MMWR Morb Mortal Wkly Rep. 2013 Sep 6;62(35):721-7.
Deaths attributed to lack of preventive health care or timely and effective medical care can be considered avoidable. In this report, avoidable causes of death are either preventable, as in preventing cardiovascular events by addressing risk factors, or treatable, as in treating conditions once they have occurred. Although various definitions for avoidable deaths exist, studies have consistently demonstrated high rates in the United States. Cardiovascular disease is the leading cause of U.S. deaths (approximately 800,000 per year) and many of them (e.g., heart disease, stroke, and hypertensive deaths among persons aged <75 years) are potentially avoidable.
National Vital Statistics System mortality data for the period 2001-2010 were analyzed. Avoidable deaths were defined as those resulting from an underlying cause of heart disease (ischemic or chronic rheumatic), stroke, or hypertensive disease in decedents aged <75 years. Rates and trends by age, sex, race/ethnicity, and place were calculated.
In 2010, an estimated 200,070 avoidable deaths from heart disease, stroke, and hypertensive disease occurred in the United States, 56% of which occurred among persons aged <65 years. The overall age-standardized death rate was 60.7 per 100,000. Rates were highest in the 65-74 years age group, among males, among non-Hispanic blacks, and in the South. During 2001-2010, the overall rate declined 29%, and rates of decline varied by age.
Nearly one fourth of all cardiovascular disease deaths are avoidable. These deaths disproportionately occurred among non-Hispanic blacks and residents of the South. Persons aged <65 years had lower rates than those aged 65-74 years but still accounted for a considerable share of avoidable deaths and demonstrated less improvement.
National, state, and local initiatives aimed at improving health-care systems and supporting healthy behaviors are essential to reducing avoidable heart disease, stroke, and hypertensive disease deaths. Strategies include promoting the ABCS (aspirin when appropriate, blood pressure control, cholesterol management, and smoking cessation), reducing sodium consumption, and creating healthy environments.
由于缺乏预防保健或及时有效的医疗保健而导致的死亡可被视为可避免的。在本报告中，可避免的死亡原因要么是可预防的，例如通过解决风险因素来预防心血管事件，要么是可治疗的，例如在出现疾病后进行治疗。尽管对于可避免的死亡有各种定义，但研究一致表明美国的死亡率很高。心血管疾病是美国死亡的主要原因（每年约有 80 万人），其中许多（例如，<75 岁人群中的心脏病、中风和高血压死亡）是潜在可避免的。
分析了 2001-2010 年国家生命统计系统死亡率数据。将可避免的死亡定义为在<75 岁的死者中，由于心脏病（缺血性或慢性风湿性）、中风或高血压疾病引起的根本原因导致的死亡。按年龄、性别、种族/族裔和地点计算可避免死亡的发生率和趋势。
2010 年，美国估计有 200,070 例可避免的心脏病、中风和高血压疾病死亡，其中 56%发生在<65 岁的人群中。标准化死亡率为每 10 万人 60.7 人。在 65-74 岁年龄组、男性、非西班牙裔黑人和南部地区，死亡率最高。2001-2010 年期间，总体死亡率下降了 29%，且下降速度因年龄而异。
近四分之一的心血管疾病死亡是可避免的。这些死亡不成比例地发生在非西班牙裔黑人和南部地区的居民中。<65 岁的人群死亡率低于 65-74 岁的人群，但仍占可避免死亡的相当大份额，且改善幅度较小。
旨在改善医疗保健系统和支持健康行为的国家、州和地方举措对于减少可避免的心脏病、中风和高血压疾病死亡至关重要。策略包括推广 ABCS（在适当情况下使用阿司匹林、控制血压、管理胆固醇和戒烟）、减少钠的摄入以及创造健康的环境。
