カナダと米国における脳卒中死亡率の改善,1990年から2002年
Quanhe Yang1, Lorenzo D Botto, J David Erickson
1National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA. qay0@cdc.gov
Circulation
|March 15, 2006
まとめ
北米では葉酸の強化により,脳卒中による死亡率が低下し,1998年以降は急激に減少した. これは,強化が義務付けられていないイングランドとウェールズとは対照的に,葉酸と脳卒中による死亡率の減少との関連を示唆しています.
科学分野:
- 公衆衛生は公衆衛生である.
- 栄養学的流行病学について
- 心血管疾患の予防 心血管疾患の予防
背景:
- 穀物製品の葉酸強化は,1998年までに米国とカナダで実施されました.
- これにより,脳卒中のリスク要因であるホモシステインの血中濃度が低下しました.
研究 の 目的:
- 葉酸強化が脳卒中死亡率の傾向に与える影響を評価する.
- 強制的な強化がある国とない国の傾向を比較する.
主な方法:
- 準実験的介入デザインを用いた人口ベースのコホート研究.
- 強化前と後の脳卒中死亡率のセグメントログ線形回帰分析.
- アメリカ/カナダとイングランド/ウェールズ (強制的な要塞化なし) の比較.
主要な成果:
- 米国では,脳卒中による死亡率の減少は,強化後の (1998年-2002年) 年間0.3%から-2.9%へと加速した.
- カナダも同様の加速を示し,年間 -1.0%から -5.4%に上昇した.
- イングランドとウェールズでは,同じ期間中,脳卒中による死亡率の減少に重大な変化はなかった.
結論:
- 米国とカナダにおける脳卒中の死亡率の加速的な減少は,葉酸強化が脳卒中の死亡率を減少させるという仮説と一致しています.
- 研究結果は,葉酸の強化が心臓血管の健康にとって重要な公衆衛生の介入であることを示唆しています.
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