Health Aff (Millwood). 2013 Oct;32(10):1706-14. doi: 10.1377/hlthaff.2013.0449.
In the past several decades, some risk factors for cardiovascular disease have improved, while others have worsened. For example, smoking rates have dropped and treatment rates for cardiovascular disease have increased-factors that have made the disease less fatal. At the same time, Americans' average body mass index and incidence of diabetes have increased as the population continues to live longer-factors that have made cardiovascular disease more prevalent. To assess the aggregate impact of these opposing trends, we used the nine National Health and Nutrition Examination Survey waves from 1973 to 2010 to forecast total cardiovascular disease risk and prevalence from 2015 to 2030. We found that continued improvements in cardiovascular disease treatment and declining smoking rates will not outweigh the influence of increasing population age and obesity on cardiovascular disease risk. Given an aging population, an obesity epidemic, and declining mortality from the disease, the United States should expect to see a sharp rise in the health care costs, disability, and reductions in quality of life associated with increased prevalence of cardiovascular disease. Policies that target the treatment of high blood pressure and cholesterol and the reduction of obesity will be necessary to curb the imminent spike in cardiovascular disease prevalence.
在过去几十年中,一些心血管疾病的风险因素有所改善,而另一些则有所恶化。例如,吸烟率下降,心血管疾病的治疗率上升——这些因素降低了该疾病的致命性。与此同时,美国人的平均体重指数和糖尿病发病率随着人口寿命的延长而上升——这些因素使心血管疾病更为普遍。为了评估这些相反趋势的综合影响,我们使用了 1973 年至 2010 年的九次国家健康和营养调查数据,对 2015 年至 2030 年的心血管疾病总风险和患病率进行了预测。我们发现,心血管疾病治疗的持续改善和吸烟率的下降,不会超过人口老龄化和肥胖对心血管疾病风险的影响。鉴于人口老龄化、肥胖流行以及心血管疾病死亡率的下降,美国预计将看到与心血管疾病患病率上升相关的医疗保健费用、残疾和生活质量下降大幅增加。需要采取针对高血压和胆固醇治疗以及肥胖减少的政策,以遏制心血管疾病患病率即将出现的飙升。