Table 3.
Multivariable-adjusted hazard ratios and 95% confidence intervals for cardiovascular mortality in overall population and by gender using the competing risk regression model
| Overall |
Women |
Men |
pinteraction of women and men | ||||
|---|---|---|---|---|---|---|---|
| Case/n (%) | HR (95% CI) | Case/n (%) | HR (95% CI) | Case/n (%) | HR (95% CI) | ||
| Social determinants | |||||||
| Educational attainment | 0.002 | ||||||
| High school or above | 655/63,519 (1.0) | 1.00 (reference) | 202/38,384 (0.5) | 1.00 (reference) | 453/25,135 (1.8) | 1.00 (reference) | |
| Middle school | 802/59,786 (1.3) | 1.11 (0.99–1.24) | 310/37,742 (0.8) | 1.18 (0.98–1.43) | 492/22,044 (2.2) | 1.09 (0.95–1.25) | |
| Primary school or less | 1,873/50,699 (3.7) | 1.46 (1.31–1.63) | 1141/37,311 (3.1) | 1.57 (1.32–1.86) | 732/13,388 (5.5) | 1.40 (1.22–1.62) | |
| Marital status | 0.300 | ||||||
| Married | 2,785/160,298 (1.7) | 1.00 (reference) | 1,272/102,038 (1.3) | 1.00 (reference) | 1,513/58,260 (2.6) | 1.00 (reference) | |
| Single, divorced, separated, or widowed | 545/13,706 (4.0) | 1.17 (1.04–1.31) | 381/11,399 (3.3) | 1.07 (0.93–1.23) | 164/2,307 (7.1) | 1.34 (1.08–1.66) | |
| Living alone | 0.517 | ||||||
| No | 3,024/166,267 (1.8) | 1.00 (reference) | 1,457/107,628 (1.4) | 1.00 (reference) | 1,568/58,639 (2.7) | 1.00 (reference) | |
| Yes | 306/7,737 (4.0) | 1.18 (1.02–1.36) | 196/5,809 (3.4) | 1.14 (0.96–1.35) | 109/1,928 (5.7) | 1.20 (0.93–1.55) | |
| Moderate or severe depression | 0.873 | ||||||
| No | 3,301/172,458 (1.9) | 1.00 (reference) | 1,635/112,266 (1.5) | 1.00 (reference) | 1,666/60,192 (2.8) | 1.00 (reference) | |
| Yes | 29/1,546 (1.9) | 1.22 (0.81–1.83) | 18/1,171 (1.6) | 1.32 (0.80–2.16) | 11/375 (3.0) | 1.10 (0.56–2.15) | |
| Gross domestic product per capita (yuan)∗ | 0.003 | ||||||
| ≥36,262 | 1,693/117,187 (1.4) | 1.00 (reference) | 813/76,795 (1.1) | 1.00 (reference) | 880/40,392 (2.2) | 1.00 (reference) | |
| <36,262 | 1,637/56,817 (2.9) | 1.46 (1.34–1.59) | 840/36,642 (2.3) | 1.60 (1.43–1.80) | 797/20,175 (4.0) | 1.34 (1.19–1.51) | |
| Ambient PM2.5air pollution (μg/m3)∗ | 0.469 | ||||||
| <59.11 | 1,743/124,871 (1.4) | 1.00 (reference) | 860/81,659 (1.1) | 1.00 (Reference) | 883/43,212 (2.0) | 1.00 (Reference) | |
| ≥59.11 | 1,587/49,133 (3.2) | 1.55 (1.43–1.67) | 793/31,778 (2.5) | 1.45 (1.30–1.62) | 794/17,355 (4.6) | 1.62 (1.45–1.81) | |
| Lifestyle risk factors | |||||||
| Tobacco use | 0.061 | ||||||
| Never | 2,447/139,201 (1.8) | 1.00 (reference) | 1,591/111,225 (1.4) | 1.00 (reference) | 856/27,976 (3.1) | 1.00 (reference) | |
| Former | 247/8,192 (3.0) | 1.05 (0.91–1.22) | 17/495 (3.5) | 1.26 (0.76–2.11) | 230/7,697 (3.0) | 1.00 (0.86–1.16) | |
| Current | 636/26,611 (2.4) | 1.21 (1.08–1.35) | 45/1,717 (2.6) | 1.54 (1.13–2.08) | 591/24,894 (2.4) | 1.13 (1.01–1.28) | |
| Alcohol consumption | 0.517 | ||||||
| Never | 2,771/150,967 (1.8) | 1.00 (reference) | 1,614/110,977 (1.5) | 1.00 (reference) | 1,156/39,990 (2.9) | 1.00 (reference) | |
| Former | 146/3,832 (3.8) | 1.26 (1.05–1.52) | 8/484 (1.7) | 0.90 (0.42–1.91) | 138/3,348 (4.1) | 1.30 (1.08–1.57) | |
| Current: low | 81/4,223 (1.9) | 0.77 (0.61–0.98) | 14/1,026 (1.4) | 0.86 (0.50–1.48) | 67/3,197 (2.1) | 0.76 (0.59–0.99) | |
| Current: moderate | 148/7,718 (1.9) | 0.72 (0.60–0.87) | 5/455 (1.1) | 0.61 (0.23–1.59) | 143/7,263 (2.0) | 0.73 (0.61–0.88) | |
| Current: high | 184/7,264 (2.5) | 0.98 (0.82–1.16) | 11/495 (2.3) | 1.21 (0.68–2.18) | 173/6,769 (2.6) | 0.99 (0.83–1.18) | |
| Diet score | 0.315 | ||||||
| 3–4 | 321/26,744 (1.2) | 1.00 (reference) | 154/17,060 (0.9) | 1.00 (reference) | 167/9,684 (1.7) | 1.00 (reference) | |
| 2 | 1,132/68,396 (1.7) | 1.16 (1.02–1.32) | 566/44,931 (1.3) | 1.10 (0.92–1.33) | 566/23,465 (2.4) | 1.20 (1.00–1.45) | |
| 0–1 | 1,877/78,864 (2.4) | 1.30 (1.14–1.48) | 933/51,446 (1.8) | 1.18 (0.98–1.41) | 944/27,418 (3.4) | 1.43 (1.19–1.71) | |
| Physical activity | 0.922 | ||||||
| High | 959/47,177 (2.0) | 1.00 (reference) | 444/30,718 (1.5) | 1.00 (reference) | 515/16,459 (3.1) | 1.00 (reference) | |
| Moderate | 1,193/67,064 (1.8) | 0.94 (0.86–1.03) | 623/44,346 (1.4) | 0.99 (0.87–1.13) | 569/22,718 (2.5) | 0.89 (0.79–1.02) | |
| Low | 1,178/59,763 (2.0) | 1.02 (0.93–1.12) | 586/38,373 (1.5) | 1.00 (0.87–1.15) | 593/21,390 (2.8) | 1.04 (0.91–1.18) | |
| Sleep duration (hours per night) | 0.089 | ||||||
| 6–8 | 1,567/105,943 (1.5) | 1.00 (reference) | 759/69,424 (1.1) | 1.00 (reference) | 808/36,519 (2.2) | 1.00 (reference) | |
| <6 | 136/8,945 (1.5) | 0.85 (0.65–1.11) | 66/5,785 (1.1) | 0.81 (0.58–1.13) | 70/3,160 (2.2) | 0.90 (0.64–1.26) | |
| >8 | 1,627/59,116 (2.8) | 1.22 (1.12–1.34) | 828/38,228 (2.2) | 1.25 (1.10–1.40) | 799/20,888 (3.8) | 1.20 (1.07–1.35) | |
| Metabolic risk factors | |||||||
| Abdominal obesity | 0.041 | ||||||
| No | 2,243/126,976 (1.8) | 1.00 (reference) | 970/78,811 (1.2) | 1.00 (reference) | 1,273/48,165 (2.6) | 1.00 (reference) | |
| Yes | 1,087/47,028 (2.3) | 1.03 (0.96–1.12) | 683/34,626 (2.0) | 0.95 (0.86–1.06) | 404/12,402 (3.3) | 1.12 (1.00–1.26) | |
| Hypertension | 0.002 | ||||||
| No | 886/97,980 (0.9) | 1.00 (reference) | 408/66,968 (0.6) | 1.00 (reference) | 478/31,012 (1.5) | 1.00 (reference) | |
| Yes | 2,444/76,024 (3.2) | 1.67 (1.54–1.82) | 1,245/46,469 (2.7) | 1.82 (1.60–2.05) | 1,199/29,555 (4.1) | 1.53 (1.36–1.72) | |
| Diabetes | 0.450 | ||||||
| No | 2,051/133,871 (1.5) | 1.00 (reference) | 1,014/88,907 (1.1) | 1.00 (reference) | 1,037/44,964 (2.3) | 1.00 (reference) | |
| Yes | 1,279/40,133 (3.2) | 1.34 (1.24–1.45) | 639/24,530 (2.6) | 1.30 (1.17–1.45) | 640/15,603 (4.1) | 1.38 (1.24–1.53) | |
| Low-density lipoprotein cholesterol (mmol/L) | 0.816 | ||||||
| <3.4 | 2,340/127,247 (1.8) | 1.00 (reference) | 1,076/80,717 (1.3) | 1.00 (reference) | 1,264/46,530 (2.7) | 1.00 (reference) | |
| 3.4 - <4.9 | 890/43,490 (2.1) | 1.04 (0.96–1.12) | 516/30,230 (1.7) | 1.06 (0.96–1.18) | 374/13,260 (2.8) | 1.00 (0.89–1.13) | |
| ≥4.9 | 100/3,267 (3.1) | 1.52 (1.24–1.87) | 61/2,490 (2.5) | 1.33 (1.03–1.72) | 39/777 (5.1) | 1.96 (1.40–2.76) | |
| Urine albumin-creatinine ratio (mg/g) | 0.066 | ||||||
| <30 | 2,322/155,501 (1.5) | 1.00 (reference) | 1,073/100,742 (1.1) | 1.00 (reference) | 1,249/54,759 (2.3) | 1.00 (reference) | |
| 30 - <300 | 767/16,320 (4.7) | 1.68 (1.54–1.84) | 447/11,288 (4.0) | 1.74 (1.53–1.98) | 320/5,032 (6.4) | 1.58 (1.38–1.82) | |
| ≥300 | 241/2,183 (11.0) | 3.15 (2.70–3.68) | 133/1,407 (9.5) | 3.25 (2.66–3.98) | 108/776 (13.9) | 2.98 (2.35–3.78) | |
| Estimated glomerular filtration rate <60 (ml/min per 1.73 m2) | 0.808 | ||||||
| No | 3,037/170,897 (1.8) | 1.00 (reference) | 1,515/111,600 (1.4) | 1.00 (reference) | 1,522/59,297 (2.6) | 1.00 (reference) | |
| Yes | 293/3,107 (9.4) | 1.34 (1.17–1.54) | 138/1,837 (7.5) | 1.30 (1.07–1.57) | 155/1,270 (12.2) | 1.41 (1.16–1.71) | |
For the 15 individual-level risk factors (excluding gross domestic product per capita and ambient PM2.5 air pollution), each model was adjusted for age, gender, region (urban or rural), and all other individual-level risk factors. ∗For the two community-level risk factors of gross domestic product per capita and ambient PM2.5 air pollution, a separate model was employed with adjustment for age, gender, region (urban or rural), and the remaining 15 individual-level risk factors.
See also Tables S1, S2, and S4 and Figures S3 and S5.