METHODS: A total of 5395 participants were recruited in 2011-2012 and followed up until 2018 from the China Health and Retirement Longitudinal Study. The cut-off value of the VAI was obtained by the receiver-operating characteristic curve. Participants were grouped based on VAI change patterns during the follow-up period (2011-2015): the low-low group, low-high group, high-low group, and high-high group. CVD was defined as a medical diagnosis of heart disease and/or stroke. A Cox proportional hazards model was used to evaluate the correlation between VAI transition and CVD.
RESULTS: Over a median follow-up period of 7 years, 969 participants (17.9 %) developed CVD. VAI change patterns were significantly associated with CVD risk after adjustment for demographic characteristics and risk factors. The high-high group (hazard ratio (HR): 1.65, 95 % confidence interval (CI): 1.39-1.97) and the low-high group (HR: 1.29, 95 % CI: 1.04-1.61) were associated with a higher risk of CVD after adjusting for demographic characteristics and traditional risk factors compared to the low-low group, while the effect in the high-low group was not significant.
CONCLUSIONS: VAI transition was significantly associated with the risk of CVD. Monitoring the dynamics of the VAI in public health practice would help prevent CVD.
方法:2011-2012年共招募了5395名参与者,并从中国健康与退休纵向研究中随访至2018年。通过接收器工作特性曲线获得VAI的截止值。参与者根据随访期间(2011-2015年)的VAI变化模式进行分组:低-低组,低高组,高低组,高-高集团。CVD被定义为心脏病和/或中风的医学诊断。使用Cox比例风险模型来评估VAI转变与CVD之间的相关性。
结果:在7年的中位随访期内,969名参与者(17.9%)发展为CVD。在调整人口统计学特征和危险因素后,VAI变化模式与CVD风险显著相关。高-高组(风险比(HR):1.65,95%置信区间(CI):1.39-1.97)和低-高组(HR:1.29,95%CI:1.04-1.61)与低-低组相比,在调整人口统计学特征和传统危险因素后,CVD的风险更高。而高低组的效果不显著。
结论:VAI转变与CVD风险显著相关。在公共卫生实践中监测VAI的动态将有助于预防CVD。