Ideal cardiovascular health behaviors and factors and high sensitivity C-reactive protein: the Kailuan cross-sectional study in Chinese

Hao Xue; Jianli Wang; Jinhong Hou; Jingsheng Gao; Shuohua Chen; Hang Zhu; Yutang Wang; Yundai Chen; Shouling Wu

doi:10.1515/cclm-2013-0657

Article

Ideal cardiovascular health behaviors and factors and high sensitivity C-reactive protein: the Kailuan cross-sectional study in Chinese

Hao Xue , Jianli Wang , Jinhong Hou , Jingsheng Gao , Shuohua Chen , Hang Zhu , Yutang Wang , Yundai Chen and Shouling Wu

Published/Copyright: May 1, 2014

Published by

Become an author with De Gruyter Brill

Submit Manuscript Author Information

From the journal Clinical Chemistry and Laboratory Medicine (CCLM) Volume 52 Issue 9

Abstract

Background: High sensitivity C-reactive protein (hs-CRP) is an inflammatory marker associated with increased cardiovascular disease risk. Health-related behaviors and factors decrease the risk of cardiovascular disease events, but the association between ideal cardiovascular health behaviors and hs-CRP is not clear. This study evaluated the relationship between the number of ideal cardiovascular health metrics and hs-CRP levels.

Methods: We conducted a cross-sectional study from 2006 to 2007 that included 93,967 healthy subjects and 7869 diabetic patients. hs-CRP was measured by high-sensitivity nephelometry. Multivariate logistic regression was performed to analyze the association between the number of ideal cardiovascular health metrics and hs-CRP levels in the general population and in non-diabetic and diabetic subjects.

Results: We found that hs-CRP levels decreased as the number of ideal cardiovascular health metrics increased in the general population, different genders, non-diabetic and diabetic subgroups. After adjusting for traditional risk factors, logistic regression analyses revealed that the risk of hs-CRP >3 mg/L in the general population with 6–7 ideal cardiovascular health metrics was 0.39 times lower than in those with 0–1 ideal metrics. Similarly, the risks were 0.39 times lower than in those with 0–1 ideal metrics in non-diabetic population. The risk of hs-CRP >3 mg/L in the diabetic population with 4–6 ideal cardiovascular health metrics was 0.45 times lower than those with 0–1 ideal metrics.

Conclusions: Our findings demonstrate an inverse relationship between the number of ideal health metrics and hs-CRP in the general population, and similar relationships were observed for different gender, non-diabetic and diabetic subgroups.

Keywords: cardiovascular health behaviors; cardiovascular health factors; cross-sectional study; high sensitivity C-reactive protein

Corresponding author: Shouling Wu, Department of Cardiology, Kailuan Hospital, Hebei United University, 57 Xinhua Road (East), Tangshan, 063000, P.R. China, Phone: +86 315 3025655, Fax: +86 315 3725312, E-mail: drwusl@163.com

aDrs. Hao Xue, Jianli Wang and Jinhong Hou contributed equally to this work.

Acknowledgments

We thank the staff and participants of the KaiLuan study for their important contributions.

Conflict of interest statement

Authors’ conflict of interest disclosure: The authors stated that there are no conflicts of interest regarding the publication of this article.

Research funding: None declared.

Employment or leadership: None declared.

Honorarium: None declared.

References

1. Ministry of Health of the People’s Republic of China. China Health statistics yearbook [M]. Peking Union Medical College Press 2010;276:315.Search in Google Scholar

2. Mozaffarian D, Kamineni A, Carnethon M, Djoussé L, Mukamal KJ, Siscovick D. Lifestyle risk factors and new-onset diabetes mellitus in older adults: the cardiovascular health study. Arch Intern Med 2009;169:798–807.10.1001/archinternmed.2009.21Search in Google Scholar PubMed PubMed Central

3. Yamamoto K, Okazaki A, Ohmori S. The relationship between psychosocial stress, age, BMI, CRP, lifestyle, and the metabolic syndrome in apparently healthy subjects. Physiol Anthropol 2011;30:15–22.10.2114/jpa2.30.15Search in Google Scholar PubMed

4. Libby P, Okamoto Y, Rocha VZ, Folco E. Inflammation in atherosclerosis: transition from theory to practice. Circulation 2010;74:213–20.10.1253/circj.CJ-09-0706Search in Google Scholar

5. Lloyd-Jones DM, Hong Y, Labarthe D, Mozaffarian D, Appel LJ, Van Horn L, et al. Defining and setting national goals for cardiovascular health promotion and disease reduction: the American Heart Association’s strategic impact goal through 2020 and beyond. Circulation 2010;121:586–613.10.1161/CIRCULATIONAHA.109.192703Search in Google Scholar PubMed

6. Folsom AR, Yatsuya H, Nettleton JA, Lutsey PL, Cushman M, Rosamond WD, et al. Community prevalence of ideal cardiovascular health, by the American Heart Association definition, and relationship with cardiovascular disease incidence. Am Coll Cardiol 2011;57:1690–6.10.1016/j.jacc.2010.11.041Search in Google Scholar PubMed PubMed Central

7. Palmieri L, Panico S, Vanuzzo D, Ferrario M, Chiodini P, Pilotto L, et al. Favorable cardiovascular risk profile (low risk) and 10-year stroke incidence in women and men: findings from 12 Italian population studies. Am J Epidemiol 2006,163:893–902.10.1093/aje/kwj110Search in Google Scholar PubMed

8. Lien LF, Brown AJ, Ard JD, Loria C, Erlinger TP, Feldstein AC, et al. Effects of PREMIER lifestyle modifications on participants with and without the metabolic syndrome. Hypertension 2007;50:609–16.10.1161/HYPERTENSIONAHA.107.089458Search in Google Scholar PubMed

9. Giallauria F, Lucci R, D’Agostino M, Vitelli A, Maresca L, Mancini M, et al. Two-year multicomprehensive secondary prevention program: favorable effects on cardiovascular functional capacity and coronary risk profile after acute myocardial infarction. J Cardiovasc Med (Hagerstown) 2009;10:772–80.10.2459/JCM.0b013e32832d55feSearch in Google Scholar PubMed

10. Packard RR, Libby P. Inflammation in atherosclerosis: from vascular biology to biomarker discovery and risk prediction. Clin Chem 2008;54:24–38.10.1373/clinchem.2007.097360Search in Google Scholar PubMed

11. Pearson TA, Mensah GA, Alexander RW, Anderson JL, Cannon RO 3rd, Criqui M, et al. Markers of inflammation and cardiovascular disease: application to clinical and public health practice: a statement for healthcare professionals from the Centers for Disease Control and Prevention and the American Heart Association. Circulation 2003;107:499–511.10.1161/01.CIR.0000052939.59093.45Search in Google Scholar PubMed

12. Wu S, Huang Z, Yang X, Zhou Y, Wang A, Chen L, et al. Prevalence of ideal cardiovascular health and its relationship with the 4-year cardiovascular events in a northern Chinese industrial city. Circ Cardiovasc Qual Outcomes 2012;5:487–93.10.1161/CIRCOUTCOMES.111.963694Search in Google Scholar PubMed

13. Wu S, Li Y, Jin C, Yang P, Li D, Li H, et al. Intra-individual variability of high-sensitivity C-reactive protein in Chinese general population. Int J Cardiol 2012;157:75–9.10.1016/j.ijcard.2010.12.019Search in Google Scholar PubMed

14. Bergström G, Behre CJ, Schmidt C. Moderate intensities of leisure-time physical activity are associated with lower levels of high-sensitivity C-reactive protein in healthy middle-aged men. Angiology 2012;63:412–5.10.1177/0003319711423386Search in Google Scholar PubMed

15. Ford ES. Does exercise reduce inflammation? Physical activity and C-reactive protein among US adults. Epidemiology 2002,13:561–8.10.1097/00001648-200209000-00012Search in Google Scholar PubMed

16. Fogarty AW, Lewis SA, McKeever TM, Britton JR. Is higher sodium intake associated with elevated systemic inflammation? A population-based study. Clin Nutr 2009;89:1901–4.10.3945/ajcn.2008.27006Search in Google Scholar PubMed

17. Oliveira A, Rodríguez-Artalejo F, Lopes C. The association of fruits, vegetables, antioxidant vitamins and fibre intake with high-sensitivity C-reactive protein: sex and body mass index interactions. Eur J Clin Nutr 2009;63:1345–52.10.1038/ejcn.2009.61Search in Google Scholar PubMed

18. Su MC, Chen YC, Huang KT, Wang CC, Lin MC, Lin H. Association of metabolic factors with high-sensitivity C-reactive protein in patients with sleep-disordered breathing. Eur Arch Otorhinolaryngol 2013;270: 749–54.10.1007/s00405-012-2191-4Search in Google Scholar PubMed

19. Wen J, Liang Y, Wang F, Sun L, Guo Y, Duan X, et al. Association of C-reactive protein and metabolic syndrome in a rural Chinese population. Clin Biochem 2009;42:976–83.10.1016/j.clinbiochem.2009.03.026Search in Google Scholar PubMed

20. Dong C, Rundek T, Wright CB, Anwar Z, Elkind MS, Sacco RL. Ideal cardiovascular health predicts lower risks of myocardial infarction, stroke, and vascular death across whites, blacks, and hispanics: the northern Manhattan study. Circulation 2012;125:2975–84.10.1161/CIRCULATIONAHA.111.081083Search in Google Scholar PubMed PubMed Central

21. Artero EG, España-Romero V, Lee DC, Sui X, Church TS, Lavie CJ, et al. Ideal cardiovascular health and mortality: Aerobics Center Longitudinal Study. Mayo Clin Proc 2012;87:944–52.10.1016/j.mayocp.2012.07.015Search in Google Scholar PubMed PubMed Central

22. Shi L, Morrison JA, Wiecha J, Horton M, Hayman LL. Healthy lifestyle factors associated with reduced cardiometabolic risk. Br J Nutr 2011;105:747–54.10.1017/S0007114510004307Search in Google Scholar PubMed

23. Greenland P, Alpert JS, Beller GA, Benjamin EJ, Budoff MJ, Fayad ZA, et al. 2010 ACCF/AHA guideline for assessment of cardiovascular risk in asymptomatic adults: a report of the American College of Cardiology Foundation/American Heart Association Task Force on practice guidelines. Circulation 2010;122:e584–636.10.1161/CIR.0b013e3182051b4cSearch in Google Scholar PubMed

24. Abd TT, Eapen DJ, Bajpai A, Goyal A, Dollar A, Sperling L. The role of C-reactive protein as a risk predictor of coronary atherosclerosis: implications from the JUPITER trial. Curr Atheroscler Rep 2011;13:154–61.10.1007/s11883-011-0164-5Search in Google Scholar PubMed

25. Koenig W. High-sensitivity C-reactive protein and atherosclerotic disease: from improved risk prediction to risk-guided therapy. Int J Cardiol 2013;168:5126–34.10.1016/j.ijcard.2013.07.113Search in Google Scholar PubMed

26. Perk J, De Backer G, Gohlke H, Graham I, Reiner Z, Verschuren M, et al. The fifth joint task force of the European Society of Cardiology and other societies on cardiovascular disease prevention in clinical practice (constituted by representatives of nine societies and by invited experts). Eur Heart J 2012;33:1635–701.10.1093/eurheartj/ehs092Search in Google Scholar PubMed

Received: 2013-8-16

Accepted: 2014-3-18

Published Online: 2014-5-1

Published in Print: 2014-9-1

You are currently not able to access this content.

Articles in the same Issue

https://doi.org/10.1515/cclm-2013-0657

Keywords for this article

cardiovascular health behaviors; cardiovascular health factors; cross-sectional study; high sensitivity C-reactive protein