Zeng X Y, Liu S W, Wang L J, Zhang M, Yin P, Liu Y N, Zhao Z P, Wang L M
Division of Integrated Prevention and Evaluation, National Center for Chronic and Non-communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 100050, China.
Division of Vital Statistics and Death Surveillance, National Center for Chronic and Non-communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 100050, China.
Zhonghua Liu Xing Bing Xue Za Zhi. 2017 Aug 10;38(8):1011-1016. doi: 10.3760/cma.j.issn.0254-6450.2017.08.003.
To estimate the deaths (mortality) and life expectancy that attributable to high blood pressure in people from different regions and gender, in China in 2013. Data was from the 'China Chronic Disease Risk Factor Surveillance 2013' and the 'China National Mortality Surveillance 2013'. According to the comparative risk assessment theory, population attributable fraction () of high blood pressure by gender, urban-rural, east-central-west regions was calculated before the estimations on deaths (mortality) and life expectancy attributable to high blood pressure was made. In 2013, among the Chinese people aged 25 years old and above, the mean SBP was (129.48±20.27) mmHg. High blood pressure[SBP>(115±6) mmHg]caused 20.879 million deaths and accounted for 22.78% of the total deaths. SBP, deaths, mortality rate and standardized mortality rate that attributable to high blood pressure all appeared higher in men [(131.15±18.73) mmHg, 11.517 million, 165.56/100 000 and 106.97/100 000, respectively]than in women[(127.79±21.60) mmHg, 9.362 million, 141.99/100 000 and 68.93/100 000, respectively]. SBP, deaths, mortality rate and were all seen higher in rural[(130.25±20.66) mmHg, 11.234 million, 178.58/100 000 and 23.59%, respectively]than in urban[(128.58±19.77) mmHg, 9.645 million, 132.87/100 000 and 21.54%, respectively]areas. However, levels of SBP were similar in the east, central or west regions, with attributable deaths, attributable mortality rate and the highest as 7.658 million 179.93/100 000, and 26.72% respectively. In 2013, among the Chinese people aged 25 years old and above, deaths caused by cardiovascular disease and chronic kidney disease attributable to high blood pressure were 19.912 million and 0.966 million, accounting for 52.31% of the total deaths due to cardiovascular diseases and 62.11% to the total chronic kidney diseases. The top three deaths attributable to high blood pressure were ischemic heart disease (6.656 million), hemorrhagic stroke (5.331 million) and ischemic stroke (3.593 million). When the effect of high blood pressure had been eliminated, the life expectancy per capita would have increased by 2.86 years old, with higher in women than in men (3.07 and 2.64 years old, respectively), higher in central than in east and west (3.48, 2.56 and 2.58 years, respectively) areas, in rural than in urban (2.97 and 2.59 years, respectively) areas. In 2013, the number of deaths attributable to high blood pressure was around 20.9 million, accounting for 22.78% of the total deaths, and appeared higher in men than in women, in rural than in urban, in central than in east and west areas. The mortality burden induced by ischemic heart disease, hemorrhagic stroke and ischemic stroke was most serious since the high blood pressure brought about 2.86 years of lost in life expectancy.
为估算2013年中国不同地区、不同性别人群中归因于高血压的死亡(死亡率)及预期寿命。数据来自“2013年中国慢性病危险因素监测”和“2013年中国国家死亡监测”。根据比较风险评估理论,在估算归因于高血压的死亡(死亡率)和预期寿命之前,先计算了按性别、城乡、东中西部地区划分的高血压人群归因分数(PAF)。2013年,在25岁及以上的中国人中,收缩压均值为(129.48±20.27)mmHg。高血压[SBP>(115±6) mmHg]导致2087.9万人死亡,占总死亡人数的22.78%。归因于高血压的收缩压、死亡人数、死亡率和标准化死亡率在男性中[分别为(131.15±18.73) mmHg、1151.7万人、165.56/10万和106.97/10万]均高于女性[分别为(127.79±21.60) mmHg、936.2万人、141.99/10万和68.93/10万]。收缩压、死亡人数、死亡率和PAF在农村地区[分别为(130.25±20.66) mmHg、1123.4万人、178.58/10万和23.59%]均高于城市地区[分别为(128.58±19.77) mmHg、964.5万人、132.87/10万和21.54%]。然而,东、中、西部地区的收缩压水平相似,归因死亡人数、归因死亡率和PAF最高,分别为765.8万人、179.93/10万和26.72%。2013年,在25岁及以上的中国人中,归因于高血压的心血管病和慢性肾病死亡人数分别为1991.2万人和96.6万人,分别占心血管病总死亡人数的52.31%和慢性肾病总死亡人数的62.11%。归因于高血压的前三位死亡原因是缺血性心脏病(665.6万人)、出血性卒中(533.1万人)和缺血性卒中(359.3万人)。消除高血压影响后,人均预期寿命将增加2.86岁,女性高于男性(分别为3.07岁和2.64岁),中部地区高于东部和西部地区(分别为3.48岁、2.56岁和2.58岁),农村地区高于城市地区(分别为2.97岁和2.59岁)。2013年,归因于高血压的死亡人数约为2090万,占总死亡人数的22.78%,男性高于女性,农村高于城市,中部地区高于东部和西部地区。由于高血压导致预期寿命损失2.86岁,缺血性心脏病、出血性卒中和缺血性卒中引起的死亡负担最为严重。