量化到2020年减少冠心病死亡率的选择
Mark D Huffman1, Donald M Lloyd-Jones, Hongyan Ning
1Northwestern University Feinberg School of Medicine, Department of Preventive Medicine, 680 N Lake Shore Drive, Suite 1400, Chicago, IL 60611, USA. m-huffman@northwestern.edu
Circulation
|May 11, 2013
概括
改善心血管健康可以在2020年之前预防24-30%的冠心病 (CHD) 死亡. 专注于胆固醇和血压等指标是关键,但肥胖和糖尿病的增加带来了风险.
科学领域:
- 公共卫生 公共卫生
- 流行病学 流行病学
- 心血管疾病研究研究
背景情况:
- 美国心脏协会 (AHA) 设定了2020年美国心血管健康改善20%的目标.
- 这项研究旨在估计潜在的冠心病 (CHD) 死亡率的减少,以实现这一目标.
研究的目的:
- 估计到2020年,冠心病 (CHD) 死亡人数的潜在减少.
- 模拟改善心血管健康指标对心血管疾病死亡率的影响.
主要方法:
- 利用国家健康和营养检查调查 (NHANES) 数据 (1988-2010) 对40,373名成年人.
- 6个心血管健康指标的量化趋势:胆固醇,血压,身体不活动,吸烟,糖尿病和肥胖.
- 采用IMPACT CHD模型,在不同情景下预测到2020年的CHD死亡人数.
主要成果:
- 如果不进行干预,CHD死亡人数预计将在2020年增加12%,达到大约48万.
- 在所有6个指标中的20%的改善可以将心脏病死亡率降低24%,至365,000.
- 持续的近期趋势,包括糖尿病和肥胖症的增加,可能导致心脏病死亡率下降30% (335,000),其他指标的改善被不利趋势所抵消.
结论:
- 实现心血管健康指标20%的改善,可以防止2020年预计24%的心血管疾病死亡.
- 肥胖和糖尿病的持续负面趋势显著抵消了潜在的死亡率降低.
- 建模是为公共卫生政策和预防心血管疾病的干预提供信息的宝贵工具.
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