Cardiovascular health in urban Chinese children and adolescents
Open accessAbstract
INTRODUCTION: Cardiovascular diseases remain the leading cause of death and disease burden in China and worldwide. We aimed to evaluate the status of cardiovascular health among urban Chinese children and adolescents. METHODS: We conducted a cross-sectional study comprising 12,618 children and adolescents aged 6-18 years, who were recruited from Chinese urban areas during 2013-2015. The poor, intermediate, and ideal levels of 7 cardiovascular health metrics, including smoking, body mass index, dietary intake, physical activity, blood pressure, blood glucose, and total cholesterol were defined according to revised American Heart Association criteria. RESULTS: Ideal smoking status was the most prevalent health component (overall, 90.7%; males, 86.3% and females, 95.4%), whereas ideal health diet score (overall, 8.7%; males, 9.1% and females, 8.3%) was the least prevalent among urban Chinese children and adolescents. The majority (overall, 84.9%; males, 82.6% and females, 87.4%) of participants had 3-5 ideal metrics. The overall prevalence of ideal cardiovascular health (i.e. meeting all 7 ideal components) was extremely low (overall, 0.5%; males, 0.5% and females, 0.4%). CONCLUSIONS: The prevalence of ideal cardiovascular health in urban Chinese children and adolescents is extremely low, particularly for physical activity and healthy dietary intake. Effective public health interventions are required to improve cardiovascular health in children and adolescents to reduce future cardiovascular risk. Key messages Ideal health diet score was the least prevalent health component among urban Chinese children and adolescents The prevalence of ideal cardiovascular health in urban Chinese children and adolescents was extremely low Effective public health interventions are required to improve cardiovascular health in children and adolescents to reduce future cardiovascular risk.
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There is an extremely low prevalence (0.5%) of ideal cardiovascular health among Chinese children and adolescents as reflected by seven health metrics.
“Overall, there is an extremely low prevalence (0.5%) of ideal cardiovascular health as reflected by seven health metrics, namely smoking, body mass index (BMI), dietary intake, physical activity, blood pressure, blood glucose and total cholesterol.21”
From Physical activity and health in Chinese children and adolescents: expert consensus statement (2020) (2020) · cites this paper as [21]
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Cites
National High Blood Pressure Education Program Working Group on High Blood Pressure in Children and Adolescents (2004) · PEDIATRICS · doi:10.1542/peds.114.2.s2.555 · Cited by 6,895 · see citing works
CDC growth charts: United States.
Kuczmarski, R. J., Ogden, C. L., Grummer‐Strawn, L. M., Flegal, K. M., Guo, S. S., Wei, R. X., Mei, Z., Curtin, L. R., Roche, A. F., & Johnson, C. L. (2000) · PubMed · Cited by 5,298 · see citing works
Lloyd-Jones, D. M., Hong, Y., Labarthe, D., Mozaffarian, D., Appel, L. J., Van Horn, L., Greenlund, K., Daniels, S., Nichol, G., Tomaselli, G. F., et al. (2010) · Circulation · doi:10.1161/circulationaha.109.192703 · Cited by 4,750 · see citing works
Berenson, G. S., Srinivasan, S. R., Bao, W., Newman, W. P., Tracy, R. E., & Wattigney, W. A. (1998) · New England Journal of Medicine · doi:10.1056/nejm199806043382302 · Cited by 4,032 · see citing works
Childhood Adiposity, Adult Adiposity, and Cardiovascular Risk Factors
Juonala, M., Magnussen, C. G., Berenson, G. S., Venn, A., Burns, T. L., Sabin, M. A., Srinivasan, S. R., Daniels, S. R., Davis, P. H., Chen, W., et al. (2011) · New England Journal of Medicine · doi:10.1056/nejmoa1010112 · Cited by 1,665 · see citing works
Physical activity from childhood to adulthood
Telama, R., Yang, X., Viikari, J., Välimäki, I., Wanne, O., & Raitakari, O. (2005) · American Journal of Preventive Medicine · doi:10.1016/j.amepre.2004.12.003 · Cited by 1,585 · see citing works
Tracking of Blood Pressure From Childhood to Adulthood
Chen, X., & Wang, Y. (2008) · Circulation · doi:10.1161/circulationaha.107.730366 · Cited by 1,491 · see citing works
Zhou, M., Wang, H., Zhu, J. W., Chen, W., Wang, L., Liu, S., Yichong, L., Wang, L., Liu, Y., Yin, P., et al. (2015) · The Lancet · doi:10.1016/s0140-6736(15)00551-6 · Cited by 1,466 · see citing works
Global Sodium Consumption and Death from Cardiovascular Causes
Mozaffarian, D., Fahimi, S., Singh, G. M., Micha, R., Khatibzadeh, S., Engell, R. E., Lim, S., Danaei, G., Ezzati, M., & Powles, J. (2014) · New England Journal of Medicine · doi:10.1056/nejmoa1304127 · Cited by 1,218 · cited 1× · see citing works
“Elevated salt intake has been associated with cardiovascular disease [29], and Chinese adults and youths have high salt intake compared with other countries [30].”
BackgroundTracking of obesity-related behaviours from childhood to adulthood: A systematic review
Craigie, A. M., Lake, A. A., Kelly, S. A., Adamson, A. J., & Mathers, J. C. (2011) · Maturitas · doi:10.1016/j.maturitas.2011.08.005 · Cited by 1,088 · see citing works
Wu, S., Huang, Z., Yang, X., Zhou, Y., Wang, A., Chen, L., Zhao, H., Ruan, C., Wu, Y., Xin, A., et al. (2012) · Circulation Cardiovascular Quality and Outcomes · doi:10.1161/circoutcomes.111.963694 · Cited by 429 · see citing works
Shay, C. M., Ning, H., Allen, N. B., Carnethon, M. R., Chiuve, S. E., Greenlund, K. J., Daviglus, M. L., & Lloyd-Jones, D. M. (2012) · Circulation · doi:10.1161/circulationaha.111.035733 · Cited by 368 · see citing works
Laitinen, T. T., Pahkala, K., Magnussen, C. G., Viikari, J. S. A., Oikonen, M., Taittonen, L., Mikkilä, V., Jokinen, E., Hutri-Kähönen, N., Laitinen, T., et al. (2012) · Circulation · doi:10.1161/circulationaha.111.073585 · Cited by 299 · see citing works
Combined Effects of Child and Adult Elevated Blood Pressure on Subclinical Atherosclerosis
Juhola, J., Magnussen, C. G., Berenson, G. S., Venn, A., Burns, T. L., Sabin, M. A., Srinivasan, S. R., Daniels, S. R., Davis, P. H., Chen, W., et al. (2013) · Circulation · doi:10.1161/circulationaha.113.001614 · Cited by 285 · see citing works
The road to effective tobacco control in China
Yang, G., Wang, Y., Wu, Y., Yang, J., & Wan, X. (2015) · The Lancet · doi:10.1016/s0140-6736(15)60174-x · Cited by 269 · see citing works
Cheng-Ye, & Ji (2005) · 生物医学与环境科学：英文版 · Cited by 239 · see citing works
A Meta-Analysis of the Effect of Soy Protein Supplementation on Serum Lipids
Reynolds, K., Chin, A., Lees, K. A., Nguyen, A., Bujnowski, D., & He, J. (2006) · The American Journal of Cardiology · doi:10.1016/j.amjcard.2006.03.042 · Cited by 237 · see citing works
Effect of Soybean Protein on Blood Pressure: A Randomized, Controlled Trial
He, J., Gu, D., Wu, X., Chen, J., Duan, X., Chen, J., & Whelton, P. K. (2005) · Annals of Internal Medicine · doi:10.7326/0003-4819-143-1-200507050-00004 · Cited by 212 · see citing works
Ji, C.-Y. (2005) · PubMed · Cited by 195 · see citing works
Magnussen, C. G., Venn, A., Thomson, R. J., Juonala, M., Srinivasan, S. R., Viikari, J. S. A., Berenson, G. S., Dwyer, T., & Raitakari, O. T. (2009) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2008.09.061 · Cited by 192 · see citing works
Status of Cardiovascular Health in US Adolescents
Shay, C. M., Ning, H., Daniels, S. R., Rooks, C. R., Gidding, S. S., & Lloyd‐Jones, D. M. (2013) · Circulation · doi:10.1161/circulationaha.113.001559 · Cited by 183 · see citing works
Status of Cardiovascular Health in Chinese Adults
Bi, Y., Jiang, Y., He, J., Xu, Y., Wang, L., Xu, M., Zhang, M., Yichong, L., Wang, T., Dai, M., et al. (2015) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2014.12.044 · Cited by 175 · see citing works
Magnussen, C. G., Raitakari, O. T., Thomson, R. J., Juonala, M., Patel, D. A., Viikari, J. S. A., Marniemi, J., Srinivasan, S. R., Berenson, G. S., Dwyer, T., et al. (2007) · Circulation · doi:10.1161/circulationaha.107.718981 · Cited by 150 · see citing works
Salt and Sodium Intake in China
Hipgrave, D. B., Chang, S., Li, X., & Wu, Y. (2016) · JAMA · doi:10.1001/jama.2015.15816 · Cited by 129 · see citing works
The University of North Carolina at Chapel Hill University Libraries (2020) · PubMed · doi:10.17615/zvhq-e884 · Cited by 123 · see citing works
Development of blood pressure reference standards for Chinese children and adolescents
Pi-ming, Z. (2010) · Chinese Journal of Evidence-Based Pediatrics · Cited by 115 · see citing works
Factors Associated With Tracking of BMI: A Meta‐Regression Analysis on BMI Tracking*
Bayer, O., Krüger, H., von Kries, R., & Toschke, A. M. (2010) · Obesity · doi:10.1038/oby.2010.250 · Cited by 89 · see citing works
Ideal cardiovascular health in Chinese urban population
Zeng, Q., Dong, S.-Y., Song, Z., Zheng, Y., Wu, H., & Mao, L. (2012) · International Journal of Cardiology · doi:10.1016/j.ijcard.2012.06.022 · Cited by 70 · see citing works
Status of Cardiovascular Health in US Children Up to 11 Years of Age
Ning, H., Labarthe, D. R., Shay, C. M., Daniels, S. R., Hou, L., Horn, L. V., & Lloyd‐Jones, D. M. (2015) · Circulation Cardiovascular Quality and Outcomes · doi:10.1161/circoutcomes.114.001274 · Cited by 65 · see citing works
Chen, T. J., Modin, B. E., Ji, C., & Hjern, A. (2011) · Acta Paediatrica · doi:10.1111/j.1651-2227.2011.02397.x · Cited by 64 · see citing works
Chen, Y., Zheng, Z., Yi, J., & Yao, S. (2014) · BMC Public Health · doi:10.1186/1471-2458-14-744 · Cited by 53 · see citing works
Wu, H., Sun, Z., Cao, D.-P., Wu, L., & Zeng, Q. (2012) · International Journal of Cardiology · doi:10.1016/j.ijcard.2012.09.235 · Cited by 42 · see citing works
Yan, W., Li, X., Zhang, Y., Niu, D., Mu, K., Ye, Y., & Liu, F. (2016) · Journal of Hypertension · doi:10.1097/hjh.0000000000001114 · Cited by 29 · see citing works
Meng, L., Dongqing, H., Xinying, S., & Mi, J. (2013) · Chinese Journal of Hypertension · Cited by 18 · see citing works
Zhu, J.-F., Liang, L., Fu, J., Gong, C., Xiong, F., Liu, G., Luo, F., & Chen, S.-K. (2012) · PubMed · Cited by 6 · see citing works
Flagged first, then by citations
Research works printed but not linked: 1
- Zhonghua Liu Xing Bing Xue Za Zhi. 2012;33: 1005-1009.
Cited by
Sorted by citations
Physical activity and health in Chinese children and adolescents: expert consensus statement (2020)
Chen, P., Wang, D., Shen, H., Yu, L., Gao, Q., Mao, L., Jiang, F., Luo, Y., Xie, M., Zhang, Y., et al. (2020) · British Journal of Sports Medicine · doi:10.1136/bjsports-2020-102261 · Cited by 225 · see citing works
“21 The persistent trend in low levels of physical activity and achievement in meeting physical fitness standards among Chinese children and adolescents has been accompanied by a high prevalence of sedentary behaviours exhibited outside school environments, a situation made worse by excess dietary…”
Xiao, P., Dong, H., Li, H., Yan, Y., Cheng, H., Liu, J., Zhao, X., Hou, D., & Mi, J. (2020) · BMJ Open Diabetes Research & Care · doi:10.1136/bmjdrc-2019-000846 · Cited by 37 · see citing works
Regional Adipose Compartments Confer Different Cardiometabolic Risk in Children and Adolescents:
Yan, Y., Liu, J., Zhao, X., Cheng, H., Huang, G., Mi, J., Mi, J., Yan, Y., Dong, H., Liu, J., et al. (2019) · Mayo Clinic Proceedings · doi:10.1016/j.mayocp.2019.05.026 · Cited by 35 · see citing works
Zhang, F., Yin, X., Bi, C., Ji, L., Wu, H., Li, Y., Sun, Y., Ren, S., Wang, G., Yang, X., et al. (2020) · BMC Public Health · doi:10.1186/s12889-020-09819-7 · Cited by 36 · see citing works
Noncommunicable chronic disease prevention should start from childhood
Yan, Y., & Mi, J. (2021) · Pediatric Investigation · doi:10.1002/ped4.12254 · Cited by 33 · see citing works
Dong, H., Yan, Y., Liu, J., Cheng, H., Zhao, X., Shan, X., Huang, G., Mi, J., Mi, J., Liu, J., et al. (2020) · Clinical Nutrition · doi:10.1016/j.clnu.2020.08.012 · Cited by 31 · see citing works
Application of Life’s Essential 8 to assess cardiovascular health during early childhood
Perng, W., Aris, I. M., Slopen, N. B., Younoszai, N., Swanson, V., Mueller, N. T., Sauder, K. A., & Dabelea, D. (2023) · Annals of Epidemiology · doi:10.1016/j.annepidem.2023.02.004 · Cited by 26 · see citing works
Status of Cardiovascular Health in Chinese Children and Adolescents
Zhu, Y., Guo, P., Zou, Z., Li, X., Cao, M., Ma, J., & Jin, J. (2022) · JACC Asia · doi:10.1016/j.jacasi.2021.09.007 · Cited by 22 · see citing works
Ayling, K., Li, R., Muhardi, L., Melse‐Boonstra, A., Sun, Y., Chen, W., & Kudla, U. (2023) · Nutrients · doi:10.3390/nu15061536 · Cited by 18 · see citing works
Xiao, P., Cheng, H., Li, H., Zhao, X., Hou, D., Xie, X., & Mi, J. (2022) · Frontiers in Cardiovascular Medicine · doi:10.3389/fcvm.2022.836376 · Cited by 18 · see citing works
Gande, N., Pechlaner, R., Bernar, B., Staudt, A., Stock, K., Hochmayr, C., Geiger, R., Kiechl‐Kohlendorfer, U., Knoflach, M., Asare, M., et al. (2020) · Nutrition Metabolism and Cardiovascular Diseases · doi:10.1016/j.numecd.2020.11.002 · Cited by 15 · see citing works
Perng, W., Francis, E. C., Schuldt, C., Barbosa, G. R., Dabelea, D., & Sauder, K. A. (2021) · The Journal of Pediatrics · doi:10.1016/j.jpeds.2021.03.014 · Cited by 15 · see citing works
Food Insecurity and Ideal Cardiovascular Health Risk Factors Among US Adolescents
Hammad, N. M., Wolfson, J. A., de Ferranti, S. D., Willett, W. C., & Leung, C. W. (2024) · Journal of the American Heart Association · doi:10.1161/jaha.123.033323 · Cited by 14 · see citing works
Relationships for vitamin D with childhood height growth velocity and low bone mineral density risk
Xiao, P., Cheng, H., Wang, L., Hou, D., Li, H., Zhao, X., Xie, X., & Mi, J. (2023) · Frontiers in Nutrition · doi:10.3389/fnut.2023.1081896 · Cited by 11 · see citing works
Cardiovascular Risk Factors in China
Hu, S. (2024) · 老年心脏病学杂志：英文版 · doi:10.26599/1671-5411.2024.02.008 · Cited by 6 · see citing works
Perng, W., Galai, N., Zhao, Q., Litonjua, A. A., Geiger, S. D., Sauder, K. A., O’Shea, T. M., Hivert, M., Oken, E., Dabelea, D., et al. (2024) · Journal of the American Heart Association · doi:10.1161/jaha.124.036279 · Cited by 7 · see citing works
Lyu, J., Liu, Z., Zhou, S., Feng, X., Lin, Y., Gao, A., Zhang, F., Li, L., Hebestreit, A., & Wang, H. (2022) · Nutrients · doi:10.3390/nu14163272 · Cited by 6 · see citing works
Pompeo, E. D. P., Leite, J. A., Pereira, R. A., Muraro, A. P., Gorgulho, B. M., Souza, B. S. N., Ferreira, M. G., Souza, A. D. M., & Rodrigues, P. R. M. (2022) · Nutrition Metabolism and Cardiovascular Diseases · doi:10.1016/j.numecd.2022.08.015 · Cited by 8 · see citing works
Xiao, P., Cheng, H., Yan, Y., Hou, D., Dong, H., Zhao, X., & Mi, J. (2022) · Frontiers in Public Health · doi:10.3389/fpubh.2022.1023717 · Cited by 4 · see citing works
Pengpid, S., & Peltzer, K. (2021) · Vascular Health and Risk Management · doi:10.2147/vhrm.s302168 · Cited by 4 · see citing works
Exploring Visceral Fat as a Screening Marker for Cardiometabolic Risk in Children and Adolescents
Wang, X., Cheng, H., Xiong, J., Liu, J., Dong, H., Fu, L., Xie, X., Shan, X., Zhao, X., Yan, Y., et al. (2025) · Children · doi:10.3390/children12030308 · Cited by 3 · see citing works
Gui, Z., Cai, L., Lv, Y., Lai, L., Zeng, X., & Chen, Y. (2022) · Frontiers in Public Health · doi:10.3389/fpubh.2021.736424 · Cited by 3 · see citing works
Changes in ideal cardiovascular health among Iranian adolescents: 2007–2008 to 2015–2017
Asghari, G., Mirmiran, P., Rezaeemanesh, A., Mahdavi, M., Azizi, F., & Hadaegh, F. (2022) · BMC Pediatrics · doi:10.1186/s12887-022-03504-x · Cited by 3 · see citing works
Dong, H., Cheng, H., Liu, J., Yan, Y., Zhao, X., Shan, X., Huang, G., & Mi, J. (2023) · Obesity · doi:10.1002/oby.23651 · Cited by 2 · see citing works
Low prevalence of ideal levels in cardiovascular behavior metrics among Mexican adolescents
Terminel-Zaragoza, R., Angulo-Urías, M., Domínguez, I. D. J. T., Quintero-Portillo, H., Díaz, C. I. B., Ulloa‐Mercado, G., Gortáres‐Moroyoqui, P., Arias‐Gastélum, M., Legarreta-Muela, F., & Rentería-Mexia, A. M. (2023) · BMC Public Health · doi:10.1186/s12889-023-15959-3 · Cited by 2 · see citing works
Wang, H., Cheng, L., Yuan, X., Lyu, J., Li, P., Yan, S.-Y., Wang, H., Ding, Y.-S., Hong, S., & Wang, H.-J. (2025) · Nutrients · doi:10.3390/nu17030376 · Cited by 2 · see citing works
Gonçalves, L. G. D. O., dos Santos, J. P., & Farias, E. D. S. (2021) · Revista de Atenção à Saúde · doi:10.13037/ras.vol19n68.7495
Terminel-Zaragoza, R., Angulo-Urías, M., de Jesús Toledo-Domínguez, I., Quintero-Portillo, H., Díaz, C. I. B., Ulloa‐Mercado, G., Gortáres‐Moroyoqui, P., Arias‐Gastélum, M., Legarreta-Muela, F., & Rentería-Mexía, A. (2023) · Figshare · doi:10.6084/m9.figshare.23504971
Asghari, G., Mirmiran, P., Rezaeemanesh, A., Mahdavi, M., Azizi, F., & Hadaegh, F. (2022) · Figshare · doi:10.6084/m9.figshare.20381995
Terminel-Zaragoza, R., Angulo-Urías, M., de Jesús Toledo-Domínguez, I., Quintero-Portillo, H., Díaz, C. I. B., Ulloa‐Mercado, G., Gortáres‐Moroyoqui, P., Arias‐Gastélum, M., Legarreta-Muela, F., & Rentería-Mexía, A. (2023) · Figshare · doi:10.6084/m9.figshare.23504968
- Authors
- Yan, Y., Liu, J., Zhao, X., Cheng, H., Huang, G., Hou, D., Mi, J., & on behalf of the China Child and Adolescent Cardiovascular Health (CCACH) collaboration group
- Affiliations
- Capital Medical University (CN)
- Capital Institute of Pediatrics (CN)
- Corresponding author
- Mi, Jie
- Venue
- Annals of Medicine
- Publisher
- Informa UK Limited
- Published
- 2019-01-02
- Volume
- 51
- Issue
- 1
- Pages
- 88-96
- ISSN
- 0785-3890 (ISSN-L)
- 1365-2060
- PMC
- PMC7857444
- OpenAlex
- W2911805107
- Cited by
- 30
- References
- 36
- Citations by year
- 2025: 2 · 2024: 3 · 2023: 7 · 2022: 8 · 2021: 4 · 2020: 5 · 2019: 1
- FWCI
- 3.25
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Annals of Medicine (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Key Research and Development Program of China (2016YFC0900602, 2016YFC1300101)
- National Science and Technology Support Projects for the “Twelfth Five-Year Plan” of China (2012BAI03B03)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Health and Risk Factors
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Obesity, Physical Activity, Diet
- Health Sciences › Medicine › Physiology › Physical Activity and Health
- Keywords
- cardiovascular health, children, adolescents, urban Chinese population, ideal cardiovascular health, smoking, body mass index, dietary intake, physical activity, blood pressure, blood glucose, total cholesterol, cardiovascular risk, public health interventions
- MeSH terms
- Adolescent, Blood Glucose, Blood Pressure, Cardiovascular Diseases, Child, China, Cholesterol, Cross-Sectional Studies, Feeding Behavior, Female, Health Status, Humans, Male, Risk Factors, Smoking, Urban Health, Exercise, Body Mass Index, Prevalence, Cost of Illness
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