Association between balance ability and cardiovascular disease onsets among middle-aged and older adults: an observational cohort study from the China Health and Retirement Longitudinal Study

BackgroundPrevious studies showed the association between poor balance ability and a high risk of cardiovascular disease (CVD) mortality. However, there is little evidence regarding balance function and the onset of CVD. We aimed to examine the relationship between the balance ability and incident C...

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Main Authors: Yinghe Lin, Shanshan Zhong, Zhihua Sun
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-01-01
Series:Frontiers in Public Health
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Online Access:https://www.frontiersin.org/articles/10.3389/fpubh.2025.1436520/full
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author Yinghe Lin
Shanshan Zhong
Zhihua Sun
author_facet Yinghe Lin
Shanshan Zhong
Zhihua Sun
author_sort Yinghe Lin
collection DOAJ
description BackgroundPrevious studies showed the association between poor balance ability and a high risk of cardiovascular disease (CVD) mortality. However, there is little evidence regarding balance function and the onset of CVD. We aimed to examine the relationship between the balance ability and incident CVD risk.MethodsThis study retrospectively included participants (≥45 years) without CVD at baseline from the China Health and Retirement Longitudinal Study (CHARLS) in 2011 and those who were followed up in 2018. CHARLS used the semi-tandem stand test to assess balance ability. CVD was defined as the presence of physician-diagnosed heart disease and/or stroke. Cox proportional hazards models (considering competing risks) and stratification analysis were used to determine the association between balance ability and incident CVD risk.ResultsThe median age of the 10,154 participants was 57.0 (51.0, 64.0) years old, with 51.0% female. Compared to those with good balance ability, individuals with moderate balance ability had a higher risk of incident CVD [HR (95% CI): 1.15 (1.03–1.28)], and the risk was more pronounced in female (20.0%), rural residence (21.0%), never smoking (22.0%), never drinking (23.0%), hypertension (16.0%), without dyslipidemia (17.0%), and without kidney disease (13.0%) participants. After multiple imputations of metabolic biomarkers data, the results of sensitivity analyses were generally consistent.ConclusionLower balance ability was associated with an increased risk of incident CVD among middle-aged and older Chinese adults. The simple, economical, effective, and safe physical measurements of balance function deserve further investigation in public health.
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spelling doaj-art-43c0a420408748d78d3a22cbe1dc9ffe2025-01-24T05:21:21ZengFrontiers Media S.A.Frontiers in Public Health2296-25652025-01-011310.3389/fpubh.2025.14365201436520Association between balance ability and cardiovascular disease onsets among middle-aged and older adults: an observational cohort study from the China Health and Retirement Longitudinal StudyYinghe LinShanshan ZhongZhihua SunBackgroundPrevious studies showed the association between poor balance ability and a high risk of cardiovascular disease (CVD) mortality. However, there is little evidence regarding balance function and the onset of CVD. We aimed to examine the relationship between the balance ability and incident CVD risk.MethodsThis study retrospectively included participants (≥45 years) without CVD at baseline from the China Health and Retirement Longitudinal Study (CHARLS) in 2011 and those who were followed up in 2018. CHARLS used the semi-tandem stand test to assess balance ability. CVD was defined as the presence of physician-diagnosed heart disease and/or stroke. Cox proportional hazards models (considering competing risks) and stratification analysis were used to determine the association between balance ability and incident CVD risk.ResultsThe median age of the 10,154 participants was 57.0 (51.0, 64.0) years old, with 51.0% female. Compared to those with good balance ability, individuals with moderate balance ability had a higher risk of incident CVD [HR (95% CI): 1.15 (1.03–1.28)], and the risk was more pronounced in female (20.0%), rural residence (21.0%), never smoking (22.0%), never drinking (23.0%), hypertension (16.0%), without dyslipidemia (17.0%), and without kidney disease (13.0%) participants. After multiple imputations of metabolic biomarkers data, the results of sensitivity analyses were generally consistent.ConclusionLower balance ability was associated with an increased risk of incident CVD among middle-aged and older Chinese adults. The simple, economical, effective, and safe physical measurements of balance function deserve further investigation in public health.https://www.frontiersin.org/articles/10.3389/fpubh.2025.1436520/fullpostural balancepublic healthcardiovascular diseasesheart disease risk factorsstroke
spellingShingle Yinghe Lin
Shanshan Zhong
Zhihua Sun
Association between balance ability and cardiovascular disease onsets among middle-aged and older adults: an observational cohort study from the China Health and Retirement Longitudinal Study
Frontiers in Public Health
postural balance
public health
cardiovascular diseases
heart disease risk factors
stroke
title Association between balance ability and cardiovascular disease onsets among middle-aged and older adults: an observational cohort study from the China Health and Retirement Longitudinal Study
title_full Association between balance ability and cardiovascular disease onsets among middle-aged and older adults: an observational cohort study from the China Health and Retirement Longitudinal Study
title_fullStr Association between balance ability and cardiovascular disease onsets among middle-aged and older adults: an observational cohort study from the China Health and Retirement Longitudinal Study
title_full_unstemmed Association between balance ability and cardiovascular disease onsets among middle-aged and older adults: an observational cohort study from the China Health and Retirement Longitudinal Study
title_short Association between balance ability and cardiovascular disease onsets among middle-aged and older adults: an observational cohort study from the China Health and Retirement Longitudinal Study
title_sort association between balance ability and cardiovascular disease onsets among middle aged and older adults an observational cohort study from the china health and retirement longitudinal study
topic postural balance
public health
cardiovascular diseases
heart disease risk factors
stroke
url https://www.frontiersin.org/articles/10.3389/fpubh.2025.1436520/full
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AT shanshanzhong associationbetweenbalanceabilityandcardiovasculardiseaseonsetsamongmiddleagedandolderadultsanobservationalcohortstudyfromthechinahealthandretirementlongitudinalstudy
AT zhihuasun associationbetweenbalanceabilityandcardiovasculardiseaseonsetsamongmiddleagedandolderadultsanobservationalcohortstudyfromthechinahealthandretirementlongitudinalstudy