Department of Epidemiology and Biostatistics, Drexel University School of Public Health, Philadelphia, PA, USA.
Am J Cardiol. 2013 Jan 1;111(1):68-72. doi: 10.1016/j.amjcard.2012.08.045. Epub 2012 Oct 3.
We examined the burden of cardiovascular disease (CVD) and its associated risk factors using statewide representative data from the Pennsylvania Behavior Risk Factors Surveillance System. The data from 35,576 subjects aged ≥ 18 years participating in the Pennsylvania Behavior Risk Factors Surveillance System in 2005, 2007, and 2009 were analyzed. The age-adjusted prevalence rates of CVD were computed. Logistic regression analysis was applied to examine associations between the risk factors and CVD prevalence, with adjustment for confounding variables. The results showed that no significant changes in the prevalence of CVD, coronary heart disease, and stroke were observed in either European Americans or African Americans from 2005 to 2009 (p >0.05). African Americans had significantly greater CVD rates than European Americans. Although smoking rates significantly decreased, several other CVD risk factors (i.e., obesity, hypertension, and hypercholesterolemia) significantly increased from 2005 to 2009 in European Americans. Similar changes were observed in African Americans, although these changes did not reach statistical significance. Logistic regression analysis indicated that African Americans had a 35% greater risk of CVD. Education level less than high school, smoking, obesity, hypertension, and diabetes were significantly and positively associated with CVD. In conclusion, no significant achievements in CVD control and risk factor reduction were observed from 2005 to 2009 in Pennsylvania. Additional aggressive control of hypertension, obesity, and diabetes for both European and African Americans must be made to reduce the burden of CVD.
我们使用宾夕法尼亚州行为风险因素监测系统的全州代表性数据来检查心血管疾病(CVD)的负担及其相关危险因素。对 2005、2007 和 2009 年参与宾夕法尼亚州行为风险因素监测系统的 35576 名年龄≥18 岁的受试者的数据进行了分析。计算了 CVD 的年龄调整患病率。应用逻辑回归分析来检查危险因素与 CVD 患病率之间的关联,并对混杂变量进行了调整。结果表明,在 2005 年至 2009 年期间,欧洲裔美国人和非裔美国人的 CVD、冠心病和中风患病率均无显著变化(p>0.05)。非裔美国人的 CVD 发生率明显高于欧洲裔美国人。尽管吸烟率显著下降,但从 2005 年至 2009 年,欧洲裔美国人的其他几个 CVD 危险因素(即肥胖、高血压和高胆固醇血症)显著增加。非裔美国人也观察到类似的变化,尽管这些变化没有达到统计学意义。逻辑回归分析表明,非裔美国人患 CVD 的风险增加了 35%。教育程度低于高中、吸烟、肥胖、高血压和糖尿病与 CVD 显著正相关。总之,2005 年至 2009 年,宾夕法尼亚州在 CVD 控制和危险因素减少方面没有取得显著成就。必须对欧洲裔美国人和非裔美国人的高血压、肥胖和糖尿病进行更积极的控制,以降低 CVD 的负担。