Differences in all-cause, cardiovascular and cancer mortality between Hong Kong and Singapore: Role of nutrition

BACKGROUND: The majority of inhabitants in Hong Kong and Singapore are ethnic Chinese, but all-cause and cardiovascular mortality rates in these two regions are markedly different. This study describes differences in the magnitude and trends in mortality and attempts to explain these differences. METHODS: Data of mortality rates in 1963-1965 and 1993-1995 in the age class of 45-74 years, dietary habits and other factors were compared between Hong Kong and Singapore using Japan, Spain and the USA as reference countries. Mortality and food consumption data were obtained from WHO and FAO, respectively. RESULTS: Large differences in all-cause and cardiovascular mortality exist between Hong Kong and Singapore. The difference in total cancer mortality was less consistent and smaller. The most pronounced finding was that ischemic heart disease mortality in 1993-1995 was 2.98 and 3.14 times higher in Singapore than in Hong Kong in men and women, respectively. Of the five countries considered, Singapore has the highest all-cause mortality in both sexes in the period of 1960-1995. The ratio of animal to vegetal fat was higher in Singapore (2.24) than in Hong Kong (1.08). Singapore had higher serum concentrations of total cholesterol and low-density lipoprotein cholesterol than Hong Kong, but the opposite result was observed for high-density lipoprotein cholesterol. CONCLUSIONS: There are striking differences in all-cause and cardiovascular mortality between Hong Kong and Singapore. These differences can be most reasonably and plausibly explained by their differences in dietary habits, for example, a higher consumption of coconut and palm oil, mainly containing saturated fat, in Singapore.     

Exposure to workplace noise and the risk of cardiovascular disease events and mortality among older adults

Background

We aimed to examine whether cross-sectional (prevalence) and longitudinal relationships (5-year incidence and 10-year mortality) exist between workplace noise exposure and cardiovascular diseases (CVD).

Methods

2942 participants aged 55+ years of the Blue Mountains Eye Study, Australia (1997–9 and 2002–4). Participants self-reported workplace noise exposure, hearing protector use and physician diagnosed CVD. CVD deaths were confirmed using the Australian National Death Index.

Results

133 and 937 participants self-reported workplace noise exposure, and use or non-use of hearing protection devices, respectively. After multivariate adjustment, those who did not use hearing protection devices were 53% and 75% more likely to have prevalent CVD and angina, respectively, compared to those never exposed to workplace noise. Exposure to severe workplace noise for less than 1 to 5 years versus no exposure was associated with incident stroke OR 3.44 (95% CI 1.11–10.63). The mortality rate of CVD was 0.94% per year in people unexposed to workplace noise. Participants reporting less than 1 to 5 years versus those with no workplace noise exposure had a higher risk of CVD mortality, hazard ratio, HR, 1.60 (95% CI 1.10–2.33).

Discussion

These data highlight the public health impact of workplace noise exposure on the vascular health of older adults.     

Sodium and potassium intake and risk of cardiovascular events and all-cause mortality: the Rotterdam Study

Background Dietary electrolytes influence blood pressure, but their effect on clinical outcomes remains to be established. We examined sodium and potassium intake in relation to cardiovascular disease (CVD) and mortality in an unselected older population. Methods A case–cohort analysis was performed in the Rotterdam Study among subjects aged 55 years and over, who were followed for 5 years. Baseline urinary samples were analyzed for sodium and potassium in 795 subjects who died, 206 with an incident myocardial infarction and 181 subjects with an incident stroke, and in 1,448 randomly selected subjects. For potassium, dietary data were additionally obtained by food-frequency questionnaire for 78% of the cohort. Results There was no consistent association of urinary sodium, potassium, or sodium/potassium ratio with CVD and all-cause mortality over the range of intakes observed in this population. Dietary potassium estimated by food frequency questionnaire, however, was associated with a lower risk of all-cause mortality in subjects initially free of CVD and hypertension (RR = 0.71 per standard deviation increase; 95% confidence interval: 0.51–1.00). We observed a significant positive association between urinary sodium/potassium ratio and all-cause mortality, but only in overweight subjects who were initially free of CVD and hypertension (RR = 1.19 (1.02–1.39) per unit). Conclusion The effect of sodium and potassium intake on CVD morbidity and mortality in Western societies remains to be established.     

2004—2011年中国人群心血管病死亡的性别差异分析

目的分析我国主要心血管疾病死亡的性别差异及其变化情况,为提出有效的干预措施提供依据。方法利用全国疾病监测系统2004—2011年死因监测数据,分析不同年度、不同年龄组心血管病死亡性别比的差异和变化趋势,并对2010年不同地区间心血管疾病死亡性别比进行比较。结果2004—2011年,全国各主要心血管病死亡率除风湿性心脏病以外。均表现为男性高于女性,性别比（男性：女性）为1．37—1．59;各类心血管疾病死亡性别比呈逐年升高趋势,尤以其他心脏病的上升幅度最快;各年龄组心血管病死亡性别比均呈上升趋势,并表现为低年龄组上升速度较快的特点;心血管病死亡率性别比以30-45岁年龄组最高,75岁以上组最低。2010年,我国心血管病死亡率性别比表现为农村高于城市（其他心脏病除外）、东部地区高于中西部地区的特点。结论针对农村和东部地区,尤其是低年龄组男性人群开展心血管病的预防和干预,同时提示,女性人群风湿性心脏病的防治是今后心血管疾病的防治重点。     

中国10个地区成年人自评健康状况与全因死亡、心血管疾病死亡风险的关联研究

目的:分析自评健康状况（SRH）与全因死亡和心血管疾病（CVD）死亡风险的关联性。方法:研究对象来自中国慢性病前瞻性研究,剔除有逻辑错误和信息缺失的个体,最终纳入512 713名研究对象。SRH在基线问卷调查时搜集,包括整体自评健康状况（GSRH）及与同龄人相比自评健康状况（ASRH）;死亡事件及原因通过链接到疾病死亡...     

Anthropometric measures and risk of all-cause and cardiovascular mortality: An 18 years follow-up

BackgroundThe contribution of anthropometric measures to predict mortality in normal-weight subjects is unclear. We aimed to study the association of central obesity measures, e.g., waist circumference (WC), waist-to-hip ratio (WHR), waist-to-height ratio (WHtR), with the risk of all-cause and CVD mortality.MethodsIn a prospective population-based Tehran Lipid and Glucose Study, 8287 participants aged ≥30 y, followed for a median of 18 years. The association of WC, WHR and WHtR with the risk for mortality was estimated using multivariate Cox proportional hazard models in different BMI groups.ResultsWe documented 821 deaths, of which 251 were related to CVD mortality. Normal weight individuals with central obesity were significantly at increased risk of all-cause (HR: 1.5; 95% CI: 1.10, 2.1) and CVD mortality (HR: 1.6; 95% CI: 0.92, 2.9) compared with normal-weight individuals without central obesity; the risk remained significant only in women. Also, normal-weight women (not men) with high WHR were at increased risk of all-cause (HR: 1.7; 95% CI: 1.0, 2.8) and CVD mortality (HR: 5.9; 95% CI: 1.5, 23.2). High WHtR increased the risk of all-cause (HR: 1.5; 95% CI: 1.2, 1.8) and CVD mortality (HR: 1.8; 95% CI: 1.2, 2.7) which remained significant in normal-weight men and women. All central obesity indicators were significantly associated with all-cause and CVD mortality in subjects aged under 65.ConclusionEven in normal-weight individuals, WC and WHR in women and WHtR in both sexes are predictors of all-cause and CVD mortality. WHtR shows a stronger association, especially in the population aged under 65.     

中国成年人饮茶与死亡风险的前瞻性关联研究

目的分析中国成年人饮茶与全因死亡和死因别死亡风险间的关联。方法本研究分析基于中国慢性病前瞻性研究项目。饮茶信息为基线自报。死亡信息主要通过链接死亡监测系统获取。使用Cox比例风险回归模型计算风险比(HR)及其95%CI。结果纳入分析的438 443例研究对象随访11.1年共发生死亡34 661例。与从不饮茶者相比, 当前非每日饮茶者和每日饮茶者全因死亡HR值(95%CI)依次为0.89(0.86～0.91)和0.92(0.88～0.95)。分性别分析显示, 饮茶对全因死亡风险的保护作用主要见于男性(交互P<0.05)。与从不饮茶者相比, 当前每日饮茶者死于缺血性心脏病、缺血性脑卒中、出血性脑卒中、恶性肿瘤、呼吸系统疾病及其他死因的HR值(95%CI)依次为0.83(0.76～0.92)、0.82(0.69～0.97)、0.86(0.78～0.94)、1.03(0.97～1.09)、1.00(0.87～1.16)、0.84(0.78～0.90)。在不吸烟且不过量饮酒者中, 每日饮茶与恶性肿瘤死亡风险间不存在有统计学显著性的关联, 但在吸烟或过量饮酒者中, 每日饮茶者死于恶性肿瘤的风...     

Trans fat and cardiovascular disease mortality: Evidence from bans in restaurants in New York

This paper analyzes the impact of trans fat bans on cardiovascular disease (CVD) mortality rates. Several New York State jurisdictions have restricted the use of ingredients containing artificial trans fat in food service establishments. The resulting within-county variation over time and the differential timing of the policy's rollout is used in estimation. The results indicate that the policy caused a 4.5% reduction in CVD mortality rates, or 13 fewer CVD deaths per 100,000 persons per year. The averted deaths can be valued at about $3.9 million per 100,000 persons annually.