Trends in prevalence and clustering of modifiable cardiovascular disease risk factors across socioeconomic spectra in rural southwest China: a cross-sectional study

OBJECTIVES: This study aimed to determine the changing prevalence of clustering of cardiovascular disease (CVD) risk factors across socioeconomic spectra in rural southwest China. DESIGN: Data were collected from two waves of cross-sectional health interviews and examinations among individuals aged ≥35 years in rural China. Anthropometric measurements, blood pressure and fasting blood sugar levels were recorded for each participant. SETTING: This study was conducted in rural Yunnan Province of China. PARTICIPANTS: 8187 individuals in 2011 and 7572 in 2021 consented to participate in this study. RESULTS: From 2011 to 2021, prevalence increased of hypertension (26.1% vs 41.6%), diabetes mellitus (5.9% vs 9.8%), obesity (5.9% vs 12.0%) and central obesity (50.0% vs 58.3%) (p<0.01), while prevalence decreased of current smoking (35.2% vs 29.6%), secondhand smoke exposure (42.6% vs 27.4%) and current drinking (26.6% vs 29.6%) (p<0.01). This decade also saw an increase in the prevalence of participants with clustering of ≥2 (61.8% vs 63.0%) and ≥3 CVD risk factors (28.4% vs 32.2%) (p<0.05). These increasing rates were also observed among subgroups categorised by sex, ethnicity, education level, income level and those ≥45 years of age (p<0.05). In both 2011 and 2021, male participants and participants with a lower education level had higher prevalence of clustering of ≥2 and ≥3 CVD risk factors than their counterparts (p<0.01). Ethnic minority participants and participants with higher annual income had higher prevalence of clustering of CVD risk factors in 2011 but presented opposite associations in 2021 (p<0.01). CONCLUSION: The prevalence of clustering of CVD risk factors increased substantially across all socioeconomic spectra in rural southwest China from 2011 to 2021. Future efforts to implement comprehensive lifestyle interventions to promote the prevention and control of CVD should in particular focus on men, those of Han ethnicity and those with low socioeconomic status.