National and regional trend in cardiovascular health among Chinese school-aged children during 1989 to 2018 (Preprint)

BACKGROUND The updated metrics of “Life’s Essential 8 (LE8)” in quantifying cardiovascular health (CVH) status were released, whiles its distribution in Chinese children has not be reported. OBJECTIVE To assess the national distribution of Chinese school-aged children’s CVH status by LE8 scores and their temporal changes over time. METHODS Participants who aged between 7 and 19 years from 11 waves (1989-2018) of the China Health and Nutrition Survey were included. Scores of overall CVH and each LE8 metrics were calculated individually. Temporal changes were assessed with geographic regions, the causal relationship between health behaviors and health factors over time were built with cross-lagged panel models. RESULTS 21921 participants (52.6% boys) with data of at least four CVH components were included in the present analysis, the mean age was 13.0 (standard deviation, SD: 3.6) years. The overall CVH score remained stable in most regions with slight increased by 0.38 (95% CI: 0.29, 0.46; P<0.001) for every 5 years. Decline of diet score during 2004-2008 led to the decline in BMI score during 2009-2013 with the coefficient of 0.190 (95% CI: 0.030, 0.351; P=0.021), while decline of BMI score during 2004-2008 led to decline in sleep health during 2009-2013 with the coefficient of 0.089 (95% CI: 0.010, 0.168; P=0.027). CONCLUSIONS Chinese school-aged children and adolescents are generally of moderate CVH status, but mutual influences existed between CVH metrics. Interventions on diet may be the priority for promoting overall CVH in the future.