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从亚太地区视角理解心力衰竭的流行病学以改善管理实践

Understanding the Epidemiology of Heart Failure to Improve Management Practices: An Asia-Pacific Perspective.

作者信息

Rajadurai Jeyamalar, Tse Hung-Fat, Wang Chao-Hung, Yang Ning-I, Zhou Jingmin, Sim David

机构信息

Department of Cardiology, Subang Jaya Medical Centre, Subang Jaya, Malaysia.

Department of Medicine, University of Hong Kong, Queen Mary Hospital, Hong Kong, China.

出版信息

J Card Fail. 2017 Apr;23(4):327-339. doi: 10.1016/j.cardfail.2017.01.004. Epub 2017 Jan 19.

Abstract

Heart failure (HF) is a major global healthcare problem with an estimated prevalence of approximately 26 million. In Asia-Pacific regions, HF is associated with a significant socioeconomic burden and high rates of hospital admission. Epidemiological data that could help to improve management approaches to address this burden in Asia-Pacific regions are limited, but suggest patients with HF in the Asia-Pacific are younger and have more severe signs and symptoms of HF than those of Western countries. However, local guidelines are based largely on the European Society of Cardiology and American College of Cardiology Foundation/American Heart Association guidelines, which draw their evidence from studies where Western patients form the major demographic and patients from the Asia-Pacific region are underrepresented. Furthermore, regional differences in treatment practices likely affect patient outcomes. In the following review, we examine epidemiological data from existing regional registries, which indicate that these patients represent a distinct subpopulation of patients with HF. In addition, we highlight that patients with HF are under-treated in the region despite the existence of local guidelines. Finally, we provide suggestions on how data can be enriched throughout the region, which may positively affect local guidelines and improve management practices.

摘要

心力衰竭(HF)是一个重大的全球性医疗保健问题,估计患病率约为2600万。在亚太地区,心力衰竭与巨大的社会经济负担和高住院率相关。有助于改善亚太地区应对这一负担的管理方法的流行病学数据有限,但表明亚太地区的心力衰竭患者比西方国家的患者更年轻,心力衰竭的体征和症状更严重。然而,当地指南很大程度上基于欧洲心脏病学会以及美国心脏病学会基金会/美国心脏协会的指南,这些指南的证据来自以西方患者为主要人群的研究,而亚太地区的患者代表性不足。此外,治疗方法的地区差异可能会影响患者的治疗结果。在以下综述中,我们研究了现有地区登记处的流行病学数据,这些数据表明这些患者代表了心力衰竭患者中的一个独特亚群。此外,我们强调尽管有当地指南,但该地区的心力衰竭患者治疗不足。最后,我们就如何在整个地区丰富数据提出建议,这可能会对当地指南产生积极影响并改善管理实践。

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