Research Article: Prevalence of valvular heart diseases and associated risk factors in Han, Uygur and Kazak population in Xinjiang, China

Date Published: March 29, 2017

Publisher: Public Library of Science

Author(s): Yong-Tao Wang, Jing Tao, Ailifeire Maimaiti, Dilare Adi, Yi-Ning Yang, Xiao-Mei Li, Xiang Ma, Fen Liu, Bang-Dang Chen, Yi-Tong Ma, Yoshiaki Taniyama.

http://doi.org/10.1371/journal.pone.0174490

Abstract

Valvular heart diseases (VHD) is very common in clinical practice and has became the subject of growing attention in the field of cardiovascular medicine. Our aim was to assess the prevalence and correlates of VHD in the general population in Xinjiang, China.

Using a 4-stage stratified cluster random sampling method, a total of 14618 participants were recruited in the Cardiovascular Risk Survey (CRS) study. The participants’ personal information, medical history were assessed by questionnaire. VHD was diagnosed by transthoracic echocardiography. We carried out the statistical analysis utilizing SPSS Statistics version 19.0.

In the total study group, VHD was observed in 1397 (9.65%) individuals. The prevalence rates of VHD in Han, Uygur and Kazak group are 13.51%, 2.71% and 12.29% respectively. The prevalence rates of VHD increased strikingly with age (all P < 0.001). The results of multinomial regression analysis indicated that VHD were related to age in Han group, to age smoking and hypertension in Uygur group, to age and hypertension in Kazak group. Our research provides a unique prevalence rate of VHD in Xinjiang natural population. The result suggests that VHD are notably common in this population (9.65%) and increase with age. There exists significant difference of prevalence rate between ethnics. The main risk factors of VHD are age, hypertension and smoking. Valvular heart diseases should be regarded as a serious and growing public-health problem.

Partial Text

In the past two decades, the pattern of global disease has changed considerably, from primarily communicable, maternal, and perinatal causes to non-communicable disease (NCD) [1,2]. According to the statistics of World Health Organization in 2012, 17.6 million people died of Cardiovascular disease (CVD) worldwide, and proportionally, this accounts for 31.43% of global mortality [3]. CVD has become the most largest and important cause of NCD deaths. Valvular heart diseases (VHD), as a common disease in clinical practices, is an important cause of increased morbidity and mortality [4–9]. The national prevalence of VHD in adults older than 18 years in the US is 2.5% [10]. The result of this study also show that prevalence of VHD increased with age, from 0.7% in 18–44 years old to 13.3% in the 75 years and older group. Lu et al. performed a cross-sectional study and found that the total prevalence of VHD was 5.3% in Hunan Shaoyang area in China. The distribution of prevalence in ages was:1.5% between 18 and 29 years old, 2.7% between 30 and 39 years old, 1.8% between 40 and 49 years old, 4.8% between 50 and 59 years old, 13.2% between 60 and 74 years old [11]. The prevalence increased substantially with age too. The strong association between VHD and age, combined with the aging Chinese population, means that VHD has been described as the ‘next cardiac epidemic’ in China. The role of VHD as a severe public-health issue should be reconsidered. While the prevalence of VHD in China remains unclear.

From October 2007 to March 2010, a total of 14618 participants were enrolled in the cross-sectional study. The actual number of completed investigations was 14,478. Table 1 shows the basic characteristics of participants with and without VHD in different ethnics. Among the Han subjects, participants with and without VHD differed significantly with regards to age, prevalence of male, smoking, hypertension and diabetes (all P<0.05). Among the Uygur subjects, age and prevalence of male, smoking and hypertension were significantly higher in participants with VHD than in the participants without VHD (all P<0.05). We found that participants with VHD had higher age and prevalence of hypertension and lower prevalence of smoking compared with participants without VHD (all P<0.05). The general characteristics of participants were also presented in S1 Table in detail. This survey is the first cross-sectional epidemiological study to assess the prevalence of VHD in Xinjiang, China. In our study, the prevalence rate of VHD was 9.65%. The prevalence rates of VHD in the current study were higher than those reported in previous studies. The discrepancies in prevalence may be accounted for the reasons as follow: first, the study population is different and there may be a racial difference in the prevalence of VHD [18]; Second, the health conditions between industrialized and developing countries are different [19]; Third, each study may adopt different definitions of VHD [20–21]. In our study, VHD contained symptomatic and asymptomatic VHD, while in other studies, the definition of VHD may be only symptomatic significant VHD. In conclusion, our research provides a unique prevalence rate and distribution of VHD in Xinjiang natural population. Through the epidemiological investigation, we found that valvular heart diseases were notably common in Xinjiang and increase with age. The prevalence of VHD in Xinjiang is higher than that in other area in China. VHD is a asymptomatic and chronic disease with long incubation period and echocardiography is the only method to diagnose. Most patients with VHD are diagnosed after symptoms and not all elderly patients can be candidates for surgery. Increasing number of people have gradually realized the high prevalence and serious consequences of VHD, thus it should be regarded as a serious and growing public-health problem.   Source: http://doi.org/10.1371/journal.pone.0174490

 

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