Tai Hing Lam

The University of Hong Kong, Hong Kong, Hong Kong

Are you Tai Hing Lam?

Claim your profile

Publications (560)2386.02 Total impact

  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: The numbers of women smoking have risen 72.5% since 1990 with the increasing population - from 56,100 to 96,800 in 2012, reflecting an alarming situation in Hong Kong. The study aimed to describe the smoking behaviour, attitudes and associated factors among women in Hong Kong. A qualitative cross-sectional study involving semi-structured interview was conducted with Chinese women from five community centres in different districts in Hong Kong in 2010. A purposive sample of 73 female participants (24 current smokers, 20 ex-smokers and 29 never-smokers) were recruited. The 73 women were classified by their smoking status and age to form 15 focus groups. Most informants knew about the general health hazards of smoking, such as cancer and heart or respiratory diseases, but not about the female-specific health consequences of smoking. A few smokers considered smoking to be a weight control strategy, fearing a gain in weight if they gave up. Moreover, a few relied on smoking as a coping strategy to relieve negative emotions and stress. Additionally, a few smokers had misconceptions about giving up: that a loss of concentration would result, that continued smoking would not further affect their health as they had become desensitised to the chemicals in tobacco smoke or that quitting would harm their health. This study generates new knowledge about the behavior, attitudes, and experiences related to smoking of current female smokers, ex-smokers and non-smokers in Hong Kong, which is unique as a Chinese but highly westernized community but with a very low female smoking prevalence.
    BMC Public Health 12/2015; 15(1):1529. DOI:10.1186/s12889-015-1529-4 · 2.32 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: The prevalence and correlates of hardcore smokers, who have high daily cigarette consumption, no quitting history and no intention to quit, have been studied in several western developed countries, but no previous trials of smoking cessation have tested intervention effectiveness for these smokers. The current study examined if hardcore smokers can benefit from smoking reduction intervention to achieve cessation, and explored the underlying reasons. A posteriori analysis was conducted on data from a randomized controlled trial of smoking reduction intervention on 1,154 smokers who did not want to quit. Odds ratios of 7-day point prevalence of abstinence, smoking reduction by at least 50% and quit attempt at the 6-month follow-up comparing subgroups of smokers were analyzed. In hardcore smokers, the odds ratio comparing the quit rate between the intervention and control group was 4.18 (95% CI: 0.51-34.65), which was greater than non-hardcore smokers (OR = 1.58, 95% CI: 0.98-2.54). The number needed to treat for hardcore and non-hardcore smokers was 8.33 (95% CI: 5.56-16.67) and 16.67 (95% CI: 8.33-233.64), respectively. In smokers who did not have quit attempt experience and those who smoked more than 15 cigarettes daily, the odds ratio comparing intervention and control group was 3.29 (95% CI: 0.72-14.98) and 1.36 (95% CI: 0.78-2.36), respectively. The a posteriori analysis provided pilot results that smoking reduction intervention may be effective to help hardcore smokers to quit and reduce smoking. Having no previous quit attempt was identified as more important than having large cigarette consumption in explaining the greater effectiveness of the intervention.
    Tobacco Induced Diseases 04/2015; 13(1):9. DOI:10.1186/s12971-015-0034-y · 1.50 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Parental alcohol-related practices are important risk factors of adolescent drinking, but little is known about the factors associated with these parental pro-drinking practices (PPDPs). We investigated the correlates of 9 PPDPs in drinking parents of adolescents in Hong Kong. A total of 2200 students (age 14.8±2.0; boys 63.2%) participated in a school-based cross-sectional survey in 2012. Analysis was restricted to 1087 (61.8%) students with at least 1 drinking parent as PPDPs were much more common in these families. Logistic regression was used to identify correlates of each PPDP. Among 1087 students, the prevalence of PPDPs ranged from 8.2% for training drinking capacity to 65.7% for seeing parents drink. Only 14.8% of students had not experienced any of these practices. More frequent maternal drinking predicted parental training of drinking capacity. Older age predicted helping parents buy alcohol and parental encouragement of drinking. Adolescent girls were more likely to have received parental training of drinking capacity than boys. Higher perceived family affluence was associated with hearing parents saying benefits of drinking, and helping parents open bottle and pour alcohol. PPDPs were associated with parental drinking frequency and various socio-demographic factors. These results have implications on alcohol control programmes involving parents to tailor messages for reducing PPDPs based on the characteristics of adolescents and parents.
    PLoS ONE 03/2015; 10(3):e0119554. DOI:10.1371/journal.pone.0119554 · 3.53 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Weight change predicted diseases and mortality. We investigate 3-year changes in individual body mass index (BMI) and waist circumference in Hong Kong Chinese adults. In the Population Health Survey, 7084 adults in 2003 (baseline) were followed up in 2006. Longitudinal anthropometric data were available in 2941 (41.5%) for BMI and 2956 for waist circumference. Weight status and central obesity were based on objectively measured BMI and waist circumference using Asian standards. Mean BMI (SD) increased from 22.8 (3.62) to 23.1 (3.95) (p<0.001) with 1.3 percentage point increase in prevalence of overweight and obesity (from 44.3% to 45.6%). One in 5 (22.0%) normal or underweight baseline respondents became overweight or obese and a similar proportion (24.8%) of overweight and obese respondents became normal or underweight. Prevalence of central obesity increased from 28.3% to 32.4% (p<0.001) with a non-significantly greater increase in women (30.0% to 38.1%) than men (23.0% to 26.1%) (p=0.63). A higher proportion of centrally obese respondents returned to normal (29.4%) than normal respondents developing central obesity (17.4%). This is one of the few studies in Chinese, which found dynamic longitudinal changes (increase/stable/decrease) in individual weight status and waist circumference. Future studies with better follow-up and investigating the causes of such changes are warranted.
    PLoS ONE 03/2015; 10(3):e0119827. DOI:10.1371/journal.pone.0119827 · 3.53 Impact Factor
  • Public Health 03/2015; DOI:10.1016/j.puhe.2015.01.019 · 1.48 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: In Western countries, lower socioeconomic status is associated with a higher risk of cardiovascular disease (CVD) and premature mortality. These associations may plausibly differ in Asian populations, but data are scarce and direct comparisons between the two regions are lacking. We, thus, aimed to compare such associations between Asian and Western populations in a large collaborative study, using the highest level of education attained as our measure of social status. Cohort studies in general populations conducted in Asia or Australasia. 303 036 people (71% from Asia) from 24 studies in the Asia Pacific Cohort Studies Collaboration. Studies had to have a prospective cohort study design, have accumulated at least 5000 person-years of follow-up, recorded date of birth (or age), sex and blood pressure at baseline and date of, or age at, death during follow-up. We used Cox regression models to estimate relationships between educational attainment and CVD (fatal or non-fatal), as well as all-cause, cardiovascular and cancer mortality. During more than two million person-years of follow-up, 11 065 deaths (3655 from CVD and 4313 from cancer) and 1809 CVD non-fatal events were recorded. Adjusting for classical CVD risk factors and alcohol drinking, hazard ratios (95% CIs) for primary relative to tertiary education in Asia (Australasia) were 1.81 (1.38, 2.36) (1.10 (0.99, 1.22)) for all-cause mortality, 2.47(1.47, 4.17) (1.24 (1.02, 1.51)) for CVD mortality, 1.66 (1.00, 2.78) (1.01 (0.87, 1.17)) for cancer mortality and 2.09 (1.34, 3.26) (1.23 (1.04, 1.46)) for all CVD. Lower educational attainment is associated with a higher risk of CVD or premature mortality in Asia, to a degree exceeding that in the Western populations of Australasia. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.
    BMJ Open 03/2015; 5(3):e006408. DOI:10.1136/bmjopen-2014-006408 · 2.06 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: The FAMILY Cohort is a longitudinal study of health, happiness and family harmony (the '3Hs') at individual, household and neighbourhood levels in Hong Kong. Using a family living in the same household as the sampling unit, the study (n = 20 279 households and 46 001 participants) consists of a composite sample from several sources, including: a population-representative random core sample (n = 8115 households and 19 533 participants); the first-degree relatives of this sample (n = 4658 households and 11 063 participants); and oversampling in three new towns (n = 2891 households and 7645 participants) and in three population subgroups with anticipated changes in family dynamics (n = 909 households and 2160 participants). Two household visits and five telephone- or web-based follow-ups were conducted over 2009-14. Data collected include socio-demographics, anthropometrics, lifestyle and behavioural factors, measures of social capital, and standardized instruments assessing the 3Hs. We also intend to collect biomaterials in future. The analytical plan includes multilevel inter-relations of the 3Hs for individuals, households, extended families and neighbourhoods. With Hong Kong's recent history of socioeconomic development, the FAMILY Cohort is therefore relevant to global urban populations currently experiencing similarly rapid economic growth. The FAMILY Cohort is currently set up as a supported access resource. © The Author 2015; all rights reserved. Published by Oxford University Press on behalf of the International Epidemiological Association.
    International Journal of Epidemiology 01/2015; DOI:10.1093/ije/dyu257 · 9.20 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Estimates of illicit cigarette consumption are limited and the data obtained from studies funded by the tobacco industry have a tendency to inflate them. This study aimed to validate an industry-funded estimate of 35.9% for Hong Kong using a framework taken from an industry-funded report, but with more transparent data sources. Illicit cigarette consumption was estimated as the difference between total cigarette consumption and the sum of legal domestic sales and legal personal imports (duty-free consumption). Reliable data from government reports and scientifically valid routine sources were used to estimate the total cigarette consumption by Hong Kong smokers and legal domestic sales in Hong Kong. Consumption by visitors and legal duty-free consumption by Hong Kong passengers were estimated under three scenarios for the assumptions to examine the uncertainty around the estimate. A two-way sensitivity analysis was conducted using different levels of possible undeclared smoking and under-reporting of self-reported daily consumption. Illicit cigarette consumption was estimated to be about 8.2-15.4% of the total cigarette consumption in Hong Kong in 2012 with a midpoint estimate of 11.9%, as compared with the industry-funded estimate of 35.9% of cigarette consumption. The industry-funded estimate was inflated by 133-337% of the probable true value. Only with significant levels of under-reporting of daily cigarette consumption and undeclared smoking could we approximate the value reported in the industry-funded study. The industry-funded estimate inflates the likely levels of illicit cigarette consumption. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.
    Tobacco Control 01/2015; DOI:10.1136/tobaccocontrol-2014-051937 · 5.15 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: QT interval prolongation, a predictor of cardiac arrhythmias, and elevated heart rate are associated with higher risk of cardiovascular mortality. Observationally testosterone is associated with shorter corrected QT interval and slower heart rate; however, the evidence is open to residual confounding and reverse causality. We examined the association of testosterone with electrocardiogram (ECG) parameters using a separate-sample instrumental variable (SSIV) estimator. To minimize reverse causality, a genetic score predicting testosterone was developed in 289 young Chinese men from Hong Kong, based on a parsimonious set of single nuclear polymorphisms (rs10046, rs1008805 and rs1256031). Linear regression was used to examine the association of genetically predicted testosterone with QT interval, corrected QT interval [using the Framingham formula (QTf) and Bazett formula (QTb)] and heart rate in 4212 older (50+ years) Chinese men from the Guangzhou Biobank Cohort Study. Predicted testosterone was not associated with QT interval [-0.08 ms per nmol/l testosterone, 95% confidence interval (CI) -0.81 to 0.65], QTf interval (0.40 ms per nmol/l testosterone, 95% CI -0.12 to 0.93) or heart rate (0.26 beats per minute per nmol/l testosterone, 95% CI -0.04 to 0.56), but was associated with longer QTb interval (0.66 ms per nmol/l testosterone, 95% CI 0.02 to 1.31). Our findings do not corroborate observed protective associations of testosterone with QT interval or heart rate among men, but potentially suggest effects in the other direction. Replication in a larger sample is required. © The Author 2014; all rights reserved. Published by Oxford University Press on behalf of the International Epidemiological Association.
  • [Show abstract] [Hide abstract]
    ABSTRACT: Previous cross-sectional studies showed that short or long sleep duration was associated with memory impairment (MI), but longitudinal studies are scarce. We examined whether sleep duration was associated with memory decline or development of MI.
    Sleep 10/2014; DOI:10.5665/sleep.4162 · 5.06 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Aims: We investigated the prevalence of various parental pro-drinking practices and its association with parental drinking status. Methods: A school-based survey was completed by 2200 students (mean age 14.8, SD 2.0; boys 51.4%) from 4 randomly selected secondary schools in Hong Kong. Students reported whether they had ever experienced each of nine parental pro-drinking practices (PPDPs). Results: Overall, 67.5% of students reported at least one PPDP, but the prevalence was much higher if both parents were drinkers (89.0%) compared with non-drinkers (38.8%). The adjusted odds ratio (AOR) (95% CI) of experiencing at least one PPDP was 6.79 (4.98, 9.26) if either parent drank and 15.71 (10.50, 23.50) if both drank compared with none (P for trend <0.001). Compared with non-drinking, the AORs (95% CI) of experiencing at least one PPDP for occasional drinking and frequent drinking were 6.72 (5.03, 8.98) and 18.11 (9.88, 33.18) in fathers (P for trend <0.001), and 7.33 (5.15, 10.44) and 5.33 (1.98, 14.45) in mothers. Conclusion: The prevalence of PPDPs was generally low in non-drinking parents, but increased dramatically with the number of drinking parents and the frequency of paternal drinking.
    Alcohol and alcoholism (Oxford, Oxfordshire). Supplement 10/2014; 49(6). DOI:10.1093/alcalc/agu063
  • [Show abstract] [Hide abstract]
    ABSTRACT: AimsDiabetes rates are high in Asia despite relatively low rates of obesity, which might be related to lower muscle mass. Muscle mass plays an important role in glucose metabolism. Peak muscle mass is obtained in late adolescence. We tested the hypothesis that pubertal testosterone is negatively associated with glucose metabolism mediated by muscle mass.Methods Participants aged 15 years (278 boys and 223 girls) were recruited from the Hong Kong's ‘Children of 1997’ birth cohort in 2012. Multivariable linear regression with multiple imputation and inverse probability weighting was used to examine the adjusted associations of pubertal testosterone with skeletal muscle index, body fat percentage, fasting glucose, insulin and homeostasis model of assessment – insulin resistance.ResultsTotal testosterone was negatively associated with fasting glucose (–0.008, 95% confidence interval –0.015 to –0.002), insulin (–0.43, 95% confidence interval –0.56 to –0.30) and insulin and homeostasis model of assessment – insulin resistance (–0.089, 95% confidence interval –0.12 to –0.062) adjusted for sex, birth weight, highest parental education, mother's place of birth and physical activity. These associations were attenuated by additional adjustment for skeletal mass index or body fat percentage.Conclusions Adolescent glucose metabolism may be influenced by testosterone, perhaps partially via skeletal muscle mass.This article is protected by copyright. All rights reserved.
    Diabetic Medicine 10/2014; 32(4). DOI:10.1111/dme.12602 · 3.06 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Background and AimsLarge cohort studies on smoking and mortality in older people are scarce and few studies examined smokers aged 85+ years separately. We estimated the risks of all-cause and cause specific mortality due to smoking in an elderly Chinese cohort in Hong Kong.DesignA population-based prospective cohort of 65,510 Chinese enrolled from 1998 to 2001 and followed until May 2012.SettingAll 18 Elderly Health Service centres in Hong Kong, China.ParticipantsOlder people aged 65+ yearsMeasurementsSelf-reported smoking status was assessed at baseline interview and categorized as never, former and current smokers.FindingsCompared with never smokers, after adjustment for sex, age, education, social security assistance, housing type, monthly expenditure, alcohol use, depressive symptoms and health status, the hazards ratio (HR) for current smokers was 1.89 (95% confidence interval (CI) 1.81-1.98) for all participants aged 65+ years at baseline, corresponding to an attributable fraction (AF) of about 50%, which is based on AF = (HR-1)/HR. As the effect of smoking varied with age (P for age interaction <0.001), subgroup analysis by age group showed that the adjusted HR for current smokers aged 65-84 years was 1.93 (1.84-2.03), and for 85+ years was 1.29 (1.05-1.58). All the risk estimates did not vary by sex (P for sex interaction ranged 0.74-0.89).Conclusions In Hong Kong, the risk of death from smoking appears to be the same for Chinese women as it is for men. Half of all deaths in Chinese smokers aged 65 years and over and a quarter of all deaths in Chinese smokers aged 85 years and over are caused by smoking-attributable diseases.
    Addiction 10/2014; 110(3). DOI:10.1111/add.12776 · 4.60 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Inequalities in Internet use and health information seeking are well documented, but less is known about information for family life activities.
    Journal of Medical Internet Research 10/2014; 16(10):e227. DOI:10.2196/jmir.3386 · 4.67 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: To recalibrate and modify the Framingham diabetes mellitus (DM) function and establish a simple point score for predicting near-term incident diabetes in a large sample of Chinese.
    Preventive Medicine 09/2014; 69. DOI:10.1016/j.ypmed.2014.09.004 · 2.93 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Objectives: The causal role of some cardiovascular risk factors, such as HDL cholesterol, has been increasingly challenged and attention is returning to all elements of Virchow's triad, i. e., hypercoagulability (including viscosity) as well as endothelial function and blood flow. We examined the life course origins of coagulability. Methods: We used multivariable linear regression to assess whether childhood influences, proxied by height and its components, were associated with hematocrit (Hct), hemoglobin (HGB), and other hematological parameters in 28,595 older Chinese adults (mean age=61.8 years) from the Guangzhou Biobank Cohort Study. Results: Adjusted for age, sex, and recruitment phase, leg length was negatively associated with platelets (PLT) (-0.83 x 10(9) /l per centimeter (cm), 95% confidence interval (CI) -1.01 to -0.65). Sitting height and height were positively associated with Hct (0.05% per cm, 95% CI 0.04-0.07 for sitting height; 0.02% per cm, 95% CI 0.01-0.02 for height), HGB (0.21 g/l per cm, 95% CI 0.17-0.25; 0.07 g/l per cm, 95% CI 0.04-0.09) and negatively associated with PLT (-1.2 x 10(9) /l per cm, 95% CI -1.4 to -1.0; -0.83 x 10(9) /l per cm, 95% CI -0.95 to -0.70). Further adjustment for potential confounders did little to change the estimates. Conclusions: For the first time we provide anthropometric evidence for the different roles of prepubertal and pubertal influences in relation to Hct and HGB. Whether factors that promote leg growth but reduce growth of sitting height may help to prevent cardiovascular events, via effects on hypercoagulability or viscosity, overall or in specific subgroups, remains to be determined. (C) 2014Wiley Periodicals, Inc.
    American Journal of Human Biology 09/2014; 26(5). DOI:10.1002/ajhb.22568 · 1.93 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Background Adolescent smoking has been associated with general parenting style, although potential differences between fathers and mothers were seldom investigated, especially in non-Western populations. Purpose The aim of this study is to investigate associations between Hong Kong adolescents’ smoking and their perceptions of paternal and maternal parenting styles. Method In a school-based survey in 2006-2007, 33,408 adolescents (44.6 % boys; mean age 14.5 ± 1.3 years) provided information on smoking and the frequency of care and control by each parent, who was classified into one of four adolescent-reported parenting styles: authoritative (high care, high control), authoritarian (low care, high control), permissive (high care, low control), or neglectful (low care, low control). Logistic regression was used to calculate adjusted odds ratios (AORs) of current smoking (past 30 days) for parenting variables, considering potential effect modification by age, sex and parental smoking. Results Maternal care and control were strongly and significantly associated with lower odds of adolescent current smoking. However, such association was weak for paternal care and observed only in girls. Conversely, paternal control was positively associated with current smoking, especially if the father smoked. The lowest AORs of current smoking were associated with authoritative mothers, permissive fathers and combinations of maternal and paternal parenting styles with an authoritative mother whether or not the father was authoritative. Conclusion Maternal care, control and authoritative parenting were associated with lower odds of adolescent smoking in Hong Kong. Paternal care was only weakly associated with lower odds of adolescent smoking, and paternal control was even associated with higher odds of smoking.
    International Journal of Behavioral Medicine 09/2014; 22(2). DOI:10.1007/s12529-014-9436-0 · 2.63 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Background: Smokefree legislation may protect children from secondhand smoke (SHS) in the home from smoking parent(s). We examined the effect of the 2007 smokefree legislation on children's exposure to SHS in the home and maternal action to protect children from SHS exposure in Hong Kong. Methods: Families with a smoking father and a non-smoking mother were recruited from public clinics before (2005-2006, n = 333) and after the legislation (2007-2008, n = 742) which led to a major extension of smokefree places in Hong Kong. Main outcomes included children's SHS exposure in the home, nicotine level in mothers' and children's hair and home environment, mothers' action to protect children from SHS, and their support to the fathers to quit. Results: Fewer mothers post-legislation reported children's SHS exposure in the home (87.2% versus 29.3%, p<0.01), which was consistent with their hair nicotine levels (0.36ng/mg versus 0.04ng/mg, p<0.01). More mothers post-legislation in the last month took their children away from cigarette smoke (6.3% versus 92.2%; p<0.01) and advised fathers to quit over 3 times (8.3% versus 33.8%; p<0.01). No significant change was found in the content of smoking cessation advice and the proportion of mothers who took specific action to support the fathers to quit. Conclusions: SHS exposure in the home decreased and maternal action to protect children from SHS increased after the 2007 smokefree legislation. Maternal support to fathers to quit showed moderate improvement. Cessation services for smokers and specific interventions for smoking families should be expanded together with smokefree legislation.
    PLoS ONE 08/2014; 9(8):e105781. DOI:10.1371/journal.pone.0105781 · 3.53 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: BACKGROUND: High blood pressure, blood glucose, serum cholesterol, and BMI are risk factors for cardiovascular diseases and some of these factors also increase the risk of chronic kidney disease and diabetes. We estimated mortality from cardiovascular diseases, chronic kidney disease, and diabetes that was attributable to these four cardiometabolic risk factors for all countries and regions from 1980 to 2010. METHODS: We used data for exposure to risk factors by country, age group, and sex from pooled analyses of population-based health surveys. We obtained relative risks for the effects of risk factors on cause-specific mortality from meta-analyses of large prospective studies. We calculated the population attributable fractions for each risk factor alone, and for the combination of all risk factors, accounting for multicausality and for mediation of the effects of BMI by the other three risks. We calculated attributable deaths by multiplying the cause-specific population attributable fractions by the number of disease-specific deaths. We obtained cause-specific mortality from the Global Burden of Diseases, Injuries, and Risk Factors 2010 Study. We propagated the uncertainties of all the inputs to the final estimates. FINDINGS: In 2010, high blood pressure was the leading risk factor for deaths due to cardiovascular diseases, chronic kidney disease, and diabetes in every region, causing more than 40% of worldwide deaths from these diseases; high BMI and glucose were each responsible for about 15% of deaths, and high cholesterol for more than 10%. After accounting for multicausality, 63% (10·8 million deaths, 95% CI 10·1-11·5) of deaths from these diseases in 2010 were attributable to the combined effect of these four metabolic risk factors, compared with 67% (7·1 million deaths, 6·6-7·6) in 1980. The mortality burden of high BMI and glucose nearly doubled from 1980 to 2010. At the country level, age-standardised death rates from these diseases attributable to the combined effects of these four risk factors surpassed 925 deaths per 100 000 for men in Belarus, Kazakhstan, and Mongolia, but were less than 130 deaths per 100 000 for women and less than 200 for men in some high-income countries including Australia, Canada, France, Japan, the Netherlands, Singapore, South Korea, and Spain. INTERPRETATION: The salient features of the cardiometabolic disease and risk factor epidemic at the beginning of the 21st century are high blood pressure and an increasing effect of obesity and diabetes. The mortality burden of cardiometabolic risk factors has shifted from high-income to low-income and middle-income countries. Lowering cardiometabolic risks through dietary, behavioural, and pharmacological interventions should be a part of the global response to non-communicable diseases.

Publication Stats

9k Citations
2,386.02 Total Impact Points

Institutions

  • 1982–2015
    • The University of Hong Kong
      • • School of Public Health
      • • Department of Community Medicine
      Hong Kong, Hong Kong
  • 2014
    • University of Queensland
      • School of Population Health
      Brisbane, Queensland, Australia
  • 2013
    • City University of Hong Kong
      Chiu-lung, Kowloon City, Hong Kong
  • 2012
    • University of Ottawa
      Ottawa, Ontario, Canada
  • 2006–2012
    • University of Birmingham
      • Department of Public Health, Epidemiology and Biostatistics
      Birmingham, ENG, United Kingdom
  • 2003–2010
    • Queen Mary Hospital
      Hong Kong, Hong Kong
    • Isfahan University of Medical Sciences
      • Epidemiology and Biostatistics Department
      Isfahan, Ostān-e Eşfahān, Iran
  • 2008–2009
    • Hong Kong SAR Government
      Hong Kong, Hong Kong
  • 2006–2007
    • The George Institute for Global Health
      • Renal and Metabolic Division
      Sydney, New South Wales, Australia
  • 2005–2007
    • Yonsei University
      Sŏul, Seoul, South Korea
    • University of Oxford
      Oxford, England, United Kingdom
  • 2004–2007
    • University of Sydney
      • George Institute for Global Health
      Sydney, New South Wales, Australia
  • 1998–2007
    • The Chinese University of Hong Kong
      • Department of Medicine and Therapeutics
      Hong Kong, Hong Kong
    • The University of Sheffield
      Sheffield, England, United Kingdom
  • 2000–2002
    • The University of Hong Kong - Shenzen Hospital
      Hong Kong, Hong Kong
    • Chongqing University of Medical Science
      Ch’ung-ch’ing-shih, Chongqing Shi, China
  • 2001
    • The Hong Kong Polytechnic University
      • Department of Rehabilitation Sciences
      Hong Kong, Hong Kong
  • 1989
    • Kwong Wah Hospital
      Hong Kong, Hong Kong
    • Christian Hospital
      Saint Louis, Michigan, United States
  • 1987
    • Queen Elizabeth Hospital
      Hong Kong, Hong Kong