加拿大心血管疾病危险因素的趋势：时间、社会人口统计学和地理因素。
Trends in risk factors for cardiovascular disease in Canada: temporal, socio-demographic and geographic factors.
作者信息
Lee Douglas S, Chiu Maria, Manuel Douglas G, Tu Karen, Wang Xuesong, Austin Peter C, Mattern Michelle Y, Mitiku Tezeta F, Svenson Lawrence W, Putnam Wayne, Flanagan William M, Tu Jack V
机构信息
Institute for Clinical Evaluative Sciences, Toronto, Ont.
出版信息
CMAJ. 2009 Aug 4;181(3-4):E55-66. doi: 10.1503/cmaj.081629. Epub 2009 Jul 20.
BACKGROUND
Temporal trends in risk factors for cardiovascular disease and the impact of socio-economic status on these risk factors remain unclear.
METHODS
Using data from the National Population Health Survey and the Canadian Community Health Survey, we examined national trends in heart disease, hypertension, diabetes mellitus, obesity and smoking prevalence from 1994 to 2005, adjusting for age and sex. We stratified data by income adequacy category, body mass index and region of residence.
RESULTS
An estimated 1.29 million Canadians reported having heart disease in 2005, representing increases of 19% for men and 2% for women, relative to 1994. Heart disease increased significantly in the lowest income category (by 27%), in the lower middle income category (by 37%) and in the upper middle income category (by 12%); however, it increased by only 6% in the highest income group. Diabetes increased in all but the highest income group: by 56% in the lowest income group, by 93% in the lower middle income group and by 59% in the upper middle income group. Hypertension increased in all income groups: by 85% in the lowest income group, by 80% in the lower middle income group, by 91% in the upper middle income group and by 117% in the highest income group. Obesity also increased in all income groups: by 20% in the lowest income group, by 25% in the lower middle income group, by 33% in the upper middle income group and by 37% in the highest income group. In addition to socio-economic status, obesity and overweight also modified the trends in risk factors. Diabetes increased to a greater extent among obese participants (61% increase) and overweight participants (25% increase), as did hypertension, which increased by 80% among obese individuals and by 74% among overweight individuals. Trends in diabetes, hypertension and obesity were consistent for all provinces.
INTERPRETATION
During the study period, heart disease, hypertension, diabetes and obesity increased for all or most income groups in Canada. Further interventions supporting modification of lifestyle and risk factors are needed to prevent future cardiovascular disease.
背景
心血管疾病危险因素的时间趋势以及社会经济地位对这些危险因素的影响仍不明确。
方法
利用全国人口健康调查和加拿大社区健康调查的数据，我们研究了1994年至2005年期间心脏病、高血压、糖尿病、肥胖症和吸烟率的全国趋势，并对年龄和性别进行了调整。我们按收入充足类别、体重指数和居住地区对数据进行了分层。
结果
2005年估计有129万加拿大人报告患有心脏病，与1994年相比，男性增加了19%，女性增加了2%。心脏病在最低收入类别中显著增加（增加了27%），在中低收入类别中增加了37%，在中高收入类别中增加了12%；然而，在最高收入组中仅增加了6%。除最高收入组外，糖尿病在所有收入组中均有所增加：最低收入组增加了56%，中低收入组增加了93%，中高收入组增加了59%。高血压在所有收入组中均有所增加：最低收入组增加了85%，中低收入组增加了80%，中高收入组增加了91%，最高收入组增加了117%。肥胖症在所有收入组中也有所增加：最低收入组增加了20%，中低收入组增加了25%，中高收入组增加了33%，最高收入组增加了37%。除社会经济地位外，肥胖和超重也改变了危险因素的趋势。糖尿病在肥胖参与者（增加61%）和超重参与者（增加25%）中增加的幅度更大，高血压也是如此，肥胖个体中增加了80%，超重个体中增加了74%。糖尿病、高血压和肥胖症的趋势在所有省份都是一致的。
解读
在研究期间，加拿大所有或大多数收入组的心脏病、高血压、糖尿病和肥胖症都有所增加。需要进一步采取支持改变生活方式和危险因素的干预措施，以预防未来的心血管疾病。
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