1Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Korea.
2Korea Institute of Drug Safety and Risk Management, Seoul, Korea.
3Department of Social Medicine, Hallym University College of Medicine, Chuncheon, Korea.
4Department of Preventive Medicine, Cheju National University College of Medicine, Jeju, Korea.
5Department of Social and Preventive Medicine, Sungkyunkwan University School of Medicine, Suwon, Korea.
6Department of Preventive Medicine, Ulsan University College of Medicine, Seoul, Korea.
7Department of Epidemiology and Statistics, School of Public Health Sciences, Jilin University, Changchun, China.
8Korean Foundation for Cancer Research, Seoul, Korea.
Copyright © 2013 The Korean Society for Preventive Medicine
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Variables | All-cause death (n = 1054) | Live cohort (n = 11 484) | p-value | |
---|---|---|---|---|
Age (y) | Mean±SD | 50.0±5.2 | 47.3±5.0 | <0.001 |
40-44 | 203 (19.3) | 4247 (37.0) | <0.001 | |
45-49 | 258 (24.5) | 3383 (29.5) | ||
50-54 | 349 (33.1) | 2675 (23.3) | ||
55-59 | 244 (23.1) | 1179 (10.3) | ||
Education attainment | ≥College |
579 (54.9) | 6158 (53.6) | <0.001 |
≤High school | 475 (45.1) | 5325 (46.4) | ||
Missing | 0 (0.0) | 1 (0.01) | ||
Family history of CVD | No | 856 (81.2) | 9245 (80.5) | 0.42 |
Yes | 166 (15.8) | 1945 (16.9) | ||
Missing | 32 (3.0) | 294 (2.6) | 0.01 | |
Alcohol drinking | Never | 212 (20.1) | 2785 (24.3) | |
Former | 101 (9.6) | 930 (8.1) | ||
Current | 717 (68.0) | 7466 (65.0) | ||
Missing | 24 (2.3) | 303 (2.6) | 0.002 | |
Sleep hours | 8 Hours or more | 270 (25.6) | 2985 (26.0) | |
6-7 Hours | 722 (68.5) | 8093 (70.5) | ||
5 Hours or less | 57 (5.4) | 370 (3.2) | ||
Missing | 5 (0.5) | 36 (0.3) | ||
Cardiovascular health metrics | ||||
Smoking | Never | 162 (15.4) | 2757 (24.0) | <0.001 |
Former (quit >12 mo) | 176 (16.7) | 2463 (21.4) | ||
Former (quit ≤12 mo) | 37 (3.5) | 515 (4.5) | ||
Current | 679 (64.4) | 5749 (50.1) | ||
Physical activity |
Ideal | 410 (38.9) | 4740 (41.3) | 0.002 |
Intermediate | 394 (37.4) | 4542 (39.5) | ||
None | 250 (23.7) | 2202 (19.2) | ||
BMI (kg/m2) | ≥18.5 and <23 | 469 (44.5) | 4944 (43.0) | 0.62 |
≥23 and <25 | 336 (31.9) | 3811 (33.2) | ||
≥25 | 249 (23.6) | 2729 (23.8) | ||
Healthy diet score components |
≥2 | 38 (3.6) | 509 (4.4) | 0.21 |
<2 | 1016 (96.4) | 10 975 (95.6) | ||
Total cholesterol (mg/dL) | <200 | 554 (52.6) | 5991 (52.2) | 0.41 |
200-239 | 350 (33.2) | 3996 (34.8) | ||
≥240 | 150 (14.2) | 1497 (13.0) | ||
Blood pressure (mmHg) | <120/80 | 607 (57.6) | 7481 (65.1) | <0.001 |
120-139/80-89 | 222 (21.1) | 2296 (20.0) | ||
≥140/≥90 | 225 (21.3) | 1707 (14.9) | ||
Fasting blood glucose (mg/dL) | <100 | 1011 (95.9) | 11 216 (97.7) | 0.002 |
100-125 | 15 (1.4) | 102 (0.9) | ||
≥126 | 28 (2.7) | 166 (1.4) | ||
No. of cardiovascular health metrics | 0 | 1 (0.1) | 5 (0.04) | <0.001 |
1 | 8 (0.8) | 69 (0.6) | ||
2 | 78 (7.4) | 534 (4.6) | ||
3 | 246 (23.3) | 1983 (17.3) | ||
4 | 371 (35.2) | 3860 (33.6) | ||
5 | 284 (26.9) | 3648 (31.8) | ||
6 | 60 (5.7) | 1307 (11.4) | ||
7 | 6 (0.6) | 78 (0.7) |
Cardiovascular health metrics | Participant (n = 12 538) | All-cause mortality |
CVD mortality |
||||
---|---|---|---|---|---|---|---|
All deaths (n = 1054) | Crude HR (95% CI) | Adjusted HR |
CVD deaths (n = 171) | Crude HR (95% CI) | Adjusted HR |
||
Current smoking |
|||||||
Yes | 6428 (51.3) | 679 | 1.00 | 1.00 | 114 | 1.00 | 1.00 |
No | 6110 (48.7) | 375 | 0.57 (0.50, 0.64) | 0.57 (0.50, 0.66) | 57 | 0.52 (0.38, 0.70) | 0.45 (0.32, 0.63) |
Physical activity | |||||||
No | 2452 (19.6) | 250 | 1.00 | 1.00 | 42 | 1.00 | 1.00 |
Yes | 10 086 (80.4) | 804 | 0.77 (0.67, 0.89) | 0.89 (0.77, 1.03) | 129 | 0.74 (0.52, 1.04) | 0.87 (0.60, 1.26) |
BMI (kg/m2) | |||||||
≥23 | 7125 (56.8) | 585 | 1.00 | 1.00 | 103 | 1.00 | 1.00 |
≥18.5 and <23 | 5413 (43.2) | 469 | 1.06 (0.94, 1.19) | 1.06 (0.93, 1.20) | 68 | 0.87 (0.64, 1.18) | 0.91 (0.66, 1.26) |
Healthy diet score components | |||||||
<2 | 11 991 (95.6) | 1016 | 1.00 | 1.00 | 167 | 1.00 | 1.00 |
≥2 | 547 (4.4) | 38 | 0.82 (0.59, 1.13) | 0.81 (0.57, 1.14) | 4 | 0.52 (0.19, 1.41) | 0.44 (0.14, 1.39) |
Total cholesterol (mg/dL) | |||||||
≥200 | 1647 (13.1) | 150 | 1.00 | 1.00 | 29 | 1.00 | 1.00 |
<200 | 10 891 (86.9) | 904 | 0.91 (0.76, 1.08) | 0.95 (0.79, 1.13) | 142 | 0.74 (0.49, 1.10) | 0.82 (0.54, 1.24) |
Blood pressure (mmHg) |
|||||||
≥120/≥80 | 4450 (35.5) | 447 | 1.00 | 1.00 | 97 | 1.00 | 1.00 |
<120/<80 | 8088 (64.5) | 607 | 0.74 (0.65, 0.83) | 0.83 (0.73, 0.94) | 74 | 0.41 (0.31, 0.56) | 0.45 (0.33, 0.62) |
Fasting blood glucose (mg/dL) |
|||||||
≥100 | 311 (2.5) | 43 | 1.00 | 1.00 | 11 | 1.00 | 1.00 |
<100 | 12 227 (97.5) | 1011 | 0.58 (0.42, 0.78) | 0.66 (0.48, 0.91) | 160 | 0.36 (0.19, 0.66) | 0.49 (0.26, 0.92) |
Cardiovascular health metrics | Participants n=12 538 | All-cause mortality |
|||
---|---|---|---|---|---|
All deaths n = 1054 | Adjusted PAR |
CVD deaths n = 171 | Adjusted PAR |
||
One cardiovascular health metric | |||||
Current smoking (yes) | 6428 | 679 | 29.2 (22.2, 35.9) | 114 | 30.9 (13.7, 46.2) |
Blood pressure (≥120/≥80 mmHg) | 4450 | 447 | 7.3 (1.0, 13.5) | 97 | 28.1 (10.6, 43.9) |
Fasting blood glucose (≥100 mg/dL) | 311 | 43 | 1.2 (0.0, 2.9) | 11 | 5.0 (0.0, 11.2) |
Combination of two cardiovascular health metrics | |||||
Current smoking (yes) and blood pressure (≥120/≥80 mm Hg) | 2139 | 285 | 34.5 (23.3, 44.7) | 66 | 50.6 (24.0, 70.1) |
Current smoking (yes) and fasting blood glucose (≥100 mg/dL) | 172 | 29 | 30.1 (20.6, 39.0) | 4 | 34.3 (11.1, 54.0) |
Blood pressure (yes) and fasting blood glucose (≥100 mg/dL) | 160 | 27 | 8.4 (0.0, 17.4) | 8 | 31.3 (8.4, 51.0) |
Combination of three cardiovascular health metrics | |||||
Current smoking (yes) and blood pressure (≥120/≥80 mmHg) and fasting blood glucose (≥100 mg/dL) | 88 | 16 | 35.2 (21.7-47.4) | 2 | 52.8 (22.0-74.0) |
Characteristic | No. of cardiovascular health metrics |
p-trends |
||||
---|---|---|---|---|---|---|
0-2 | 3 | 4 |
5 |
6-7 |
||
All-cause mortality | ||||||
All deaths (n = 1054) | 87 | 246 | 371 | 284 | 66 | |
No. of participants (n = 12 538) | 695 | 2229 | 4231 | 3932 | 1451 | |
Total person-years | 12 522 | 40 689 | 77 637 | 72 697 | 27 145 | |
Mortality rate (1000 PY) |
6.83 | 5.95 | 4.83 | 3.99 | 2.52 | <0.001 |
Crude HR (95% CI) | 1 | 0.87 (0.68, 1.11) | 0.68 (0.54, 0.86) | 0.56 (0.44, 0.71) | 0.35 (0.25, 0.48) | <0.001 |
Adjusted HR |
1 | 0.93 (0.73, 1.21) | 0.76 (0.59, 0.96) | 0.65 (0.51, 0.84) | 0.42 (0.31, 0.59) | <0.001 |
CVD mortality | ||||||
CVD deaths (n = 171) | 21 | 50 | 60 | 36 | 4 | |
No. of participants (n = 12 538) | 695 | 2229 | 4231 | 3932 | 1451 | |
Total person-years | 12 522 | 40 689 | 77 637 | 72 697 | 27 145 | |
Mortality rate (1000 PY) |
1.62 | 1.20 | 0.78 | 0.51 | 0.16 | <0.001 |
Crude HR (95% CI) | 1.00 | 0.73 (0.44, 1.22) | 0.46 (0.28, 0.75) | 0.29 (0.17, 0.50) | 0.09 (0.03, 0.25) | <0.001 |
Adjusted HR |
1.00 | 0.77 (0.46, 1.29) | 0.46 (0.27, 0.76) | 0.31 (0.18, 0.53) | 0.10 (0.03, 0.29) | <0.001 |
Values are presented as number (%). CVD, cardiovascular disease; BMI, body mass index; SD, standard deviation. University dropouts included. Ideal physical activity (moderate intensity ≥150 min/wk, or at vigorous intensity ≥75 min/wk, or moderate + vigorous intensity ≥150 min/wk; intermediate physical activity (1.149 min/wk at moderate intensity, or 1-74 min/wk at vigorous intensity, or 1-149 min/wk at moderate + vigorous intensity). Healthy diet components: fruits and vegetables (≥450 g/d), fish (≥2 times/wk), sodium (<2000 mg/d), brown rice (≥1 time/d), sugar-sweetened beverages (sugar-sweetened coffee ≤1 time/d and soft drink ≤1 L/wk).
Participants are presented as number (%). CVD, cardiovascular disease; HR, hazard ratio; CI, confidence interval; BMI, body mass index. For age, educational attainment, alcohol consumption, sleep hours, family history of CVD, and all other cardiovascular health metrics.
PAR, population-attributable risk; CVD, cardiovascular disease; CI, confidence interval; HR, hazard ratio. For age, educational attainment, alcohol consumption, sleep hours, family history of CVD, and all other cardiovascular health metrics. The individual PARs cannot be calculated for the cardiovascular health metrics with adjusted HRs ≥1.0 and statistically non-significant HRs. where t denotes a stratum of unique combinations of levels of all background risk factors not under study, t=1,…, T; RR2t is the relative risk in combination t relative to the lowest risk level, where RR The joint prevalence of exposure groups and stratum
HR, hazard ratio; CVD, cardiovascular disease; PY, person-years; CI, confidence interval. For trends across the categories of cardiovascular health metrics scores based on a Satterthwaite adjusted F-test. Adjusted for age. For age, educational attainment, alcohol consumption, and family history of CVD.