Andersen Karl, Aspelund Thor, Gudmundsson Elías Freyr, Siggeirsdottir Kristin, Thorolfsdottir Rosa Bjork, Sigurdsson Gunnar, Gudnason Vilmundur
Laeknabladid. 2017;103(10):411-420. doi: 10.17992/lbl.2017.10.153.
Coronary artery disease has been the leading cause of death and disability in Iceland during the past decades although in recent years, malignancy has taken over that position. A steady improvement in the level of major risk factors has been evident since 1980. This trend explains 72% of the decrease in premature mortality from coronary artery disease during the past three decades. However, an opposing trend in increasing obesity and type 2 diabetes has attenuated this decline in premature deaths. Unchanged risk factor trends will lead to increasing cardiovascular mortality in the years to come. This will result from the above mentioned changes in major risk factors as well as an increased ageing of the Icelandic population. At the same time case fatality after myocardial infarction has declined substantially. This will result in a steadily growing proportion of elderly in the population as well as a high burden of chronic non-communicable diseases among the elderly population. The resulting increase in long term disease and disability will put a major constraint on the health care system and economy alike. According to vital statistics and secular trends the rate of Icelanders in working age for each one reaching retirement age will decrease from the current 5.6 to 2.6 by year 2060. This paper addresses the driving factors of risk factor change in Iceland with previously unpublished data extending to 2013.
在过去几十年里，冠状动脉疾病一直是冰岛死亡和残疾的主要原因，不过近年来，恶性肿瘤已取代了这一地位。自1980年以来，主要危险因素水平有了稳步改善。这一趋势解释了过去三十年冠状动脉疾病过早死亡率下降的72%。然而，肥胖和2型糖尿病不断增加的相反趋势削弱了过早死亡人数的下降。危险因素趋势不变将导致未来几年心血管疾病死亡率上升。这将是上述主要危险因素变化以及冰岛人口老龄化加剧的结果。与此同时，心肌梗死后的病死率大幅下降。这将导致老年人口在总人口中的比例稳步上升，以及老年人口中慢性非传染性疾病的高负担。由此导致的长期疾病和残疾增加将给医疗保健系统和经济都带来重大限制。根据人口动态统计和长期趋势，到2060年，每一个达到退休年龄的冰岛劳动年龄人口的比率将从目前的5.6降至2.6。本文利用截至2013年的未发表数据探讨了冰岛危险因素变化的驱动因素。
