Bertuccio Paola, Levi Fabio, Lucchini Francesca, Chatenoud Liliane, Bosetti Cristina, Negri Eva, La Vecchia Carlo
Department of Epidemiology, Istituto di Ricerche Farmacologiche 'Mario Negri', Milan, Italy.
Eur J Cardiovasc Prev Rehabil. 2011 Aug;18(4):627-34. doi: 10.1177/1741826710389393. Epub 2011 Apr 26.
Over the last two decades, mortality from coronary heart disease (CHD) and cerebrovascular disease (CVD) declined by about 30% in the European Union (EU).
We analyzed trends in CHD (X ICD codes: I20-I25) and CVD (X ICD codes: I60-I69) mortality in young adults (age 35-44 years) in the EU as a whole and in 12 selected European countries, over the period 1980-2007.
Data were derived from the World Health Organization mortality database. With joinpoint regression analysis, we identified significant changes in trends and estimated average annual percent changes (AAPC).
CHD mortality rates at ages 35-44 years have decreased in both sexes since the 1980s for most countries, except for Russia (130/100,000 men and 24/100,000 women, in 2005-7). The lowest rates (around 9/100,000 men, 2/100,000 women) were in France, Italy and Sweden. In men, the steepest declines in mortality were in the Czech Republic (AAPC = -6.1%), the Netherlands (-5.2%), Poland (-4.5%), and England and Wales (-4.5%). Patterns were similar in women, though with appreciably lower rates. The AAPC in the EU was -3.3% for men (rate = 16.6/100,000 in 2005-7) and -2.1% for women (rate = 3.5/100,000). For CVD, Russian rates in 2005-7 were 40/100,000 men and 16/100,000 women, 5 to 10-fold higher than in most western European countries. The steepest declines were in the Czech Republic and Italy for men, in Sweden and the Czech Republic for women. The AAPC in the EU was -2.5% in both sexes, with steeper declines after the mid-late 1990s (rates = 6.4/100,000 men and 4.3/100,000 women in 2005-7).
CHD and CVD mortality steadily declined in Europe, except in Russia, whose rates were 10 to 15-fold higher than those of France, Italy or Sweden. Hungary and Poland, and also Scotland, where CHD trends were less favourable than in other western European countries, also emerge as priorities for preventive interventions.
在过去二十年中，欧盟（EU）的冠心病（CHD）和脑血管疾病（CVD）死亡率下降了约30%。
我们分析了1980年至2007年期间，整个欧盟以及12个选定欧洲国家中，年轻成年人（35 - 44岁）的冠心病（国际疾病分类代码：I20 - I25）和脑血管疾病（国际疾病分类代码：I60 - I69）死亡率趋势。
数据来源于世界卫生组织死亡率数据库。通过连接点回归分析，我们确定了趋势的显著变化，并估计了平均年度百分比变化（AAPC）。
自20世纪80年代以来，大多数国家35 - 44岁年龄段的冠心病死亡率在两性中均有所下降，但俄罗斯除外（2005 - 2007年，男性为130/10万，女性为24/10万）。最低死亡率（男性约为9/10万，女性约为2/10万）出现在法国、意大利和瑞典。在男性中，死亡率下降最显著的是捷克共和国（AAPC = -6.1%）、荷兰（-5.2%）、波兰（-4.5%）以及英格兰和威尔士（-4.5%）。女性的情况类似，不过死亡率明显更低。欧盟男性的AAPC为-3.3%（2005 - 2007年死亡率为16.6/10万），女性为-2.1%（死亡率为3.5/10万）。对于脑血管疾病，2005 - 2007年俄罗斯的死亡率为男性40/10万，女性16/10万，比大多数西欧国家高5至10倍。男性死亡率下降最显著的是捷克共和国和意大利，女性是瑞典和捷克共和国。欧盟两性的AAPC均为-2.5%，20世纪90年代中后期后下降更为明显（2005 - 2007年，男性死亡率为6.4/10万，女性为4.3/10万）。
欧洲的冠心病和脑血管疾病死亡率稳步下降，但俄罗斯除外，其死亡率比法国、意大利或瑞典高10至15倍。匈牙利、波兰以及冠心病趋势不如其他西欧国家有利的苏格兰，也成为预防性干预的重点地区。
