脑卒中和缺血性心脏病的相对负担的全球变化
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
概括
全球中风和缺血性心脏病 (IHD) 的负担差异很大. 低收入国家面临不成比例地更高的中风负担,这表明需要针对这些血管疾病进行量身定制的干预措施.
科学领域:
- 全球卫生健康 全球卫生健康
- 流行病学 流行病学
- 心血管疾病的研究研究.
背景情况:
- 脑卒中和缺血性心脏病 (IHD) 具有共同的风险因素,但它们的全球负担变化尚未得到充分理解.
- 了解这些差异对于公共卫生战略至关重要.
研究的目的:
- 分析全球中风和IHD死亡率的变化以及残疾调整后生命年 (DALY) 损失率.
- 调查国民收入和血管风险因素与中风和IHD的相对负担之间的关联.
主要方法:
- 利用了世界卫生组织疾病负担计划的死亡率和DALYs数据.
- 在192个国家的数据上使用线性回归和Cuzick测试进行趋势分析.
- 纳入世界银行的国民收入数据和血管风险因素估计.
主要成果:
- 在39%的国家中,中风死亡率超过了IHD率,而DALY损失率则超过32%.
- 中风负担在中国,非洲和南美洲更高;中风负担在中东,北美,澳大利亚和欧洲更高.
- 较低的国家收入与较高的相对中风死亡率和DALY损失相关 (P<0.001).
- 糖尿病和高胆固醇与更大的IHD负担有关,独立于国民收入.
结论:
- 在中风与IHD的相对公共卫生负担方面存在显著的全球差异.
- 低收入国家中风负担较高表明需要具体的,有针对性的公共卫生干预措施.
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