title: Qingdao Port Cardiovascular Health Study: a prospective cohort study.
abstract: OBJECTIVE
  In China, efforts are underway to respond to rapidly increasing rates of heart disease and stroke. Yet the epidemiology of cardiovascular disease in China may be different from that of other populations. Thus, there is a critical need for population-based studies that provide insight into the risk factors, incidence and outcomes of cardiovascular disease in China. The Qingdao Port Cardiovascular Health Study is designed to investigate the burden of cardiovascular disease and the sociodemographic, biological, environmental and clinical risk factors associated with disease onset and outcomes.
  
  
  METHODS
  For this study, from 2000 through 2013, 32,404 employees aged 18 years or older were recruited from the Qingdao Port Group in China, contributing 221,923 annual health assessments. The mean age at recruitment was 43.4 (SD=12.9); 79% were male. In this ongoing study, annual health assessments, governed by extensive quality control mechanisms, include a questionnaire (capturing demographic and employment information, medical history, medication use, health behaviours and health outcomes), physical examination, ECG, and blood and urine analysis. Additional non-annual assessments include an X-ray, echocardiogram and carotid ultrasound; bio-samples will be collected for future genetic and proteomic analyses. Cardiovascular outcomes are accessed via self-report and are actively being verified with medical insurance claims; efforts are underway to adjudicate outcomes with hospital medical records.
  
  
  RESULTS
  Early findings reveal a significant increase in cardiovascular risk factors from 2000 to 2010 (hypertension: 26.4-39.4%; diabetes: 3.3-8.9%; hyperlipidaemia: 5.0-33.6%; body mass index >28 m/kg(2): 14.1-18.6%).
  We aim to generate novel insights about the epidemiology and outcomes of cardiovascular disease in China, with specific emphasis on the potentially unique risk factor profiles of this Chinese population. Knowledge generated will be disseminated in the peer-reviewed literature, and will inform population-based strategies to improve cardiovascular health in China.
  
  
  BACKGROUND
  NCT02329886.
authors.affiliation: Center for Outcomes Research and Evaluation, Yale University/Yale-New Haven Hospital, New Haven, Connecticut, USA Section of Cardiovascular Medicine, Yale School of Medicine, New Haven, Connecticut, USA.
authors.forename: Erica S
authors.initials: ES
authors.lastname: Spatz
authors.affiliation: Section of Cardiovascular Medicine, Qingdao Fuwai Hospital, Qingdao, People's Republic of China.
authors.forename: Xianyan
authors.initials: X
authors.lastname: Jiang
authors.affiliation: National Clinical Research Center of Cardiovascular Diseases, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People's Republic of China.
authors.forename: Jiapeng
authors.initials: J
authors.lastname: Lu
authors.affiliation: Division of Cardiology, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA.
authors.forename: Frederick A
authors.initials: FA
authors.lastname: Masoudi
authors.affiliation: Department of Health Outcomes Research, Saint Luke's Mid America Heart Institute/University of Missouri-Kansas City, Kansas City, Missouri, USA.
authors.forename: John A
authors.initials: JA
authors.lastname: Spertus
authors.affiliation: Center for Outcomes Research and Evaluation, Yale University/Yale-New Haven Hospital, New Haven, Connecticut, USA Section of Cardiovascular Medicine, Yale School of Medicine, New Haven, Connecticut, USA.
authors.forename: Yongfei
authors.initials: Y
authors.lastname: Wang
authors.affiliation: National Clinical Research Center of Cardiovascular Diseases, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People's Republic of China.
authors.forename: Xi
authors.initials: X
authors.lastname: Li
authors.affiliation: Center for Outcomes Research and Evaluation, Yale University/Yale-New Haven Hospital, New Haven, Connecticut, USA.
authors.forename: Nicholas S
authors.initials: NS
authors.lastname: Downing
authors.affiliation: Center for Healthcare Advancement & Outcomes, Baptist Health South Florida, Miami, Florida, USA Miami Cardiac & Vascular Institute, Baptist Health South Florida, Miami, Florida, USA.
authors.forename: Khurram
authors.initials: K
authors.lastname: Nasir
authors.affiliation: National Clinical Research Center of Cardiovascular Diseases, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People's Republic of China.
authors.forename: Xue
authors.initials: X
authors.lastname: Du
authors.affiliation: National Clinical Research Center of Cardiovascular Diseases, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People's Republic of China.
authors.forename: Jing
authors.initials: J
authors.lastname: Li
authors.affiliation: Center for Outcomes Research and Evaluation, Yale University/Yale-New Haven Hospital, New Haven, Connecticut, USA Section of Cardiovascular Medicine, Yale School of Medicine, New Haven, Connecticut, USA The Robert Wood Johnson Foundation Clinical Scholars Program, Department of Internal Medicine, Yale School of Medicine, New Haven, Connecticut, USA Department of Health Policy and Management, Yale School of Public Health, New Haven, Connecticut, USA.
authors.forename: Harlan M
authors.initials: HM
authors.lastname: Krumholz
authors.affiliation: Section of Cardiovascular Medicine, Qingdao Fuwai Hospital, Qingdao, People's Republic of China Qingdao Fuwai Hospital, Qingdao, People's Republic of China.
authors.forename: Xiancheng
authors.initials: X
authors.lastname: Liu
authors.affiliation: National Clinical Research Center of Cardiovascular Diseases, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People's Republic of China.
authors.forename: Lixin
authors.initials: L
authors.lastname: Jiang
mesh_terms: D000328:Adult; D000368:Aged; D044466:Asian People / Q000706:statistics & numerical data*; D015992:Body Mass Index; D002318:Cardiovascular Diseases / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology / Q000517:prevention & control*; D002681:China / Q000453:epidemiology; D015331:Cohort Studies; D017281:Cost of Illness; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000175:diagnosis / Q000453:epidemiology*; D042241:Early Diagnosis; D004781:Environmental Exposure; D005260:Female; D015438:Health Behavior; D006306:Health Surveys; D006801:Humans; D006949:Hyperlipidemias / Q000150:complications / Q000175:diagnosis / Q000453:epidemiology*; D006973:Hypertension / Q000150:complications / Q000175:diagnosis / Q000453:epidemiology*; D015994:Incidence; D008297:Male; D008875:Middle Aged; D016273:Occupational Exposure; D010808:Physical Examination; D011314:Preventive Health Services; D011446:Prospective Studies; D012307:Risk Factors; D057566:Self Report; D012959:Socioeconomic Factors; D017132:Workplace
keywords: cardiovascular diseases; cohort studies; longitudinal studies; outcomes research; population surveillance