Zhang Xiao-fei, Hu Da-yi, Ding Rong-jing, Wang Hui-cheng, Yan Liu-xia
National Center for Chronic and Noncommunicable Disease Prevention and Control, China CDC, Beijing 100050, China.
Zhonghua Xin Xue Guan Bing Za Zhi. 2012 Mar;40(3):179-87.
To report the status and trend of cardio-cerebral-vascular disease (CCVD) mortality in China between 2004 and 2008.
The mortality data from population-based survey of National Disease Surveillance System in 2004 and 2008 were analyzed. This surveillance system is consisted of 161 disease surveillance points (DSPs) located in 31 provinces of China including 64 urban and 97 rural DSPs. The total population of surveillance is over 73 millions and accounted for around 6% of the whole population of China. CCVD included ischemic heart diseases (ICD-10: I05-I09, I11, I20-I27, I30-I52) and cerebral-vascular disease (ICD-10: I60-I69). The status and trend of cardiovascular disease (CVD), cerebral-vascular disease (CD), ischemic heart disease (IHD) and acute myocardial infarction (AMI) mortalities from 2004 to 2008 were analyzed by age, gender, and urban/rural regions.
The mortality of CCVD was higher in 2008 (229/100 000) than in 2004 (223.5/100 000), which was decreased in urban region (-11.7/100 000) while increased in rural region (+16.0/100 000). The mortality of CD decreased from 134.8/100 000 (2004) to 128.3/100 000 (2008). Mortality of IHD and AMI increased from 66.1/100 000 and 40.4/100 000 (2004) to 71/100 000 and 45.7/100 000 (2008), which remained stable in urban region (+0.98/100 000 and -1.96/100 000) while significantly increased in rural region (+6.7/100 000 and +9.2/100 000). The mortality rates for CVD, CD and AMI were higher in rural population than that in urban population. The age-standardized mortality rates of CVD, CD and IHD were lower in 2008 than in 2004. The mortality rates of CD and IHD decreased in 40-, 60-, and over 80 age groups (except for IHD) in 2008 than in 2004. However, IHD mortality was significantly higher in age of 80 and over group from 2004 to 2008. There were a net 5.5/100 000 increase, 6.4/100 000 decrease and 4.9/100 000 increase for CCVD, CD and IHD between 2004 and 2008. The mortality rate rise in CCVD was mainly due to the increased mortality of IHD and CD in rural population. The CCVD mortality increased with age and was significantly higher in male than in female population.
Despite decreased mortality in CD, CCVD mortality increased from 2004 to 2008, mainly due to the increased mortality of IHD and AMI in rural population. Enhanced CCVD primary and secondary prevention, particular for stressing on primary prevention, is necessary in China, especially in rural areas. Meanwhile, they will give the greatest contributions for a raise of the healthy life expectancy in China.
报告2004年至2008年中国心脑血管疾病(CCVD)死亡率的现状及趋势。
分析2004年和2008年全国疾病监测系统基于人群调查的死亡率数据。该监测系统由位于中国31个省的161个疾病监测点(DSP)组成,包括64个城市和97个农村DSP。监测总人口超过7300万,约占中国总人口的6%。CCVD包括缺血性心脏病(国际疾病分类第10版:I05-I09、I11、I20-I27、I30-I52)和脑血管疾病(国际疾病分类第10版:I60-I69)。按年龄、性别和城乡地区分析2004年至2008年心血管疾病(CVD)、脑血管疾病(CD)、缺血性心脏病(IHD)和急性心肌梗死(AMI)死亡率的现状及趋势。
2008年CCVD死亡率(229/10万)高于2004年(223.5/10万),其中城市地区下降(-11.7/10万),农村地区上升(+16.0/10万)。CD死亡率从2004年的134.8/10万降至2008年的128.3/10万。IHD和AMI死亡率从2004年的66.1/10万和40.4/10万升至2008年的71/10万和45.7/10万,城市地区保持稳定(+0.98/10万和-1.96/10万),农村地区显著上升(+6.7/10万和+9.2/10万)。农村人群的CVD、CD和AMI死亡率高于城市人群。2008年CVD、CD和IHD的年龄标准化死亡率低于2004年。2008年40岁、60岁和80岁及以上年龄组(IHD除外)的CD和IHD死亡率低于2004年。然而,2004年至2008年80岁及以上年龄组的IHD死亡率显著更高。2004年至2008年CCVD、CD和IHD的净增加分别为5.5/10万、6.4/10万和4.9/10万。CCVD死亡率上升主要是由于农村人群IHD和CD死亡率增加。CCVD死亡率随年龄增加,男性显著高于女性。
尽管CD死亡率下降,但2004年至2008年CCVD死亡率上升,主要是由于农村人群IHD和AMI死亡率增加。在中国,特别是农村地区,加强CCVD一级和二级预防,尤其是强调一级预防是必要的。同时,它们将为提高中国的健康预期寿命做出最大贡献。