Manuel Douglas G, Leung Mark, Nguyen Kathy, Tanuseputro Peter, Johansen Helen
Institute for Clinical Evaluative Sciences, University of Toronto, Toronto, Ontario, Canada.
Can J Cardiol. 2003 Aug;19(9):997-1004.
This report updates the death estimates for cardiovascular disease (CVD) in Canada and introduces a population-based perspective on disease prevalence and health-related quality of life (HRQOL) burden.
The Canadian Mortality Database was used to estimate the mortality of men and women in different age groups for the 139 Canadian health regions from 1950 to 1999. Heart disease prevalence and its impact on HRQOL were estimated using the 2000-2001 Canadian Community Health Survey (CCHS). Life table techniques were used to estimate the impact of heart disease on life and health expectancy.
Although CVD remains the leading cause of death in Canada, between 1950 and 1999 the death rates from CVD dropped from 702 per 100,000 to 288 per 100,000 men, and from 562 per 100,000 to 175 per 100,000 women. Results from the CCHS indicated that 5.4% of men and 4.6% of women reported having heart disease as diagnosed by a medical professional. Of these individuals, 14% of men and 21% of women reported difficulty ambulating - about six times more than people without heart disease. In total, 4.5 years of life expectancy and 2.8 years of health expectancy were lost due to CVD. The study also found large differences in the burden of CVD among men and women and across the 139 Canadian health regions.
CVD is a major disease burden in terms of both mortality and HRQOL and is an important source of health inequalities between populations in Canada. Any attempt to improve the health of Canadians or to reduce health inequalities should include interventions to reduce CVD mortality and morbidity. Given the present impact of CVD on HRQOL, reducing or eliminating heart disease may potentially result in an increase in life expectancy that will be larger than the gains in health expectancy.
本报告更新了加拿大心血管疾病（CVD）的死亡估计数，并引入了基于人群的疾病患病率和健康相关生活质量（HRQOL）负担视角。
利用加拿大死亡率数据库估算了1950年至1999年加拿大139个健康区域不同年龄组男性和女性的死亡率。使用2000 - 2001年加拿大社区健康调查（CCHS）估算心脏病患病率及其对HRQOL的影响。采用生命表技术估算心脏病对预期寿命和健康预期寿命的影响。
尽管CVD仍是加拿大的主要死因，但在1950年至1999年间，CVD死亡率在男性中从每10万人702例降至每10万人288例，在女性中从每10万人562例降至每10万人175例。CCHS的结果表明，5.4%的男性和4.6%的女性报告患有经医学专业人员诊断的心脏病。在这些人中，14%的男性和21%的女性报告行走困难——约为无心脏病者的六倍。总体而言，CVD导致预期寿命损失4.5年，健康预期寿命损失2.8年。该研究还发现，CVD负担在男性和女性之间以及加拿大139个健康区域之间存在很大差异。
就死亡率和HRQOL而言，CVD是一项主要的疾病负担，并且是加拿大不同人群之间健康不平等的一个重要根源。任何改善加拿大民众健康或减少健康不平等的尝试都应包括降低CVD死亡率和发病率的干预措施。鉴于目前CVD对HRQOL的影响，减少或消除心脏病可能会使预期寿命的增加幅度大于健康预期寿命的增加幅度。
