title: Prevalence and Clustering of Cardiovascular Disease Risk Factors among Tibetan Adults in China: A Population-Based Study.
abstract: OBJECTIVE
  The prevalence of cardiovascular disease risk factors has increased worldwide. However, the prevalence and clustering of cardiovascular disease risk factors among Tibetans is currently unknown. We aimed to explore the prevalence and clustering of cardiovascular disease risk factors among Tibetan adults in China.
  
  
  METHODS
  In 2011, 1659 Tibetan adults (aged ≥ 18 years) from Changdu, China were recruited to this cross-section study. The questionnaire, physical examinations and laboratory testing were completed and the prevalence of cardiovascular disease risk factors, including hypertension, diabetes, overweight/obesity, dyslipidemia, and current smoking, were counted. The association between the clustering of cardiovascular disease risk factors and demographic characteristics, and geographic altitude were assessed.
  
  
  RESULTS
  The age-standardized prevalence of hypertension, diabetes, overweight or obesity, dyslipidemia, and current smoking were 62.4%, 6.4%, 34.3%, 42.7%, and 6.1%, respectively, and these risk factors were associated with age, gender, education level, yearly family income, altitude, occupation, and butter tea consumption (P < 0.05). Overall, the age-adjusted prevalence of clustering of ≥ 1, ≥ 2, and ≥ 3 cardiovascular disease risk factors were 79.4%, 47.1%, and 20.9%, respectively. There appeared higher clustering of ≥ 2 and ≥ 3 cardiovascular disease risk factors among Tibetans with higher education level and family income yearly, and those living at an altitude < 3500 m and in a township.
  
  
  CONCLUSIONS
  The prevalence of cardiovascular disease risk factors, especially hypertension, was high in Tibetans. Moreover, there was an increased clustering of cardiovascular disease risk factors among those with higher socioeconomic status, lamas and those living at an altitude < 3500 m. These findings suggest that without the immediate implementation of an efficient policy to control these risk factors, cardiovascular disease will eventually become a major disease burden among Tibetans.
authors.affiliation: Department of Cardiology, Tianjin Medical University General Hospital, Tianjin, China.
authors.forename: Shaopeng
authors.initials: S
authors.lastname: Xu
authors.affiliation: Department of Internal medicine, Changdu Region People's Hospital, Tibet, China.
authors.forename: Zepei
authors.initials: Z
authors.lastname: Jiayong
authors.affiliation: Department of Internal medicine, Changdu Region People's Hospital, Tibet, China.
authors.forename: Bin
authors.initials: B
authors.lastname: Li
authors.affiliation: Department of Epidemiology, Tianjin Medical University, Tianjin, China.
authors.forename: Hong
authors.initials: H
authors.lastname: Zhu
authors.affiliation: Department of Internal medicine, Changdu Region People's Hospital, Tibet, China.
authors.forename: Hong
authors.initials: H
authors.lastname: Chang
authors.affiliation: Clinical laboratory, Changdu Region People's Hospital, Tibet, China.
authors.forename: Wei
authors.initials: W
authors.lastname: Shi
authors.affiliation: Department of Internal medicine, Changdu Region People's Hospital, Tibet, China.
authors.forename: Zhengxuan
authors.initials: Z
authors.lastname: Gao
authors.affiliation: Laboratory of Epidemiology, Tianjin Neurological Institute & Department of Neurology, Tianjin Medical University General Hospital, Tianjin, China.
authors.forename: Xianjia
authors.initials: X
authors.lastname: Ning
authors.affiliation: Laboratory of Epidemiology, Tianjin Neurological Institute & Department of Neurology, Tianjin Medical University General Hospital, Tianjin, China.
authors.forename: Jinghua
authors.initials: J
authors.lastname: Wang
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D044466:Asian People; D002318:Cardiovascular Diseases / Q000453:epidemiology* / Q000208:ethnology / Q000209:etiology; D016000:Cluster Analysis; D003430:Cross-Sectional Studies; D050171:Dyslipidemias / Q000150:complications; D006801:Humans; D006973:Hypertension / Q000150:complications; D008875:Middle Aged; D009765:Obesity / Q000150:complications; D050177:Overweight / Q000150:complications; D011159:Population Surveillance / Q000379:methods*; D015995:Prevalence; D018570:Risk Assessment / Q000145:classification / Q000379:methods* / Q000706:statistics & numerical data; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects; D011795:Surveys and Questionnaires; D018609:Tibet / Q000453:epidemiology; D055815:Young Adult