脳卒中と心不全性疾患の相対的な負担における世界的な変動
Anthony S Kim1, S Claiborne Johnston
1Department of Neurology, University of California, San Francisco, CA 94143-0114, USA. akim@ucsf.edu
Circulation
|July 7, 2011
まとめ
世界的な脳卒中と心不全性疾患 (IHD) の負担は著しく異なります. 低所得国は,不釣り合いの高い脳卒中負担に直面しており,これらの血管疾患に合わせた介入が必要であることを示唆しています.
科学分野:
- グローバル・ヘルス グローバル・ヘルス
- エピデミオロジー エピデミオロジー
- 心血管疾患の研究について
背景:
- 脳卒中と不全性心臓病 (IHD) はリスク要因を共有していますが,その世界的な負担の変動はよく理解されていません.
- これらの違いを理解することは,公衆衛生戦略にとって極めて重要です.
研究 の 目的:
- 脳卒中とIHDの死亡率および障害調整寿命年 (DALY) 損失率における世界的な変動を分析する.
- 国民所得と血管疾患のリスク因子の関連性を,脳卒中とIHDの相対的な負担と調査する.
主な方法:
- 死亡率とDALYsに関する世界保健機関疾病負荷プログラムデータを活用した.
- 192か国からのデータでトレンド分析のための線形回帰とCuzickテストを使用した.
- 組み込まれた世界銀行の国民所得データと血管疾患リスク因子推定.
主要な成果:
- 脳卒中による死亡率は,39%の国でIHD率,32%の国でDALY損失率を超えた.
- 脳卒中の負担は中国,アフリカ,南米で高く,IHDの負担は中東,北米,オーストラリア,ヨーロッパで高かった.
- 国民所得の低下は,より高い相対性脳卒中死亡率とDALY損失 (P<0.001) と相関する.
- 糖尿病と高コレステロールは,国民所得に関係なく,より大きなIHD負担と関連していました.
結論:
- 脳卒中とIHDの相対的な公衆衛生上の負担において,世界的な格差が顕著である.
- 低所得国における脳卒中の高い負担は,特定で標的を絞った公衆衛生介入の必要性を示している.
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