Department of Medicine, University of California, San Francisco, San Francisco, CA 94143-1211, USA.
Am J Med. 2011 Sep;124(9):827-33.e5. doi: 10.1016/j.amjmed.2011.04.010. Epub 2011 Jun 30.
The demographic shift toward an older population in the United States will result in a higher burden of coronary heart disease, but the increase has not been quantified in detail. We sought to estimate the impact of the aging US population on coronary heart disease.
We used the Coronary Heart Disease Policy Model, a Markov model of the US population between 35 and 84 years of age, and US Census projections to model the age structure of the population between 2010 and 2040.
Assuming no substantive changes in risks factors or treatments, incident coronary heart disease is projected to increase by approximately 26%, from 981,000 in 2010 to 1,234,000 in 2040, and prevalent coronary heart disease by 47%, from 11.7 million to 17.3 million. Mortality will be affected strongly by the aging population; annual coronary heart disease deaths are projected to increase by 56% over the next 30 years, from 392,000 to 610,000. Coronary heart disease-related health care costs are projected to rise by 41% from $126.2 billion in 2010 to $177.5 billion in 2040 in the United States. It may be possible to offset the increase in disease burden through achievement of Healthy People 2010/2020 objectives or interventions that substantially reduce obesity, blood pressure, or cholesterol levels in the population.
Without considerable changes in risk factors or treatments, the aging of the US population will result in a sizeable increase in coronary heart disease incidence, prevalence, mortality, and costs. Health care stakeholders need to plan for the future age-related health care demands of coronary heart disease.
美国人口向老龄化的转变将导致冠心病负担加重,但具体增加幅度尚未量化。我们旨在评估美国人口老龄化对冠心病的影响。
我们使用了冠心病政策模型(一种美国 35 至 84 岁人群的马尔可夫模型)和美国人口普查预测数据,以模拟 2010 年至 2040 年期间的人口年龄结构。
假设危险因素或治疗方法没有实质性变化,预计冠心病新发病例将增加约 26%,从 2010 年的 98.1 万例增至 2040 年的 123.4 万例;预计冠心病现患病例将增加 47%,从 1170 万例增至 1730 万例。人口老龄化将强烈影响死亡率;预计未来 30 年内,每年的冠心病死亡人数将增加 56%,从 39.2 万例增至 61 万例。如果能够实现《健康人民 2010/2020 目标》或采取干预措施,大幅降低人群中的肥胖、血压或胆固醇水平,冠心病相关医疗费用可能会增加 41%,从 2010 年的 1262 亿美元增至 2040 年的 1775 亿美元。
如果危险因素或治疗方法没有明显变化,美国人口老龄化将导致冠心病发病率、患病率、死亡率和医疗费用大幅增加。医疗保健利益相关者需要为未来与人口老龄化相关的冠心病医疗需求做好规划。