改变选定风险因素对心血管疾病可归因负担的联合作用。

Joint effect of modifying selected risk factors on attributable burden of cardiovascular diseases.

作者信息

Shadmani Fatemeh Khosravi, Karami Manoochehr

机构信息

Department of Epidemiology, School of Public Health, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

Research Center for Health Sciences and Department of Biostatistics and Epidemiology, School of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran.

出版信息

Int J Prev Med. 2013 Dec;4(12):1461-7.

PMID:24498503

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC3898453/

Abstract

BACKGROUND

There are few published studies that consider the joint effect of multiple risk factors on avoidable burden of cardiovascular diseases (CVDs). This study aimed to estimate the joint effect of avoidable burden of multiple risk factors to CVDs.

METHODS

Estimates of avoidable burden to CVDs were made using potential impact fraction (PIF). In order to calculate PIF, data on the Prevalence of the risk factors include diabetes, hypertension, central obesity, and hypercholesterolemia were obtained from 3(rd) national Surveillance of Risk Factors of Non-Communicable Diseases-2007 in Iran and data on corresponding measures of effect were derived from a cohort study with multivariate adjusted hazard ratios. Then, joint effect of risk factors was calculated.

RESULTS

About 37% (95% uncertainty interval: 21.7-50.2) of attributable disability adjusted life years (DALYs) to CVDs in adult males and 59.4% (95% uncertainty interval: 30-76) in adult females due to selected risk factors are avoidable in theoretical minimum risk levels. After changing the current prevalence of these risk factors to the plausible minimum risk levels, 17.8% (95% uncertainty interval: 10.1-25.1) of CVDs' attributable DALYs among adult males and 34% (95% uncertainty interval: 20-46.7) in adult females can be avoided.

CONCLUSIONS

To better priority setting as well as reporting the magnitude of avoidable DALYs rather than the percentage of avoidable burden, PIF should be applied to updated and revised burden of CVDs.

摘要

背景

很少有已发表的研究考虑多种风险因素对心血管疾病（CVD）可避免负担的联合影响。本研究旨在估计多种风险因素对CVD可避免负担的联合影响。

方法

使用潜在影响分数（PIF）对CVD的可避免负担进行估计。为了计算PIF，从伊朗第三次全国非传染性疾病风险因素监测-2007中获取了包括糖尿病、高血压、中心性肥胖和高胆固醇血症在内的风险因素患病率数据，并从一项具有多变量调整风险比的队列研究中得出相应的效应测量数据。然后，计算风险因素的联合影响。

结果

在理论最低风险水平下，成年男性中约37%（95%不确定区间：21.7 - 50.2）因选定风险因素导致的CVD归因残疾调整生命年（DALY）以及成年女性中59.4%（95%不确定区间：30 - 76）是可避免的。将这些风险因素的当前患病率改变为合理的最低风险水平后，成年男性中17.8%（95%不确定区间：10.1 - 25.1）的CVD归因DALY以及成年女性中34%（95%不确定区间：20 - 46.7）是可以避免的。