Abstract：
Little evidence exists regarding the sex-specific population attributable risk factors for cardiovascular and all-cause mortality in the Chinese general population. We used a sub-cohort of the China Patient-Centered Evaluative Assessment of Cardiac Events million persons project to evaluate the overall and sex-specific associations and population attributable fractions (PAFs) of twelve risk factors for cardiovascular and all-cause mortality. 95,469 participants were included between January 2016 and December 2020. The twelve risk factors (including four socioeconomic status and eight modifiable risk factors) were collected or measured at baseline. The outcomes of the study were all-cause mortality and cardiovascular mortality. Overall, 60.7% (N = 57,971) were women, and the mean age was 54.3 ± 10.2 years. After a median of 3.52 years of follow-up, 1311 (1.4%) people died, and 362 (0.4%) people died of cardiovascular causes. Majorities of risk factors were significantly associated with all-cause and cardiovascular mortality, and suboptimal blood pressure and low educational attainment were the two leading attributable risk factors for all-cause and cardiovascular mortality. The twelve risk factors collectively explained 72.4% (95% confidence interval (CI): 63.5, 79.2) and 84.0% (95% CI: 71.1, 91.1) of PAFs for all-cause and cardiovascular mortality. When stratified by sex, men had more risk factors that were significantly attributable to mortality than women, whereas low educational attainment had a more pronounced impact on female cardiovascular health. This study found that the twelve risk factors collectively explained a significant proportion of PAFs for all-cause and cardiovascular mortality. Several sex-related disparities in the associations between risk factors and mortality were noted.
摘要：
关于中国普通人群中心血管和全因死亡率的性别人群归因危险因素的证据很少。我们使用中国以患者为中心的心脏事件百万评估项目的一个子队列来评估心血管和全因死亡率的12个危险因素的总体和性别相关性以及人群归因分数（PAFs）。在2016年1月至2020年12月期间，共纳入95,469名参与者。在基线时收集或测量12个危险因素（包括4个社会经济状况和8个可改变的危险因素）。研究结果为全因死亡率和心血管死亡率。总的来说,60.7%(N=57,971)是女性，平均年龄54.3±10.2岁。经过3.52年的平均随访，1311人（1.4%）死亡，362人(0.4%)死于心血管原因。大多数危险因素与全因死亡率和心血管死亡率显著相关。低血压和低教育程度是导致全因死亡率和心血管死亡率的两个主要可归因危险因素.12个危险因素共同解释了全因和心血管死亡率的PAF的72.4％（95％置信区间（CI）：63.5，79.2）和84.0％（95％CI：71.1，91.1）。当按性别分层时，与女性相比，男性有更多显著归因于死亡率的危险因素，而低教育程度对女性心血管健康有更显著的影响.这项研究发现，12个危险因素共同解释了PAFs在全因和心血管死亡率中的显著比例。在危险因素和死亡率之间的关联中，注意到了一些与性别相关的差异。
