The aim of this prospective cohort study is to collect the multi-omics profile of cardiovascular disease (CVD) high-risk individuals in Harbin, and to discover novel biomarker signatures of major adverse cardiovascular events (MACE) during a minimum 2-year follow-up period.

This is a single-center, observational, prospective cohort study. The primary endpoint is the incidence of MACE. Participants must meet at least two of the following criteria: hypertension, hyperglycemia, hyperlipidemia, or obesity. Baseline data and biological samples will be collected at enrollment, with clinical outcomes monitored for a minimum of two years. The study aims to enroll 10,000 participants aged 45 years and older from Harbin city, located in northeastern China.

Inclusion Criteria:

• 1.Residents of Harbin city, regardless of gender.
• 2.Meets at least two of the following conditions: diabetes, hypertension, hyperlipidemia, or obesity.
• 3.No history of cardiovascular or cerebrovascular diseases.
• 4.Willing to participate in the study and sign the informed consent form

Exclusion Criteria:

• 1.History of antibiotic or probiotic treatment within the past month.
• 2. Pregnant women.
• 3. History of autoimmune diseases or malignant tumors; severe heart, liver, or kidney dysfunction; or a history of severe cardiovascular or cerebrovascular diseases.
• 4. Any unstable condition or situation that may jeopardize patient safety or compliance.
• 5. Patients unable to provide informed consent due to physical reasons or unwilling to participate.

The study will enroll 10,000 participants aged 45 and above from Harbin, a city in northeastern China. To be eligible, participants must meet at least two of the following criteria: hypertension, hyperglycemia, hyperlipidemia, or obesity.