012 until December 2015. The results were the sum of nonfatal and fatal CVD events as well as all-cause mortality. These were followed-up both in the years 2018 and 2019, and confirmed by hospital records as well as death certificates. Cox regression was used to assess the connection between individuals and combined cardiovascular risk factors (including diabetes, hypertension and high levels of low-density lipoprotein cholesterol (LDL-C)) with CVD risk and mortality from all causes. We also discussed how to calculate the PAF for CVD as well as the decrease in CVD-free life years and expectancy that are associated with various combinations of cardiometabolic disorders.

Results

In our 4.92 months of following-up we observed nine91 CVD cases and 1126 death. The risk ratio was 1.59 (95% confidence interval (CI) 1.37-1.85), 1.82 (95%CI 1.49-2.24) and 2.97 (95%CI 1.85-4.75) for CVD, and 1.38 (95%CI 1.20-1.58), 1.66 (95%CI 1.37-2.02) and 2.97 (95%CI 1.88-4.69) for all-cause mortality in those who have one, two, or three risk factors for cardiovascular disease, in comparison to those who do not have diabetes, hypertension, or high levels of LDL-C. 21.48 percent of CVD events and 15.38 percent of all-cause mortality could be attributed to the effects of hypertension and diabetes. People from 40 to 60 who suffered from three different cardiometabolic diseases experienced roughly 4.3-year lower life expectancy as in comparison to those who had no issues with their cardiometabolic disorder.

Conclusions

Cardiometabolic risk factors were linked with a risk multiplicative of CVD prevalence and all-cause mortality, which highlights the importance of a comprehensive approach to management of diabetes, hypertension and dyslipidemia for the prevention of CVD.

Introduction

Heart disease (CVD) remains the most significant cause of deaths in China and more than 4.58 million deaths were due to CVD in 2020 1. In the last 20 years, China is experiencing rapid changes in its economy and population, CVD burden is likely to increase because of the aging population as well as unfavorable lifestyle choices that could result in an increase in dyslipidemia, hypertension and diabetes and other non-communicable diseases. The estimates of the prevalence of hypertension dyslipidemia, and diabetes in China was 23.2 percent, 11.2% and 33.8 percentages [2,3,4] respectively. This could result in more CVD burden on the government and society as diabetes, hypertension, and hyperlipidemia are the primary risk factors that are attributed to metabolic processes for CVD burden [5,66. Additionally, hypertension, elevated cholesterol, and hyperglycemia typically mix, and all of them have common metabolic disorders as well as real-world evidence that showed that around 66% of patients diagnosed with diabetes suffered from hypertension and dyslipidemia 7.

Studies have previously investigated the connection between blood pressure and blood glucose as well as lipids, with CVD and risk of all-cause mortality and the burden of their attributed disease in isolation [8 9[8, 9]. Yet, only a few studies have established the connection between cardiometabolic diseases and CVD as well as all cause mortality particularly for Chinese individuals. According to our knowledge there is only one study that has h