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预测越南农村山区心血管疾病风险负担的模型

Models to Predict the Burden of Cardiovascular Disease Risk in a Rural Mountainous Region of Vietnam.

作者信息

Nguyen Thi Phuong Lan, Schuiling-Veninga C C M, Nguyen Thi Bach Yen, Hang Vu Thi Thu, Wright E Pamela, Postma M J

机构信息

Unit of PharmacoEpidemiology & PharmacoEconomics, Department of Pharmacy, University of Groningen, Groningen, The Netherlands.

Unit of PharmacoEpidemiology & PharmacoEconomics, Department of Pharmacy, University of Groningen, Groningen, The Netherlands.

出版信息

Value Health Reg Issues. 2014 May;3:87-93. doi: 10.1016/j.vhri.2014.03.003. Epub 2014 May 10.

Abstract

OBJECTIVE

To compare and identify the most appropriate model to predict cardiovascular disease (CVD) in a rural area in Northern Vietnam, using data on hypertension from the communities.

METHODS

A cross-sectional survey was conducted including all residents in selected communities, aged 34 to 65 years, during April to August 2012 in Thai Nguyen province. Data on age, sex, smoking status, blood pressure, and blood tests (glucose, total cholesterol, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol) were collected to identify the prevalence of high blood pressure and to use as input variables for the models. We compared three models, Asian, Chinese Multiple-provincial Cohort Study (CMCS), and Framingham, to estimate cardiovascular risk in the coming years in this context and compare these models and outcomes.

RESULTS

The prevalence of high blood pressure in these communities was lower than reported nationally (12.3%). CVD risk differed greatly depending on the model applied: approximately 21% of the subjects according to the CMCS and Asian models, but 37% using the Framingham model, had more than 10% risk for CVD. In the group without current CVD, these numbers decreased to 9% using the CMCS and Asian models but increased to 28% according to the Framingham model. There were no significant differences between the Asian and CMCS models, but differences were highly significant when comparing Asian versus Framingham or CMCS versus Framingham model.

CONCLUSIONS

The Asian and CMCS models provided similar results in predicting CVD risk in the Vietnamese population in Thai Nguyen. The Framingham model provided vastly different results. The suggestion may be that for the specific Vietnamese setting, the Asian and CMCS models provide most valid and reliable results; however, this has to be investigated in further analyses using real-life data for potential confirmation.

摘要

目的

利用社区高血压数据,比较并确定越南北方农村地区预测心血管疾病(CVD)的最合适模型。

方法

于2012年4月至8月在北江省进行了一项横断面调查,纳入选定社区中所有年龄在34至65岁的居民。收集年龄、性别、吸烟状况、血压和血液检测(血糖、总胆固醇、低密度脂蛋白胆固醇、高密度脂蛋白胆固醇)数据,以确定高血压患病率,并用作模型的输入变量。我们比较了三种模型,即亚洲模型、中国多省份队列研究(CMCS)模型和弗雷明汉模型,以估计该背景下未来几年的心血管风险,并比较这些模型及结果。

结果

这些社区的高血压患病率低于全国报告水平(12.3%)。根据所应用的模型,心血管疾病风险差异很大:根据CMCS模型和亚洲模型,约21%的受试者心血管疾病风险超过10%,但使用弗雷明汉模型时这一比例为37%。在目前无心血管疾病的人群中,使用CMCS模型和亚洲模型时这一数字降至9%,但根据弗雷明汉模型则升至28%。亚洲模型和CMCS模型之间无显著差异,但在比较亚洲模型与弗雷明汉模型或CMCS模型与弗雷明汉模型时差异非常显著。

结论

亚洲模型和CMCS模型在预测北江省越南人群心血管疾病风险方面提供了相似的结果。弗雷明汉模型提供了截然不同的结果。可能的建议是,对于越南的特定情况,亚洲模型和CMCS模型提供了最有效和可靠的结果;然而,这必须在进一步分析中使用实际数据进行潜在验证。

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