Prevalence and clustering trends association of modifiable cardiovascular disease risk factors and ASCVD risk change in ethnic areas of the Southwest China plateau: progressively increasing sex disparity

The purpose of the study was to determine the prevalence and clustering changes of cardiovascular disease (CVD) risk factors, the atherosclerotic cardiovascular diseases (ASCVD) risk change in ethnic minority areas of the Southwest China Plateau from the perspective of sex disparity. This study conducted two cross-sectional studies in Yunnan Province, China, in 2018 and 2024, respectively, enrolling 1,197 and 1,047 participants aged 35–75 years with no history of CVD. The China-PAR model was used to assess participants’ 10-year risk of ASCVD. Changes in the prevalence and clustering of 9 CVD risk factors were described. Multivariate-adjusted Poisson regression by robust was used to calculate the association between the number of CVD risk factors and high risk of ASCVD. Compared with 2018, the age-standardized prevalence of modifiable metabolic CVD risk factors such as hypertension (22.4% to 41.7%), central obesity (24.2% to 39.1%), and overweight and obesity (11.2% to 15.1%) has risen rapidly; the increase among males was much higher than among females, while the age-standardized prevalence of modifiable behavioral CVD risk factors has declined. There was no significant change in the clustering number of CVD risk factors, but there was a significant change in the combination of CVD risk factors, particularly a significant increase associated with hypertension. The proportion of individuals classified as being at high risk for ASCVD also increased significantly (6.7% vs 10.6%). For each CVD risk factor, the high risk of ASCVD increased by 5%, with a higher risk among males and 55–75 years. From 2018 to 2024, modifiable metabolic CVD risk factors increased substantially in high-altitude ethnic minority regions of Southwest China. Comprehensive lifestyle interventions should be implemented in the future to promote the prevention and control of ASCVD risk and gradually reduce sex disparity.