心血管疾病死亡的世俗趋势:一个25年的社区研究
Yariv Gerber1, Steven J Jacobsen, Robert L Frye
1Division of Cardiovascular Diseases, Mayo Clinic College of Medicine, Rochester, MN, USA.
Circulation
|May 10, 2006
概括
心血管疾病 (CVD) 死亡率显著下降,但改善在人口统计和死亡地点之间不均. 需要针对老年人和妇女制定有针对性的战略,以进一步减少心血管疾病死亡率.
科学领域:
- 流行病学 流行病学
- 公共卫生 公共卫生
- 心血管医学 心血管医学
背景情况:
- 年龄调整的心血管疾病 (CVD) 死亡率有所下降.
- 关于心血管疾病死亡趋势在死亡地点,疾病类别,年龄和性别之间的差异仍然存在重大问题.
研究的目的:
- 研究明尼苏达州奥姆斯特德县从1979年到2003年的心血管疾病死亡率趋势.
- 分析不同死亡地点,疾病类别,年龄组和性别的CVD死亡率下降差异.
主要方法:
- 对6378名死于心血管疾病的居民的人口统计数据,死亡原因和死亡地点的分析.
- 根据美国心脏协会标准对死亡进行分类:冠心病 (CHD),非CHD心脏病和非心脏循环疾病.
- 检查医院外死亡与医院内死亡的趋势,以及跨年龄和性别群体的差异.
主要成果:
- 虽然年龄调整后心血管疾病死亡率整体下降,但下降的幅度有显著差异.
- 与住院死亡 (4.8%) 相比,医院外死亡 (1.8%) 的年均下降幅度较小.
- 老年人 (≥85岁) 和妇女的心血管疾病死亡率相比,相应地较年轻人和男性的死亡率下降较小.
- 冠状动脉心脏病 (CHD) 每年显著下降 (3.3%),而非冠状动脉心脏病 (2.1%) 和非心脏循环疾病 (2.4%) 则有较为温和的下降.
结论:
- 25年来,心血管疾病死亡率在该社区显著下降,但存在很大的差异.
- 这种下降导致了对非医院和非心血管疾病死亡的转变.
- 未来降低心血管疾病死亡率需要针对老年人和妇女制定有针对性的策略,特别是应对改善程度极小的非医院死亡.
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