Background: Cardiovascular health (CVH) metrics among Chinese older adults are poorly understood. We investigated gender disparities in CVH metrics and their management among rural-dwelling older adults in China.Methods: This community-based study included 5026 participants (age ≥65 years; 57.2% women) in the baseline survey of a multimodal intervention study in rural China. Data were collected through face-to-face interviews, clinical examinations, and laboratory tests in March-September 2018.

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... We defined six CVH metrics (three behavioral factors—smoking, body mass index, and physical activity; three biological factors—blood pressure, total cholesterol, and blood glucose) following the modified American Heart Association's recommendations. We performed descriptive analysis separately for men and women.Results: Of all participants, only 0.8% achieved ideal levels in all six CVH metrics. Men were more likely than women to have ideal levels in all CVH metrics but smoking. Women had higher prevalence of ideal global CVH metrics (9.7% in women vs. 7.8% in men) and behavioral CVH metrics (18.3% vs. 9.5%) (p<0.001), whereas men had higher prevalence of ideal biological CVH metrics (5.4% in men vs. 3.5% in women, p<0.001). The prevalence of ideal global and behavioral CVH metrics increased with age in both women and men (p for trend<0.001). Women were more likely to be aware of their hypertension and diabetes, and to receive antihypertensive treatment, while men were more likely to achieve the goal of high cholesterol treatment (p<0.05).Conclusions: The CVH metrics among older adults living in the rural communities in China are characterized by an extremely low proportion of optimal global CVH metrics and distinct gender differences, alongside poor management of major biological risk factors.Trial registration: ChiCTR1800017758.