Journal of Urban Health

, Volume 89, Issue 2, pp 329–338 | Cite as

Association of Suboptimal Health Status and Cardiovascular Risk Factors in Urban Chinese Workers

  • Yu X. Yan
  • Jing Dong
  • You Q. Liu
  • Xing H. Yang
  • Man Li
  • Gilbert Shia
  • Wei Wang
Article

Abstract

Suboptimal health status (SHS) has become a new public health challenge in urban China. Despite indications that SHS may be associated with progression or development of chronic diseases such as cardiovascular and metabolic diseases, there are few reports on SHS investigations. To explore the relationship between SHS and traditional cardiovascular risk factors, a cross-sectional study was conducted in a sample of 4,881 workers employed in 21 companies in urban Beijing. Blood pressure, glucose, lipid levels (total cholesterol, high-density lipoprotein [HDL] cholesterol, low-density lipoprotein [LDL] cholesterol and triglycerides), cortisol, and body mass index were measured. SHS score was derived from data collection in the SHS questionnaire (SHSQ-25). Univariate analysis and linear two-level model were used to analyze the association of SHS with the cardiovascular risk factors. Serum cortisol level was much higher among the SHS high-score group than that among the low SHS score group (204.31 versus 161.33 ng/ml, P < 0.001). In a linear two-level model, we found correlation between SHS and systolic blood pressure, diastolic blood pressure, plasma glucose, total cholesterol, and HDL cholesterol among men, and correlation between SHS and systolic blood pressure, diastolic blood pressure, total cholesterol, triglyceride, and HDL cholesterol among women after controlling for age, education background, occupation, smoking, and physical activity. SHS is associated with cardiovascular risk factors and contributes to the development of cardiovascular disease. SHS should be recognized in the health care system, especially in primary care.

Keywords

Suboptimal health status Cardiovascular disease Risk factors 

References

  1. 1.
    Yan YX, Wang W. Advances in research of suboptimal health status. Chin J Pub Health (in Chin). 2008; 24(9): 1037–1038.Google Scholar
  2. 2.
    Yan YX, Liu YQ, Li M, et al. Development and evaluation of a questionnaire for measuring suboptimal health status in urban Chinese. J Epidemiol. 2009; 19(6): 333–341.PubMedCrossRefGoogle Scholar
  3. 3.
    Wang L, Kong LZ, Wu F, Bai YM, Burton R. Preventing chronic diseases in China. Lancet. 2005; 366(9499): 1821–1824.PubMedCrossRefGoogle Scholar
  4. 4.
    Idler EL, Kasl SV. Self-ratings of health: do they also predict change in functional ability? J Gerontol B Psychol Sci Soc Sci. 1995; 50(6): S344–S353.PubMedCrossRefGoogle Scholar
  5. 5.
    Kaplan GA, Goldberg DE, Everson SA, et al. Perceived health status and morbidity and mortality: evidence from the Kuopio ischemic heart disease risk factor study. Int J Epidemiol. 1996; 25(2): 259–265.PubMedCrossRefGoogle Scholar
  6. 6.
    Burström B, Fredlund P. Self rated health: is it as good a predictor of subsequent mortality among adults in lower as well as in higher social classes? J Epidemiol Community Health. 2001; 55(11): 836–840.PubMedCrossRefGoogle Scholar
  7. 7.
    Yan YX, Wang W. Analysis of the risk factors and estimation of the cut point for sub-optimal health status. Hong Kong: Asia Conference on Emerging Issues in Public Health; 2009.Google Scholar
  8. 8.
    Melamed S, Kushnir T, Strauss E, Vigiser D. Negative association between reported life events and cardiovascular disease risk factors in employed men: the CORDIS study. J Psychosom Res. 1997; 43(3): 247–258.PubMedCrossRefGoogle Scholar
  9. 9.
    Jenkins CD. Epidemiology of cardiovascular diseases. J Psychosom Res. 1987; 31(6): 661–671.CrossRefGoogle Scholar
  10. 10.
    Krantz DS, Contrada RJ, Hill DR, Friedler E. Environmental stress biobehavioral antecedents of coronary heart disease. J Consult Clin Psychol. 1988; 56(3): 333–341.PubMedCrossRefGoogle Scholar
  11. 11.
    Adler N, Matthews K. Health psychology: why do some people get sick and some stay well? Annu Rev Psychol. 1994; 45: 229–259.PubMedCrossRefGoogle Scholar
  12. 12.
    Goldstein MG, Niaura R. Psychological factors affecting physical condition: cardiovascular disease literature review (part I). Psychosomatics. 1992; 33(2): 134–155.PubMedCrossRefGoogle Scholar
  13. 13.
    Friedman HS, Booth-Kewley S. The disease-prone personality Q: a meta-analytic view of the construct. Am Psychol. 1987; 42(6): 539–555.PubMedCrossRefGoogle Scholar
  14. 14.
    Wu Z, Yao C, Zhao D, et al. Sino-MONICA project: a collaborative study on trends and determinants in cardiovascular diseases in China, Part I: morbidity and mortality monitoring. Circulation. 2001; 103(3): 462–468.PubMedCrossRefGoogle Scholar
  15. 15.
    Myers GL, Cooper GR, Winn CL, et al. The Centers for Disease Control-National Heart, Lung and Blood Institute Lipid Standardization Program. An approach to accurate and precise lipid measurements. Clin Lab Med. 1989; 9(1): 105–135.PubMedGoogle Scholar
  16. 16.
    Friedewald WT, Levy N, Fredrickson DS. Estimation of the concentration of low-density lipoprotein cholesterol in plasma, without use of the preparative ultracentrifuge. Clin Chem. 1972; 18(6): 499–502.PubMedGoogle Scholar
  17. 17.
    Raudenbush SW, Bryk AS. Hierarchical linear models. London, England: Sage; 2002.Google Scholar
  18. 18.
    Ministry of Health of the Peoples Republic of China. Chinese health statistics yearbook (2009). Beijing, China: Beijing Union Medical College Press; 2009.Google Scholar
  19. 19.
    Gu D, Reynolds K, Wu X, et al. Prevalence of the metabolic syndrome and overweight among adults in China. Lancet. 2005; 365(9548): 1398–1405.PubMedCrossRefGoogle Scholar
  20. 20.
    Further Study of Risk Factors for Stroke and Coronary Heart Disease Cooperation group. The prevalence of metabolic syndrome in a 11 provinces cohort in China. Zhonghua Yu Fang Yi Xue Za Zhi (Chin). 2002; 36(5): 298–300.Google Scholar
  21. 21.
    Siu OL, Spector PE, Cooper CL, Lu C. Work stress, self-efficacy, Chinese work values, and work well-being in Hong Kong and Beijing. Int J Stress Manag. 2005; 12(3): 274–288.CrossRefGoogle Scholar
  22. 22.
    Zhou Y, You LM, Zhang JB, Guan NH. Causes and prevention of sub-health. Chin J Health Educ (in Chin). 2002; 18(6): 714–715.Google Scholar
  23. 23.
    Halford C, Anderzén I, Arnetz B. Endocrine measures of stress and self-rated health: a longitudinal study. J Psychosom Res. 2003; 55(4): 317–332.PubMedCrossRefGoogle Scholar
  24. 24.
    Kristenson M, Olsson AG, Kucinskiene Z. Good self-rated health is related to psychosocial resources and a strong cortisol response to acute stress: the LiVicordia study of middle-aged men. Int J Behav Med. 2005; 12(2): 153–160.PubMedCrossRefGoogle Scholar
  25. 25.
    Weinehall L, Johnson O, Jansson JH, et al. Perceived health modifies the effect of biomedical risk factors in the prediction of acute myocardial infarction. An incident case–control study from northern Sweden. J Intern Med. 1998; 243(2): 99–107.PubMedCrossRefGoogle Scholar
  26. 26.
    Emmelin M, Weinehall L, Stegmayr B, Dahlgren L, Stenlund H, Wall S. Self-rated ill-health strengthens the effect of biomedical risk factors in predicting stroke, especially for men—an incident case referent study. J Hypertens. 2003; 21(5): 887–896.PubMedCrossRefGoogle Scholar
  27. 27.
    Kang MG, Koh SB, Cha BS, Park JK, Baik SK, Chang SJ. Job stress and cardiovascular risk factors in male workers. Prev Med. 2005; 40(5): 583–588.PubMedCrossRefGoogle Scholar
  28. 28.
    Bugajska J, Widerszal-Bazyl M, Radkiewicz P, et al. Perceived work-related stress and early atherosclerotic changes in healthy employees. Int Arch Occup Environ Health. 2008; 81(8): 1037–1043.PubMedCrossRefGoogle Scholar
  29. 29.
    Rosengren A, Hawken S, Ounpuu S, et al. Association of psychosocial risk factors with risk of acute myocardial infarction in 11119 cases and 13648 controls from 52 countries (the INTERHEART study): case–control study. Lancet. 2004; 364(9437): 953–962.PubMedCrossRefGoogle Scholar
  30. 30.
    Su CT, Yang HJ, Lin CF, Tsai MC, Shieh YH, Chiu WT. Arterial blood pressure and blood lipids as cardiovascular risk factors and occupational stress in Taiwan. Int J Cardiol. 2001; 81(2–3): 181–187.PubMedCrossRefGoogle Scholar
  31. 31.
    Smolin B, Leiba R, Levy Y. The effect of stress on markers of cardiovascular health. Nutr Metab Cardiovasc Dis. 2007; 17(6): e15–e17.PubMedCrossRefGoogle Scholar
  32. 32.
    Woolfolk RL, Allen LA. Treating somatization: a cognitive-behavioural approach. New York, NY: Guilford; 2007.Google Scholar
  33. 33.
    Brown RJ. Introduction to the special issue on medically unexplained symptoms: background and future directions. Clin Psychol Rev. 2007; 27(7): 769–780.PubMedCrossRefGoogle Scholar
  34. 34.
    al-Windi A, Elmfeldt D, Tibblin G, Svärdsudd K. The influence of sociodemographic characteristics on well-being and symptoms in a Swedish community. Results from a postal questionnaire survey. Scand J Prim Health Care. 1999; 17(4): 201–209.PubMedCrossRefGoogle Scholar
  35. 35.
    Hagen KB, Bjørndal A, Uhlig T, Kvien TK. A population study of factors associated with general practitioner consultation for non-inflammatory musculoskeletal pain. Ann Rheum Dis. 2000; 59(10): 788–793.PubMedCrossRefGoogle Scholar
  36. 36.
    Fifth National Population Census. Beijing, China: National Bureau of Statistics of China; 2000.Google Scholar

Copyright information

© The New York Academy of Medicine 2011

Authors and Affiliations

  • Yu X. Yan
    • 1
  • Jing Dong
    • 2
  • You Q. Liu
    • 2
  • Xing H. Yang
    • 1
  • Man Li
    • 1
  • Gilbert Shia
    • 1
  • Wei Wang
    • 1
    • 3
  1. 1.Department of Epidemiology and Biostatistics, School of Public Health and Family MedicineCapital Medical UniversityBeijingPeople’s Republic of China
  2. 2.Physical Examination Center, Beijing Xuanwu HospitalCapital Medical UniversityBeijingPeople’s Republic of China
  3. 3.College of Life SciencesGraduate University, Chinese Academy of SciencesBeijingPeople’s Republic of China

Personalised recommendations