Coronary heart disease and hypertension in Taiwan aborigines

A decline in the prevalence of angina pectoris: Data from the Nutrition and Health Survey in Taiwan

BACKGROUND

Angina pectoris (AP) is one of common symptoms of heart disease. The prevalence of AP varies by genders, age and ethnics. This study aimed to estimate the AP prevalence in adults and its change between surveys.

METHODS

Data was derived from the Nutrition and Health Survey in Taiwan (NAHSIT) between 1993 and 1996, and between 2005 and 2008. Participants aged ≥19 years old and grouped according to sex and age range (19-44.9, 45-64.9, and ≥65 years). The national weight prevalence rates in three types of AP (possible, definite, and confirmed) were estimated and we also estimated its change between surveys.

RESULTS

A total of 5031(1993-1996) and 4686 (2005-2008) adults were enrolled for this study. The aged-adjusted prevalence of possible, definite, and confirmed AP was 9.2%, 5.6%, and 2.1%, respectively, in 1993-1996, and 4.7%, 3.5%, and 1.1%, respectively, in 2005-2008. The age-adjusted prevalence of definite AP significantly declined from 5.6 (1993-1996) to 3.5 (2005-2008). Women had greater decline in the prevalence for possible (5.8% vs. 3.2%), definite (2.9% vs. 1.3%) and confirmed (1.6% vs. 0.5%) AP than men in both surveys. All AP prevalence rates increased by age in men in both surveys, however, the positive association between AP prevalence and age groups among women only was in 1993-1996.

CONCLUSIONS

The AP prevalence significantly declined from 1993 to 1996 to 2005-2008. The AP prevalence in women was higher. The prevalence increased with age in men, but not in women. Continuous monitoring of AP prevalence is recommended to better understand the disease burden.

High prevalence of gouty arthritis among the Hmong population in Minnesota

OBJECTIVE

The prevalence of gout is on the rise worldwide, especially among newly industrialized populations. We evaluated the prevalence of gout in the recently established Hmong of Minneapolis/St. Paul (MSP) compared with that in non-Hmong populations.

METHODS

The prevalence of self-reported gout in the Hmong population was estimated from 2 cross-sectional community surveys and compared with national data extrapolated from the Third National Health and Nutrition Examination Survey. The prevalence of physician-diagnosed gout in Hmong and non-Hmong MSP residents was separately estimated from the diagnosis codes of 11 MSP primary care clinics.

RESULTS

The prevalence of self-reported gout among MSP Hmong was 2-fold higher than in the general US population (6.5% versus 2.9%; P < 0.001). Although women of both groups reported gout at a rate of 1.9%, Hmong men were significantly more likely than their non-Hmong counterparts to report gout (11.5% versus 4.1%; P < 0.001). Similar results were observed when investigating physician-diagnosed gout in MSP (2.8% Hmong versus 1.5% non-Hmong; P < 0.001). No difference was observed between the women of the 2 groups (0.8% versus 0.7%; P = 0.833), whereas Hmong men were more than twice as likely to be diagnosed with gout compared with their non-Hmong counterparts (6.1% versus 2.5%; P < 0.001). Among Hmong men, advancing age was associated with a considerably higher likelihood of being diagnosed with gout.

CONCLUSION

A significant association is observed between Hmong ethnicity and gout, both self-reported and physician diagnosed. This unique population may provide an opportunity to further our understanding of the pathophysiology of gout.

Risk Factors for Cardiovascular Disease in the Elderly in Taiwan

The major objective of the present study was to identify biologic and behavioral risk factors of cardiovascular disease (CVD) in the elderly population in Taiwan. It is hypothesized that the selected risk factors are significantly associated with the prevalence of CVD. Data came from a nationwide geriatric survey in 1991. Stratified proportional sampling was used to recruit 2,600 subjects. These were evaluated by family physicians working for the Departments of Family Medicine at four medical centers in four major cities in Taiwan. Univariate and multivariate logistic regression analyses were used to examine the associations between risk factors and the prevalence of CVD. The prevalence of CVD was 38.31%. Patients with CVD consistently had higher values for each selected risk factor except high-density lipoprotein-cholesterol (HDL-C) and glucose concentrations. The findings also indicated that hypertension, hypertriglyceridemia, low HDL-C concentration, ex-drinking status, and overweight were significantly associated with the prevalence of CVD among the elderly in Taiwan. The findings not only confirm the risk factors for CVD, but also invite more attention to be given to the importance of biologic and behavioral risk factors in CVD.

Prevalence of cardiovascular diseases in elderly Chinese people in Taiwan

In order to study the health status and prevalence of diseases in elderly Chinese people in Taiwan, a hospital-based, physician-conducted epidemiological survey was undertaken. Study subjects were people aged > or = 65 years who were randomly selected from four regions of Taiwan. A total of 2600 subjects were studied. Most of the study subjects visited the hospitals for detailed history taking, physical examination and laboratory tests, including urinalysis, blood chemistry, electrocardiography, and chest and lumbar spine radiography. The cardiovascular data of 2518 subjects (males 1283) comprised this report. The prevalence of hypertension in the aged Chinese in Taiwan was high in both males and females (males 33.2%, females 40.9%, combined 37%). Coronary artery disease was also common (11.4%), but the prevalence was relatively low compared with Western people. Other cardiovascular diseases such as aortic aneurysm and valvular heart disease were rare. About 70% of the electrocardiograms were found abnormal. This well-organized, large-scale epidemiological survey not only presents useful information for local medical care for the elderly but also provides important data for comparison between different people in the world.

Prevalence of coronary heart disease in Kin-Chen, Kinmen

We estimated the prevalence of coronary heart disease (CHD) by the Minnesota code of a 12-lead resting electrocardiogram, Rose chest pain questionnaire and self-reported previous medical history in Kin-Chen, Kinmen (Quemoy), an island under military control for 40 years and the focal point of confrontation between mainland China and Taiwan. Among the target population of 6346 who accounted for all residents aged over 30, 3826 (60.3%) responded with complete data. The prevalence of probable CHD (Minnesota code 1.1-1.2) was 4.1% (71/1732) in men and 4.0% (84/2094) in women, whereas the prevalence of possible CHD (Minnesota code 1.3, 4.1-4.4, 5.1-5.3 and 7.1.1) was significantly higher in women (21.4%) than in men (11.6%). When compared to Chinese populations elsewhere, the increased overall prevalence may suggest a link to long-term stress conditions under military control. We also found the abnormal ECG was associated with many risk factors of CHD, particularly win women. The prevalence of Rose angina and self-reported angina or myocardial infarction was, however, low and associated poorly with any cardiovascular risk factors. Long-term follow-up studies are needed to determine the predictive value of these electrocardiographic abnormalities for cardiovascular disease morbidity and mortality in this population.

A population-based epidemiological study on cardiovascular risk factors in Kin-Chen, Kinmen

We conducted a population survey of cardiovascular risk factors in Kin-Chen, Kinmen (Quemoy), an island under military control for 40 years and the focal point of confrontation between mainland China and Taiwan. During the period 1992-1994, all residents > or = 30 years of age in Kin-Chen, the largest township in Kinmen, were invited to participate. The response rate was 60.3% (3826/6346). The prevalence of hypertension (> or = 160/95 mmHg and/or under treatment) was 25.2% in men and 17.6% in women. The rate for smoking was 41.5% in men and 2.9% in women. The prevalence of diabetes was 6.7% in men and 6.4% in women. Mean values for systolic blood pressure, diastolic blood pressure, total cholesterol, triglyceride, low-density lipoprotein cholesterol and high-density lipoprotein cholesterol were 135.3 mmHg, 85.5 mmHg, 5.3 mmol/l, 1.1 mmol/l, 3.5 mmol/l and 1.4 mmol/l in men; and 128.0 mmHg, 79.5 mmHg, 5.2 mmol/l, 1.0 mmol/l, 3.3 mmol/l and 1.5 mmol/l in women, respectively. The unexpectedly high prevalence of hypertension in Kin-Chen male may reflect the effect of more than 40 years of military control and discipline. The high serum cholesterol level in Kin-Chen relative to mainland China and the low triglyceride level relative to Taiwan and Beijing, suggest further study of the contributions of diet and other psychosocial or environmental factors.