Boix Martínez Raquel, Aragonés Sanz Nuria, Medrano Albero M José
Centro Nacional de Epidemiología. Instituto de Salud Carlos III. Madrid. España.
Rev Esp Cardiol. 2003 Sep;56(9):850-6. doi: 10.1016/s0300-8932(03)76972-3.
Ischemic heart disease is the leading cause of cardiovascular mortality and the second most frequent cause in women in Spain. It is responsible for 12% and 10%, respectively, of all-cause mortality. Our aim was to identify those provinces where recent trends differ significantly from the overall national pattern of decreasing rates in recent years, and where intervention is probably needed.
We report mortality trends due to ischemic heart disease for the periods 1988-1991 and 1994-1997 for each province in persons aged 35 to 64 years, and mortality trends in Spain in the last 19 years for all age groups. Data for ischemic heart disease mortality were obtained from files supplied by the Spanish National Institute for Statistics. Mortality rates in the two 4-year periods were compared with log-linear Poisson regression models to estimate trends. Age-adjusted and mortality hazard-rates are presented with 95% CI, and time trends and geographical variations are also reported.
The highest rates were seen at Andalucia (south), Levante (east) and the oversea provinces (Balearic [Mediterranean] and Canary Islands [Atlantic]). There were considerable geographical differences in mortality rates. Time trends showed a decrease in men in 27 provinces and a decrease in women in 12 provinces. Overall mortality trends decreased in the last 19 years in Spain.
Although the general trend is toward a decrease, there are differences between provinces in Spain. The previously reported North-South gradient and regional discrepancies were confirmed.
缺血性心脏病是心血管疾病死亡的主要原因，在西班牙女性中是第二常见病因。它分别占全因死亡率的12%和10%。我们的目的是确定那些近年来趋势与全国整体下降趋势显著不同且可能需要干预的省份。
我们报告了1988 - 1991年和1994 - 1997年各省份35至64岁人群缺血性心脏病的死亡率趋势，以及西班牙过去19年所有年龄组的死亡率趋势。缺血性心脏病死亡率数据来自西班牙国家统计局提供的档案。使用对数线性泊松回归模型比较两个4年期的死亡率，以估计趋势。给出年龄调整后的死亡率和死亡率风险率及其95%置信区间，并报告时间趋势和地理差异。
最高死亡率出现在安达卢西亚（南部）、巴伦西亚（东部）和海外省份（巴利阿里群岛[地中海]和加那利群岛[大西洋]）。死亡率存在显著的地理差异。时间趋势显示，27个省份男性死亡率下降，12个省份女性死亡率下降。西班牙过去19年总体死亡率呈下降趋势。
尽管总体趋势是下降的，但西班牙各省份之间存在差异。先前报告的南北梯度和地区差异得到了证实。
