加拿大和美国中风死亡率的改善,1990年至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
概括
北美地区的叶酸强化降低了中风死亡率,1998年以后的下降速度加速. 这与英格兰和威尔士相反,在那里强化不是强制性的,这表明叶酸和减少中风死亡之间的联系.
科学领域:
- 公共卫生 公共卫生
- 营养流行病学 营养流行病学
- 预防心血管疾病 预防心血管疾病
背景情况:
- 1998年,谷物产品的叶酸强化在美国和加拿大实施.
- 这导致血中同型半氨酸度降低,这是潜在的中风风险因素.
研究的目的:
- 评估叶酸强化对中风死亡率趋势的影响.
- 为了比较具有强制性强化和没有强制性强化国家的趋势.
主要方法:
- 基于人口的队列研究,使用准实验性干预设计.
- 强化前后中风死亡率的细分日志线性回归分析.
- 美国/加拿大和英格兰/威尔士之间的比较 (没有强制性防御).
主要成果:
- 在美国,中风死亡率下降在加强后 (1998-2002) 加速,从每年-0.3%降至-2.9%.
- 加拿大也出现了类似的加速,从每年1.0%降至5.4%.
- 在同一时期,英格兰和威尔士的中风死亡率下降没有显著变化.
结论:
- 美国和加拿大的中风死亡率的加速减少与叶酸强化减少中风死亡的假设一致.
- 研究结果表明,叶酸强化是对心血管健康的重要公共卫生干预措施.
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