Trends in the epidemiology of cardiovascular diseases in the Kailuan young adults aged 18 to 44 years from 2006 to 2020

Objective To analyze the trends in the prevalence of cardiovascular disease (CVD) and its major subclasses (stroke, myocardial infarction, heart failure) among young adults aged 18 to 44 years in the Kailuan study from 2006 to 2020. Methods Young adults aged 18 to 44 years who participated in the Kailuan health examination every 2 years from 2006 to 2020 were included. The Clopper-Pearson method was used to estimate the crude rate and 95% confidence interval (CI). The age and sex-adjusted rates and 95% CI were estimated using generalized linear models, the standardized rate and 95% CI were calculated by direct standardization method based on the 2020 Chinese census data, a Joinpoint regression analysis was used to estimate the mean annual percentage change (AAPC) and 95% CI of standardized prevalence of CVD. The trend tests were performed using the Cochran-Armitage method. Results A total of 27 278, 29 915, 28 378, 34 919, 30 671, 30 683 and 30 496 young adults were included in surveys from 2006 to 2007, 2008 to 2009, 2010 to 2011, 2012 to 2013, 2014 to 2015, 2016 to 2017 and 2018 to 2020, respectively. The standardized prevalence of CVD and its subtypes of stroke showed an overall increasing and then decreasing trend during the period of 2006-2020, from 0.22% and 0.11% in 2006-2007 to 0.32% and 0.21% in 2008-2009, respectively; in 2018-2020, it decreased to 0.27% and 0.15%, with an AAPC of -0.99% and -2.53% (Z was 1.17 and 0.93, and P_trendwas 0.24 and 0.35, respectively). There were significant differences in the standardized prevalence of CVD among different groups. The standardized prevalence of CVD in male, smoking and obesity populations increased from 0.35%, 0.24% and 0.36% in 2006-2007 to 0.46%, 0.46% and 0.93% in 2008-2009, and then decreased to 0.29%, 0.12% and 0.29% in 2018-2020, respectively (AAPC=-3.42%, -6.04% and -3.42%, and Z=3.00, 4.49 and 3.20, respectively; both P_trend<0.01). The standardized prevalence of CVD in diabetic patients increased from 0.27% in 2006-2008 to 1.66% in 2018-2020 (AAPC=9.56%, Z=-2.54, P_trend=0.01). However, the standardized prevalence of CVD in hypertensive and dyslipidemic populations showed no significant trend during 2006-2020 (AAPC=2.74% and -2.36%, Z=-0.93 and 1.83, P_trend=0.35 and 0.07). Conclusions The standardized prevalences of CVD and its subtypes of stroke in young adults aged 18 to 44 in Kailuan study show an overall increasing and then decreasing trend from 2006 to 2020. The standardized prevalence of CVD in the male, smoking and obese populations is consistent with the trend of the overall population. The standardized prevalence of CVD in diabetic population shows an increasing trend, while the standardized prevalences of CVD in hypertensive and dyslipidemic populations do not show a significant trend. These trends may be related to the regular participation in a series of health promotion activities, such as health check-ups, health education and hypertension management, among Kailuan employees.