Yoon Sung Sug Sarah, Dillon Charles F, Illoh Kachi, Carroll Margaret
Healthcare Delivery and Methodologies IRG, Division of AIDS, Behavioral, and Population Sciences, Center for Scientific Review, NIH, Bethesda, Maryland.
(Retired) National Center for Health Statistics, CDC, Hyattsville, Maryland.
Am J Prev Med. 2016 Oct;51(4):437-45. doi: 10.1016/j.amepre.2016.02.023. Epub 2016 Apr 21.
This study evaluated recent trends in the prevalence of coronary heart disease in the U.S. population aged ≥40 years.
A total of 21,472 adults aged ≥40 years from the 2001-2012 National Health and Nutrition Examination Survey were included in the analysis. The analysis was conducted in 2015. Coronary heart disease included myocardial infarction, angina, and any other type of coronary heart disease, which were defined as a history of medical diagnosis of these specific conditions. Angina was also defined as currently taking anti-angina medication or having Rose Angina Questionnaire responses that scored with a Grade ≥1. Trends from 2001 to 2012 were analyzed overall, within demographic subgroups, and by major coronary heart disease risk factors.
Between 2001 and 2012, the overall prevalence of coronary heart disease significantly decreased from 10.3% to 8.0% (p-trend<0.05). The prevalence of angina significantly decreased from 7.8% to 5.5% and myocardial infarction prevalence decreased from 5.5% to 4.7% (p-trend <0.05 for both groups). Overall coronary heart disease prevalence significantly decreased among women, adults aged >60 years, non-Hispanic whites, non-Hispanic blacks, adults who did not complete high school, adults with more than a high school education, and adults who had health insurance (p-trend <0.05 for all groups).
The overall prevalence of coronary heart disease including angina and myocardial infarction decreased significantly over the 12-year survey period. However, this reduction was seen mainly among persons without established coronary heart disease risk factors. There was no change in coronary heart disease prevalence among those with specific coronary heart disease risk factors.
本研究评估了美国40岁及以上人群冠心病患病率的近期趋势。
分析纳入了2001 - 2012年国家健康与营养检查调查中的21472名40岁及以上成年人。分析于2015年进行。冠心病包括心肌梗死、心绞痛以及任何其他类型的冠心病,这些均被定义为有这些特定病症的医学诊断史。心绞痛还被定义为当前正在服用抗心绞痛药物或玫瑰心绞痛问卷得分≥1级。分析了2001年至2012年的总体趋势、人口亚组趋势以及主要冠心病危险因素趋势。
2001年至2012年期间,冠心病总体患病率从10.3%显著降至8.0%(p趋势<0.05)。心绞痛患病率从7.8%显著降至5.5%,心肌梗死患病率从5.5%降至4.7%(两组p趋势均<0.05)。女性、60岁以上成年人、非西班牙裔白人、非西班牙裔黑人、未完成高中学业的成年人、受过高中以上教育的成年人以及有医疗保险的成年人中,冠心病总体患病率均显著下降(所有组p趋势<0.05)。
在12年的调查期内,包括心绞痛和心肌梗死在内的冠心病总体患病率显著下降。然而,这种下降主要见于没有既定冠心病危险因素的人群。有特定冠心病危险因素的人群中,冠心病患病率没有变化。