Public Health Institute, Ministry of Health, Ulaanbaatar, Mongolia.
BMC Public Health. 2012 Apr 2;12:254. doi: 10.1186/1471-2458-12-254.
To assess the coverage of individual-based primary prevention strategies for cardiovascular disease (CVD) in Cambodia and Mongolia: specifically the early identification of hypertension and diabetes mellitus, major proximate physiological CVD risk factors, and management with pharmaceutical and lifestyle advice interventions.
Analysis of data collected in national cross-sectional STEPS surveys in 2009 (Mongolia) and 2010 (Cambodia) involving participants aged 25-64 years: 5433 in Cambodia and 4539 in Mongolia.
Mongolia has higher prevalence of CVD risk factors than Cambodia--hypertension (36.5% versus 12.3%), diabetes (6.3% versus 3.1%), hypercholesterolemia (8.5% versus 3.2%), and overweight (52.5% versus 15.5%). The difference in tobacco smoking was less notable (32.1% versus 29.4%).Coverage with prior testing for blood glucose in the priority age group 35-64 years remains limited (16.5% in Cambodia and 21.7% in Mongolia). Coverage is higher for hypertension. A large burden of both hypertension and diabetes remains unidentified at current strategies for early identification: only 45.4% (Cambodia) to 65.8% (Mongolia) of all hypertensives and 22.8% (Mongolia) to 50.3% (Cambodia) of all diabetics in the age group 35-64 years had been previously diagnosed. Approximately half of all hypertensives and of all diabetics in both countries were untreated. 7.2% and 12.2% of total hypertensive population and 5.9% and 16.1% of total diabetic population in Cambodia and Mongolia, respectively, were untreated despite being previously diagnosed.Only 24.1% and 28.6% of all hypertensives and 15.9% and 23.9% of all diabetics in Mongolia and Cambodia, respectively were adequately controlled. Estimates suggest deficits in delivery of important advice for lifestyle interventions.
Multifaceted strategies are required to improve early identification, initiation of treatment and improving quality of treatment for common CVD risk factors. Periodic population-based surveys including questions on medical and treatment history and the context of testing and treatment can facilitate monitoring of individual-based prevention strategies.
评估柬埔寨和蒙古的个体一级预防心血管疾病（CVD）策略的覆盖范围：具体包括高血压和糖尿病的早期识别、主要的近期生理 CVD 风险因素，以及药物和生活方式建议干预措施的管理。
对 2009 年（蒙古）和 2010 年（柬埔寨）全国横断面 STEPS 调查中收集的数据进行分析，涉及年龄在 25-64 岁的参与者：柬埔寨 5433 人，蒙古 4539 人。
蒙古 CVD 危险因素的患病率高于柬埔寨——高血压（36.5%比 12.3%）、糖尿病（6.3%比 3.1%）、高胆固醇血症（8.5%比 3.2%）和超重（52.5%比 15.5%）。吸烟的差异不太明显（32.1%比 29.4%）。在优先年龄组 35-64 岁，之前进行血糖检测的比例仍然有限（柬埔寨为 16.5%，蒙古为 21.7%）。高血压的覆盖率较高。目前早期识别策略中，高血压和糖尿病的大量负担仍然未被发现：仅 45.4%（柬埔寨）至 65.8%（蒙古）的所有高血压患者和 22.8%（蒙古）至 50.3%（柬埔寨）的所有 35-64 岁年龄组的糖尿病患者之前被诊断过。在这两个国家，大约一半的高血压患者和所有糖尿病患者都没有得到治疗。尽管之前被诊断过，但柬埔寨和蒙古分别有 7.2%和 12.2%的高血压总人群以及 5.9%和 16.1%的糖尿病总人群未得到治疗。在蒙古和柬埔寨，分别只有 24.1%和 28.6%的所有高血压患者和 15.9%和 23.9%的所有糖尿病患者得到了充分控制。估计表明，在提供重要的生活方式干预建议方面存在不足。
需要采取多方面的策略来改善常见 CVD 风险因素的早期识别、治疗启动和改善治疗质量。定期进行基于人群的调查，包括关于医疗和治疗史以及检测和治疗背景的问题，可以促进对个体一级预防策略的监测。
