コミュニティベースの集団における心不全の発生率と生存率の傾向
Véronique L Roger1, Susan A Weston, Margaret M Redfield
1Division of Cardiovascular Diseases and Internal Medicine, Department of Health Sciences Research, Mayo Clinic and Foundation, Rochester, Minn 55095, USA. roger.veronique@mayo.edu
JAMA
|July 22, 2004
まとめ
心不全の発生率は安定しているが,生存率は全体的に改善している. しかし,生存率は女性や高齢者ではそれほど顕著ではないため,性および年齢の差異が心不全のアウトカムに顕著である.
科学分野:
- 心臓病学 心臓病学
- エピデミオロジー エピデミオロジー
- 公衆衛生は公衆衛生である.
背景:
- 心不全 (HF) の流行は,コミュニティの集団における発生率,生存率,および性別特異的な傾向に関する限られたデータで,さらなる調査を必要とします.
- 心不全の発生率と生存における時間的な傾向を理解することは,公衆衛生戦略と資源配置にとって極めて重要です.
研究 の 目的:
- 心不全 (HF) の発生率と生存率の時間的傾向を調査する.
- 心不全の発生率と時間経過における生存率における性別の違いを検証する.
- 性別によって異なる傾向で,HFの発生率が低下し,生存率が改善したという仮説を検証する.
主な方法:
- ミネソタ州オルムステッド郡のロチェスター疫学プロジェクトを利用した人口ベースのコホート研究.
- 1979年から2000年の間に心不全と診断されたオルムステッド郡の住民4,537人を含む.
- フレミングハムおよび臨床基準を用いた心不全診断の検証.
主要な成果:
- 心不全の発生率は,女性 (289/100,000) よりも男性 (378/100,000) により高く,時間の経過とともに変化を示さなかった.
- 心不全の診断後の全生存率は,1979年から1984年 (43%) から1996年から2000年 (52%) まで大幅に改善しました.
- 男性や若い個人は,女性や高齢者と比較して,生存率の改善が大きいことを経験しました.
結論:
- このコミュニティベースのコホートでは,心不全の発生率は20年以上にわたって減少していない.
- 心不全の診断後の生存率は全体的に増加しているが,顕著な格差がある.
- 女性と高齢者は,男性と若い集団と比較して生存率の改善が少ないことを示しました.
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