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ORIGINAL RESEARCH article

Front. Public Health
Sec. Aging and Public Health
Volume 13 - 2025 | doi: 10.3389/fpubh.2025.1436520
This article is part of the Research Topic Re-visiting Risk Factors for Cardiometabolic Diseases: Towards a New Epidemiological Frontier View all 14 articles

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

Provisionally accepted
Yinghe Lin Yinghe Lin *Shanshan Zhong Shanshan Zhong Zhihua Sun Zhihua Sun
  • Department of Endocrinology, The Affiliated Panyu Central Hospital of Guangzhou Medical University, Guangzhou, China

The final, formatted version of the article will be published soon.

    Background: Previous 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. Methods: This 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. Results: The median age of the 10154 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. Conclusion: Lower 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.

    Keywords: Postural Balance, Public Health, Cardiovascular Diseases, Heart disease risk factors, Stroke

    Received: 22 May 2024; Accepted: 13 Jan 2025.

    Copyright: © 2025 Lin, Zhong and Sun. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Yinghe Lin, Department of Endocrinology, The Affiliated Panyu Central Hospital of Guangzhou Medical University, Guangzhou, China

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.