Table 1
Population characteristics and risk factors at baseline.
| BASELINE | WOMEN | MEN | TOTAL | P – VALUE |
|---|---|---|---|---|
| Total – no. (%) | 4845 (64.2) | 2707 (35.8) | 7552 (100) | |
| Age in years (SD) | 50.5 (9.5) | 51.1 (9.9) | 50.7 (9.7) | 0.021 |
| Location – no. (%) | ||||
| Rural | 2378 (49.1) | 1665 (61.5) | 4043 (53.5) | <0.001 |
| Urban | 2467 (50.9) | 1042 (38.5) | 3509 (46.5) | |
| Education – no. (%) | ||||
| Primary School or Unknown | 3142 (65.0) | 1846 (68.2) | 4988 (66.2) | 0.003 |
| High School | 1004 (20.8) | 476 (17.6) | 1480 (19.6) | |
| University | 688 (14.2) | 384 (14.2) | 1072 (14.2) | |
| Civil status – no. (%) | ||||
| Never married | 663 (13.7) | 315 (11.7) | 978 (13.0) | <0.001 |
| Married – Common Law | 3187 (66.1) | 2181 (80.8) | 5368 (71.4) | |
| Widowed / Divorced | 974 (20.2) | 202 (7.5) | 1176 (15.6) | |
| Alcohol consumption* – no. (%) | 784 (16.2) | 1344 (49.6) | 2128 (28.2) | <0.001 |
| Tobacco use† – no. (%) | 446 (9.2) | 599 (22.2) | 1045 (13.9) | <0.001 |
| Low physical activity‡ – no. (%) | 803 (17.5) | 442 (18.2) | 1245 (17.7) | <0.001 |
| AHEI score (mean; SD) | 37.33 (7.10) | 36.92 (7.31) | 37.18 (7.18) | 0.021 |
| Waist circumference (cm; SD) | 85.2 (11.6) | 88.3 (11.1) | 86.3 (11.5) | <0.001 |
| Body mass index (kg/m2; SD) | 26.8 (4.9) | 25.2 (4.1) | 26.2 (4.6) | <0.001 |
| Waist–to-Hip Ratio (mean; SD) | 0.86 (0.08) | 0.93 (0.09) | 0.88 (0.09) | <0.001 |
| Relative grip strength§ (mean; SD) | 0.36 (0.13) | 0.50 (0.16) | 0.41 (0.16) | <0.001 |
| Systolic blood pressure (mmHg; SD) | 127.3 (22.3) | 131.0 (20.9) | 128.6 (21.9) | <0.001 |
| Diastolic blood pressure (mmHg; SD) | 80.4 (12.6) | 81.2 (12.9) | 80.7 (12.7) | 0.018 |
| Glucose (mg/dL; SD) | 86.8 (30.5) | 86.7 (25.9) | 86.7 (28.7) | 0.901 |
| Total cholesterol (mg/dL; SD) | 204 (46.1) | 196.3 (45.9) | 200.8 (46.1) | <0.001 |
| HDL-c (mg/dL; SD) | 44.0 (10.2) | 40.9 (10.0) | 42.7 (10.2) | <0.001 |
| Non-HDL-c (mg/dL; SD) | 160.1 (42.9) | 155.2 (42.1) | 158.0 (42.6) | <0.001 |
| Triglycerides (mg/dL; SD) | 176.4 (103.7) | 195.0 (120.9) | 184.0 (111.5) | <0.001 |
| Hypertension – no. (%) | 1869 (38.6) | 977 (36.1) | 2846 (37.7) | 0.037 |
| Diabetes – no. (%) | 286 (5.9) | 138 (5.1) | 424 (5.6) | 0.162 |
| History of CVD – no. (%) | 232 (4.8) | 122 (4.5) | 354 (4.7) | 0.617 |
[i] AHEI: alternate healthy eating index; CVD: Cardiovascular disease; HDL-c: high-density lipoprotein; LDL-c: low density lipoprotein; SD: standard deviation. *Alcohol consumption was defined has alcohol consumption at least once a year. †Tobacco use was defined as current or previous tobacco use. ‡Low physical activity was defined as less than 600 metabolic equivalent × minutes per week. §Relative grip strength was calculated by dividing the absolute handgrip strength by body mass index.
Table 2
Incidence rates of composite MACE outcome and individual outcomes during the period 2009–2021.
| INCIDENCE RATE CASES PER 1000 PERSON-YEARS (95% CI) | ||||||
|---|---|---|---|---|---|---|
| EVENTS (N) | WOMEN | EVENTS (N) | MEN | EVENTS (N) | TOTAL | |
| Composite MACE* | 204 | 3.2 (2.8 to 3.7) | 148 | 4.2 (3.6 to 4.9) | 352 | 3.6 (3.2 to 4.0) |
| Death | 276 | 4.4 (3.9 to 4.9) | 225 | 6.5 (5.7 to 7.4) | 501 | 5.1 (4.7 to 5.6) |
| Cardiovascular death | 60 | 0.9 (0.7 to 1.2) | 63 | 1.8 (1.4 to 2.2) | 123 | 1.2 (1.0 to 1.5) |
| Acute myocardial infarction | 107 | 1.7 (1.4 to 2.0) | 95 | 2.7 (2.2 to 3.3) | 202 | 2.0 (1.8 to 2.3) |
| Heart failure | 53 | 0.8 (0.6 to 1.1) | 27 | 0.8 (0.5 to 1.1) | 80 | 0.8 (0.6 to 1.0) |
| Stroke | 58 | 0.9 (0.7 to 1.2) | 40 | 1.1 (0.8 to 1.5) | 98 | 1.0 (0.8 to 1.2) |
| Diabetes | 242 | 3.8 (3.4 to 4.3) | 98 | 2.7 (2.2 to 3.3) | 340 | 3.4 (3.1 to 3.8) |
[i] MACE: Major adverse cardiovascular events.
*Composite of MACE defined as cardiovascular death, myocardial infarction, stroke, or heart failure, whichever occurred first.
Figure 1
Kaplan-Meier curves of fatal cardiovascular events.
Figure 2
Kaplan-Meier curves for all-cause mortality.
Figure 3
Associations between cardiovascular risk factors and MACE in women and men.
Note: HR = hazard ratio. *1 SD increase in waist-to-hip ratio is 0.09. § 1 SD increase in fasting blood glucose is (27.94 mg/dL). ¥ 1 SD increase in AHEI score is 7.32. ¢ 1 SD increase in triglycerides glucose index is 0.57.