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美国成年人糖尿病和心脏病死亡率下降
1National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, MD 20892, USA.
JAMA
|April 20, 1999
概括
与一般人群不同的是,糖尿病男性的心脏病死亡率下降较小,糖尿病女性的死亡率增加. 这些趋势表明,心血管疾病干预措施对糖尿病患者,尤其是女性来说效果较差.
科学领域:
- 心血管流行病学心血管流行病学
- 糖尿病研究研究 糖尿病研究
- 公共卫生 公共卫生
背景情况:
- 在过去的30年里,冠心病死亡率在美国显著下降.
- 目前尚不清楚这种下降是否延伸到糖尿病患者身上.
研究的目的:
- 为了比较所有原因,心脏病和缺血性心脏病的死亡率趋势,在患有和没有糖尿病的成年人中.
- 分析两个不同的队列之间的死亡率的时间趋势.
主要方法:
- 利用了来自国家健康和营养检查调查 (NHANES I) 和其后续调查的数据.
- 1971-1975年和1982-1984年的队列的死亡率 (每1000人年) 的比较.
- 对死亡率的预期随访平均为8-9年.
主要成果:
- 没有糖尿病的男性心脏病死亡率下降了36.4%,而糖尿病男性的死亡率仅下降了13.1%.
- 非糖尿病女性的死亡率下降了27%,而糖尿病女性的心脏病死亡率增加了23%.
- 对于全因和缺血性心脏病死亡率观察到类似的模式.
结论:
- 在一般人群中观察到的心脏病死亡率的减少,对于糖尿病患者来说可能不那么有效.
- 降低心血管风险因素和改善治疗方法似乎对糖尿病患者群体,特别是女性,的益处较小.
- 需要进一步的研究来了解和解决糖尿病患者心血管结果的差异.
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