患者心血管死亡率是否在增加? 一个回顾性美国人口研究
Ashley Curtis1, Daniela Markovic2, Andrew Liao1
1California University of Science and Medicine, Colton, California, USA.
BMJ open
|November 28, 2025
概括
心血管疾病的死亡率在患者中正在上升,特别是来自脑血管疾病和糖尿病. 缺血性心脏病死亡人数的下降也停止了,这凸显了在这个人群中需要更好地管理心血管风险.
科学领域:
- 流行病学 流行病学
- 心血管健康 心血管健康
- 神经学 神经学
背景情况:
- 与美国普通人口相比,患有的人面临高血压,糖尿病,高脂血症和肥胖的风险更高.
- 目前尚不清楚这些高风险因素是否会导致患者心血管死亡率增加.
研究的目的:
- 调查美国患者心血管死亡率的趋势.
- 从2000年到2019年,将患者的心血管死亡比例与美国一般人口进行比较.
主要方法:
- 一项回顾性纵向研究分析了2000-2019年美国死亡数据,使用CDC多种死亡原因数据库.
- 使用ICD-10代码G40.0-G40.919确定了病死亡;心血管死亡包括缺血性心脏病,脑血管疾病,糖尿病和高血压.
- 数据按年龄,种族和性别分层,使用后勤回归和标准化比例分析相对比例.
主要成果:
- 脑血管疾病和糖尿病的年龄调整后死亡率在患者与普通人群相比显著增加 (p<0.001).
- 脑血管疾病和糖尿病死亡率的增加在35-64岁年龄组中最为明显.
- 在2011年以后的缺血性心脏病死亡中观察到趋势的逆转,患者的比例稳定,而在一般人群中继续下降.
结论:
- 在患者 (2000 - 2019) 中,由于脑血管疾病和糖尿病而导致的年龄标准化死亡人数显著增加.
- 这些增加主要出现在35-64岁的年龄段,这表明干预的关键窗口.
- 缺血性心脏病死亡率的稳定,与一般人口的下降形成鲜明对比,表明需要在治疗中加强心血管风险因素管理.
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