The Cardiovascular and Cognitive Health Study (CCHS-Beijing) is a population-based study of cardiovascular disease (CVD) and cognitive impairment in adults aged 55 and older in Beijing. The main aims of the study are to investigate the prevalence rates of CVD, asymptomatic atherosclerosis, and cognitive impairment, as well as validate the risk factors related to the onset and development of CVD, Alzheimer's disease (AD) and mild cognitive impairment (MCI). The study was designed to detect the traditional and new risk factors in this age group. Participants were recruited randomly from residential regions in the greater Beijing municipality area based on the average levels of development in Beijing, China in 2012 (based on socioeconomic, demographic, and geographical characteristics). Thorough physical and laboratory examination were performed at baseline (also the cross-sectional survey) to identify the risk factors such as hypertension, dyslipidemia, diabetes, as well as newly defined risk factors like elevated homocysteine, high sensitivity C-reactive protein, and urine micro-albumin. Subclinical disease of the cerebral vasculature included atherosclerosis of carotid arteries, intracranial arteries, and retinal vessels. Subclinical cardiac diseases included left ventricular enlargement, arrhythmias, chamber hypertrophy and myocardial ischemia. Blood pressure was documented using the ankle-arm method. In addition, neuropsychological assessments were performed for all subjects aged 65 and above. Baseline evaluation began during the period August 2013 to December 2014. Follow-up examination will occur in 5 years. The initial and recurrent CVD, AD and MCI events will be verified and validated during the follow-up period.

1.
United Nations Development Programme: Human Development Report: International Cooperation at a Crossroads-Aid, Trade and Security in an Unequal World. United Nations Development Programme.
2.
Zhang NJ, Guo M, Zheng X: China: Awakening Giant Developing Solutions to Population Aging, 2012, vol 52, pp 589-596.
3.
Flaherty JH, Liu ML, Ding L, Dong B, Ding Q, Li X, Xiao S: China: the aging giant. J Am Geriatr Soc 2007;55:1295-1300.
4.
Zhang ZX, Zahner GE, Roman GC, Liu XH, Wu CB, Hong Z, Hong X, Tang MN, Zhou B, Qu QM, Zhang XJ, Li H: Socio-demographic variation of dementia subtypes in china: methodology and results of a prevalence study in Beijing, Chengdu, Shanghai, and Xian. Neuroepidemiology 2006;27:177-187.
5.
Zhang ZX, Zahner GE, Roman GC, Liu J, Hong Z, Qu QM, Liu XH, Zhang XJ, Zhou B, Wu CB, Tang MN, Hong X, Li H: Dementia subtypes in China: prevalence in Beijing, Xian, Shanghai, and Chengdu. Arch Neurol 2005;62:447-453.
6.
Gu D, Reynolds K, Wu X, Chen J, Duan X, Muntner P, Huang G, Reynolds RF, Su S, Whelton PK, He J; InterASIA Collaborative Group. The International Collaborative Study of Cardiovascular Disease in ASIA: Prevalence, awareness, treatment, and control of hypertension in china. Hypertension 2002;40:920-927.
7.
Gu D, Gupta A, Muntner P, Hu S, Duan X, Chen J, Reynolds RF, Whelton PK, He J: Prevalence of cardiovascular disease risk factor clustering among the adult population of China: results from the international collaborative study of cardiovascular disease in Asia (InterAsia). Circulation 2005;112:658-665.
8.
He J, Neal B, Gu D, Suriyawongpaisal P, Xin X, Reynolds R, MacMahon S, Whelton PK; InterASIA Collaborative Group: International collaborative study of cardiovascular disease in Asia: design, rationale, and preliminary results. Ethn Dis 2004;14:260-268.
9.
Fang XH, Zhang XH, Yang QD, Dai XY, Su FZ, Rao ML, Wu SP, Du XL, Wang WZ, Li SC: Subtype hypertension and risk of stroke in middle-aged and older Chinese: a 10-year follow-up study. Stroke 2006;37:38-43.
10.
Hyun KK, Huxley RR, Arima H, Woo J, Lam TH, Ueshima H, Fang X, Peters SA, Jee SH, Giles GG, Barzi F, Woodward M: A comparative analysis of risk factors and stroke risk for Asian and non-Asian men: the Asia Pacific cohort studies collaboration. Int J Stroke 2013;8:606-611.
11.
Huxley RR, Barzi F, Woo J, Giles G, Lam TH, Rahimi K, Konety S, Ohkubo T, Jee SH, Fang X, Woodward M; Asia Pacific Cohort Studies Collaboration: A comparison of risk factors for mortality from heart failure in Asian and non-Asian populations: an overview of individual participant data from 32 prospective cohorts from the Asia-Pacific region. BMC Cardiovasc Disord 2014;14:61.
12.
Wang C, Liu Y, Yang Q, Dai X, Wu S, Wang W, Ji X, Li L, Fang X: Body mass index and risk of total and type-specific stroke in Chinese adults: results from a longitudinal study in China. Int J Stroke 2013;8:245-250.
13.
Murakami Y, Huxley RR, Lam TH, Tsukinoki R, Fang X, Kim HC, Woodward M; Asia Pacific Cohort Studies Collaboration: Diabetes, body mass index and the excess risk of coronary heart disease, ischemic and hemorrhagic stroke in the Asia Pacific cohort studies collaboration. Prev Med 2012;54:38-41.
14.
Tsukinoki R, Murakami Y, Huxley R, Ohkubo T, Fang X, Suh I, Ueshima H, Lam TH, Woodward M; Asia Pacific Cohort Studies Collaboration: Does body mass index impact on the relationship between systolic blood pressure and cardiovascular disease?: meta-analysis of 419 488 individuals from the Asia Pacific cohort studies collaboration. Stroke 2012;43:1478-1483.
15.
Arima H, Murakami Y, Lam TH, Kim HC, Ueshima H, Woo J, Suh I, Fang X, Woodward M; Asia Pacific Cohort Studies Collaboration: Effects of prehypertension and hypertension subtype on cardiovascular disease in the Asia-Pacific region. Hypertension 2012;59:1118-1123.
16.
He Y, Jiang B, Wang J, Feng K, Chang Q, Fan L, Li X, Hu FB: Prevalence of the metabolic syndrome and its relation to cardiovascular disease in an elderly Chinese population. J Am Coll Cardiol 2006;47:1588-1594.
17.
Fang XH, Longstreth WT Jr, Li SC, Kronmal RA, Cheng XM, Wang WZ, Wu S, Du XL, Dai XY: Longitudinal study of blood pressure and stroke in over 37,000 people in China. Cerebrovasc Dis 2001;11:225-229.
18.
Jansson JH: [High homocysteine level is not a risk factor of cardiovascular disease]. Lakartidningen 2000;97:2522.
19.
Yuyun MF, Khaw KT, Luben R, Welch A, Bingham S, Day NE, Wareham NJ: A prospective study of microalbuminuria and incident coronary heart disease and its prognostic significance in a British population: the EPIC-Norfolk study. Am J Epidemiol 2004;159:284-293.
20.
Kivity S, Kopel E, Maor E, Abu-Bachar F, Segev S, Sidi Y, Olchovsky D: Association of serum uric acid and cardiovascular disease in healthy adults. Am J Cardiol 2013;111:1146-1151.
21.
Forbang NI, McDermott MM, Liao Y, Ix JH, Allison MA, Liu K, Tian L, Evans N, Criqui MH: Associations of diabetes mellitus and other cardiovascular disease risk factors with decline in the ankle-brachial index. Vasc Med 2014;19:465-472.
22.
FizeI'Ova M, Cederberg H, Stancakova A, Jauhiainen R, Vangipurapu J, Kuusisto J, Laakso M: Markers of tissue-specific insulin resistance predict the worsening of hyperglycemia, incident type 2 diabetes and cardiovascular disease. PLoS One 2014;9:e109772.
23.
Hamburg NM, Larson MG, Vita JA, Vasan RS, Keyes MJ, Widlansky ME, Fox CS, Mitchell GF, Levy D, Meigs JB, Benjamin EJ: Metabolic syndrome, insulin resistance, and brachial artery vasodilator function in Framingham offspring participants without clinical evidence of cardiovascular disease. Am J Cardiol 2008;101:82-88.
24.
Ozyol A, Yucel O, Ege MR, Zorlu A, Yilmaz MB: Microalbuminuria is associated with the severity of coronary artery disease independently of other cardiovascular risk factors. Angiology 2012;63:457-460.
25.
Kaffashian S, Dugravot A, Nabi H, Batty GD, Brunner E, Kivimaki M, Singh-Manoux A: Predictive utility of the Framingham general cardiovascular disease risk profile for cognitive function: evidence from the Whitehall II study. Eur Heart J 2011;32:2326-2332.
26.
Fillit H, Nash DT, Rundek T, Zuckerman A: Cardiovascular risk factors and dementia. Am J Geriatr Pharmacother 2008;6:100-118.
27.
Xiang X, An R: Depression and onset of cardiovascular disease in the US middle-aged and older adults. Aging Ment Health 2015;19:1084-1092.
28.
Wassertheil-Smoller S, Arredondo EM, Cai J, Castaneda SF, Choca JP, Gallo LC, Jung M, LaVange LM, Lee-Rey ET, Mosley T Jr, Penedo FJ, Santistaban DA, Zee PC: Depression, anxiety, antidepressant use, and cardiovascular disease among Hispanic men and women of different national backgrounds: results from the Hispanic community health study/study of Latinos. Ann Epidemiol 2014;24:822-830.
29.
So ES: Cardiovascular disease risk factors associated with depression among Korean adults with coronary artery disease and cerebrovascular disease. Asia Pac Psychiatry 2014;7:173-181.
30.
Wint D: Depression: a shared risk factor for cardiovascular and Alzheimer disease. Cleve Clin J Med 2011;78(suppl 1):S44-S46.
31.
Eriksson UK, Bennet AM, Gatz M, Dickman PW, Pedersen NL: Nonstroke cardiovascular disease and risk of Alzheimer disease and dementia. Alzheimer Dis Assoc Disord 2010;24:213-219.
32.
Messier C, Awad N, Gagnon M: The relationships between atherosclerosis, heart disease, type 2 diabetes and dementia. Neurol Res 2004;26:567-572.
33.
Messier C, Awad N, Gagnon M: The relationships between atherosclerosis, heart disease, type 2 diabetes and dementia. Neurol Res 2004;26:567-572.
34.
Cohen RA, Poppas A, Forman DE, Hoth KF, Haley AP, Gunstad J, Jefferson AL, Tate DF, Paul RH, Sweet LH, Ono M, Jerskey BA, Gerhard-Herman M: Vascular and cognitive functions associated with cardiovascular disease in the elderly. J Clin Exp Neuropsychol 2009;31:96-110.
35.
Bonow RO, Smaha LA, Smith SC Jr, Mensah GA, Lenfant C: World heart day 2002: the international burden of cardiovascular disease: responding to the emerging global epidemic. Circulation 2002;106:1602-1605.
36.
Wu Z, Yao C, Zhao D, Wu G, Wang W, Liu J, Zeng Z, Wu Y: Sino-MONICA project: a collaborative study on trends and determinants in cardiovascular diseases in China, part I: morbidity and mortality monitoring. Circulation 2001;103:462-468.
37.
Wang Z, Zhang L, Chen Z, Wang X, Shao L, Guo M, Zhu M, Gao R; China Hypertension Survey Group: Survey on prevalence of hypertension in China: background, aim, method and design. Int J Cardiol 2014;174:721-723.
38.
Mui AC: Geriatric depression scale as a community screening instrument for elderly Chinese immigrants. Int Psychogeriatr 1996;8:445-458.
39.
Avery K, Donovan J, Peters TJ, Shaw C, Gotoh M, Abrams P: ICIQ: a brief and robust measure for evaluating the symptoms and impact of urinary incontinence. Neurourol Urodyn 2004;23:322-330.
40.
Chinese physician association of ultrasonography. The guideline of vascular ultrasound examination. Chin J Ultrasonogr 2009;18:911-920.
41.
Babikian VL, Wechsler LR: Transcranial Doppler Ultrasonography. St Louis, Mo: Mosby-Year Book Inc; 1993.
42.
Liang YB, Friedman DS, Wong TY, Wang FH, Duan XR, Yang XH, Zhou Q, Tao Q, Zhan SY, Sun LP, Wang NL; Handan Eye Study Group: Rationale, design, methodology, and baseline data of a population-based study in rural China: the Handan Eye study. Ophthalmic Epidemiol 2009;16:115-127.
43.
Podsiadlo D, Richardson S: The timed ‘Up & Go': a test of basic functional mobility for frail elderly persons. J Am Geriatr Soc 1991;39:142-148.
44.
Yingwu Y, Yusan W, Ziyu S: National Guide to Clinical Laboratory Procedures, ed 3. Southeast University Press, 2006, pp 406-457.
45.
Ma L, Chen J, Wang R, Han Y, Zhang J, Dong W, Zhao Z, Liu Y, Chu X: Alzheimer-associated urine neuronal thread protein level increases with age in a healthy Chinese population. J Clin Neurosci 2014;21:2118-2121.
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
You do not currently have access to this content.