Hypertension was defined as currently using antihypertensive medicine and/or an average of three sitting systolic blood pressure (SBP) measurements ≥140 mmHg and/or an average of three sitting diastolic blood pressure measurements ≥90 mmHg after at least a 5‐min rest and with a 30‐s interval. Total cholesterol (TC), triglyceride (TG), and high‐density lipoprotein cholesterol (HDL‐C) were assessed on a Hitachi 7060 Clinical Analyzer (Hitachi High‐Technologies Corp., Tokyo, Japan) with cholesterol oxidase method, glycerophosphate oxidase method, and direct chemically modified enzyme method, respectively.22 Low‐density lipoprotein cholesterol (LDL‐C) levels were calculated using the Friedewald formula (LDL‐C = TC − HDL‐C − TG/5) for the participants whose TG levels were <400 mg/dl.23 Dyslipidemia was defined as currently using lipid‐lowering drugs, and/or TC ≥240 mg/dl, and/or TG ≥200 mg/dl, and/or LDL‐C ≥160 mg/dl, and/or HDL‐C <40 mg/dl after fasting for at least 10 h.24 Body mass index (BMI) was calculated as weight (kg)/height (m)2.
Other known or suspected risk factors for CVD, including demographic characteristics, lifestyle, medical history of chronic diseases, and family history of CVD, were collected using structured questionnaires face to face at each visit by trained data investigators. Age (in years), smoking status (never smoker, former smoker, current smoker), drinking status (current drinker or not), educational level (no education history, primary school, middle school, high school, college or above), monthly household income per capita (<300, 300–500, 500–800, 800–1200, 1200–2000, ≥2000 Chinese yuan [CNY]/month), and physical activity level (whether or not the ideal level was reached during the previous 12 months) were assessed with standardized questionnaires. The definition of ideal physical activity level was at least 150 min of moderate‐intensity physical activity or at least 75 min of vigorous‐intensity physical activity per week, which was recommended by World Health Organization.25 Ideal vegetable and fruit intake was defined as at least 500 g per day according to the dietary guidelines for Chinese residents.26
Other known or suspected risk factors for CVD, including demographic characteristics, lifestyle, medical history of chronic diseases, and family history of CVD, were collected using structured questionnaires face to face at each visit by trained data investigators. Age (in years), smoking status (never smoker, former smoker, current smoker), drinking status (current drinker or not), educational level (no education history, primary school, middle school, high school, college or above), monthly household income per capita (<300, 300–500, 500–800, 800–1200, 1200–2000, ≥2000 Chinese yuan [CNY]/month), and physical activity level (whether or not the ideal level was reached during the previous 12 months) were assessed with standardized questionnaires. The definition of ideal physical activity level was at least 150 min of moderate‐intensity physical activity or at least 75 min of vigorous‐intensity physical activity per week, which was recommended by World Health Organization.
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