title: Burden of carotid artery atherosclerosis in Chinese adults: Implications for future risk of cardiovascular diseases.
abstract: Background Population-based studies of ultrasound measures of carotid atherosclerosis are informative about future risks of cardiovascular disease. Design Cross-sectional studies of carotid artery atherosclerosis in 24,822 Chinese adults from the China Kadoorie Biobank and 2579 Europeans from the UK Biobank. Methods Mean intima-media thickness of the common carotid arteries and presence of carotid artery plaque were examined in the China Kadoorie Biobank study. The carotid intima-media thickness (cIMT) findings in Chinese (mean age 59 years) were compared with a European population (mean age 62 years). Results Overall, the mean cIMT in Chinese was 0.70 mm (SD 0.16) and increased with age by 0.08 mm (SE 0.008) per 10-years older age. About 31% of the Chinese had carotid plaques and the prevalence varied 10-fold with age (6% at 40-49 to 63% at 70-89 years) and four-fold by region (range, 14%-57%). After adjustment for age, sex and region, plaque prevalence was higher in smokers than in non-smokers (36% vs. 28%) and two-fold higher in individuals with systolic blood pressure ≥160 mmHg than those with systolic blood pressure <120 mmHg (44% vs. 22%) in the China Kadoorie Biobank study. Mean cIMT was similar in the younger Chinese and European adults, but increased more steeply with age in the Chinese ( p = 0.002). Conclusions About one-third of Chinese adults had carotid plaques. The rate of progression of carotid atherosclerosis with age was more extreme in the Chinese compared with the European population, highlighting the need for more intensive strategies for cardiovascular disease prevention in China.
authors.affiliation: 1 Clinical Trial Service Unit and Epidemiological Studies Unit, Nuffield Department of Population Health, University of Oxford, UK.
authors.forename: Robert
authors.initials: R
authors.lastname: Clarke
authors.affiliation: 1 Clinical Trial Service Unit and Epidemiological Studies Unit, Nuffield Department of Population Health, University of Oxford, UK.|2 MRC Population Health Research Unit, University of Oxford, UK.
authors.forename: Huaidong
authors.initials: H
authors.lastname: Du
authors.affiliation: 1 Clinical Trial Service Unit and Epidemiological Studies Unit, Nuffield Department of Population Health, University of Oxford, UK.
authors.forename: Om
authors.initials: O
authors.lastname: Kurmi
authors.affiliation: 1 Clinical Trial Service Unit and Epidemiological Studies Unit, Nuffield Department of Population Health, University of Oxford, UK.|2 MRC Population Health Research Unit, University of Oxford, UK.
authors.forename: Sarah
authors.initials: S
authors.lastname: Parish
authors.affiliation: 3 Division of Ultrasound Diagnosis, Peking Union Medical College Hospital, Beijing, China.
authors.forename: Meng
authors.initials: M
authors.lastname: Yang
authors.affiliation: 1 Clinical Trial Service Unit and Epidemiological Studies Unit, Nuffield Department of Population Health, University of Oxford, UK.
authors.forename: Matthew
authors.initials: M
authors.lastname: Arnold
authors.affiliation: 4 Chinese Academy of Medical Sciences, Beijing, China.
authors.forename: Yu
authors.initials: Y
authors.lastname: Guo
authors.affiliation: 4 Chinese Academy of Medical Sciences, Beijing, China.
authors.forename: Zheng
authors.initials: Z
authors.lastname: Bian
authors.affiliation: 3 Division of Ultrasound Diagnosis, Peking Union Medical College Hospital, Beijing, China.
authors.forename: Liang
authors.initials: L
authors.lastname: Wang
authors.affiliation: 5 Centre of Vascular Surgery, Peking Union Medical College Hospital, Beijing, China.
authors.forename: Yuexin
authors.initials: Y
authors.lastname: Chen
authors.affiliation: 6 Department of Radiology, University Medical Centre Utrecht, The Netherlands.
authors.forename: Rudy
authors.initials: R
authors.lastname: Meijer
authors.affiliation: 1 Clinical Trial Service Unit and Epidemiological Studies Unit, Nuffield Department of Population Health, University of Oxford, UK.
authors.forename: Sam
authors.initials: S
authors.lastname: Sansome
authors.affiliation: 1 Clinical Trial Service Unit and Epidemiological Studies Unit, Nuffield Department of Population Health, University of Oxford, UK.
authors.forename: John
authors.initials: J
authors.lastname: McDonnell
authors.affiliation: 1 Clinical Trial Service Unit and Epidemiological Studies Unit, Nuffield Department of Population Health, University of Oxford, UK.
authors.forename: Rory
authors.initials: R
authors.lastname: Collins
authors.affiliation: 4 Chinese Academy of Medical Sciences, Beijing, China.|7 Department of Epidemiology and Statistics, School of Public Health, Peking University Health Science Centre, Beijing, China.
authors.forename: Liming
authors.initials: L
authors.lastname: Li
authors.affiliation: 1 Clinical Trial Service Unit and Epidemiological Studies Unit, Nuffield Department of Population Health, University of Oxford, UK.|2 MRC Population Health Research Unit, University of Oxford, UK.
authors.forename: Zhengming
authors.initials: Z
authors.lastname: Chen
mesh_terms: D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D044466:Asian People; D002340:Carotid Artery Diseases / Q000000981:diagnostic imaging / Q000453:epidemiology*; D059168:Carotid Intima-Media Thickness; D002561:Cerebrovascular Disorders / Q000175:diagnosis / Q000453:epidemiology*; D002681:China / Q000453:epidemiology; D003430:Cross-Sectional Studies; D018450:Disease Progression; D005260:Female; D006304:Health Status; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000175:diagnosis / Q000453:epidemiology*; D015995:Prevalence; D011379:Prognosis; D011446:Prospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors; D006113:United Kingdom / Q000453:epidemiology; D044465:White People
keywords: Atherosclerosis; carotid intima-media thickness; plaques