六个中低收入国家老年人的心血管疾病 (CVD) 及相关危险因素：SAGE 波 1 研究结果。
Cardiovascular disease (CVD) and associated risk factors among older adults in six low-and middle-income countries: results from SAGE Wave 1.
机构信息
Shanghai Municipal Center for Disease Control and Prevention (Shanghai CDC), Shanghai, China.
World Health Organization, Geneva, Switzerland.
出版信息
BMC Public Health. 2018 Jun 20;18(1):778. doi: 10.1186/s12889-018-5653-9.
BACKGROUND
Cardiovascular disease (CVD) is one of the leading causes of death worldwide. Our study aimed to investigate the prevalence of two conditions, angina and stroke, and relevant risk factors among older adults in six low- and middle- income countries(LMICs).
METHODS
The data was from World Health Organization (WHO) Study on global AGEing and adult Health (SAGE) Wave 1 in China, Ghana, India, Mexico, Russian Federation and South Africa. Presence of CVD was based on self-report of angina and stroke. Multivariate logistic regression was performed to examine the relationship between CVD and selected variables, including age, sex, urban/rural setting, household wealth, and risk factors such as smoking, alcohol drinking, fruit/vegetable intake, physical activity and BMI.
RESULTS
The age standardized prevalence of angina ranged from 9.5 % (South Africa) to 47.5 % (Russian Federation), and for stoke from 2.0% (India) to 6.1 % (Russia). Hypertension was associated with angina in China, India and Russian Federation after adjustment for age, sex, urban/rural setting, education and marital status (OR ranging from 1.3 [1.1-1.6] in India to 3.8 [2.9-5.0] in Russian Federation), furthermore it was a risk factor of stroke in five countries except Mexico. Low or moderate physical activity were also associated with angina in China, and were also strongly associated with stroke in all countries except Ghana and India. Obesity had a stronger association with angina in Russian Federation and China(ORs were 1.5[1.1-2.0] and 1.2 [1.0-1.5] respectively), and increased the risk of stroke in China. Smoking was associated with angina in India and South Africa(ORs were 1.6[1.0-2.4] and 2.1 [1.2-3.6] respectively ), and was also a risk factor of stroke in South Africa. We observed a stronger association between frequent heavy drinking and stroke in India. Household income was associated with reduced odds of angina in China, India and Russian Federation, however higher household income was a risk factor of angina in South Africa.
CONCLUSION
While the specific mix of risk factors contribute to disease prevalence in different ways in these six countries - they should all be targeted in multi-sectoral efforts to reduce the high burden of CVD in today's society.
背景
心血管疾病（CVD）是全球范围内主要的死亡原因之一。我们的研究旨在调查六个中低收入国家（LMICs）老年人中心绞痛和中风两种疾病的流行情况及其相关危险因素。
方法
数据来自世界卫生组织（WHO）全球老龄化和成人健康研究（SAGE）第一波在中国、加纳、印度、墨西哥、俄罗斯联邦和南非进行的调查。CVD 的存在是基于自我报告的心绞痛和中风。采用多变量逻辑回归分析方法，研究 CVD 与年龄、性别、城乡环境、家庭财富等选定变量以及吸烟、饮酒、水果/蔬菜摄入、身体活动和 BMI 等危险因素之间的关系。
结果
经年龄标准化后，心绞痛的患病率范围为 9.5%（南非）至 47.5%（俄罗斯联邦），中风的患病率范围为 2.0%（印度）至 6.1%（俄罗斯联邦）。调整年龄、性别、城乡环境、教育程度和婚姻状况后，高血压与中国、印度和俄罗斯联邦的心绞痛相关（印度的比值比范围为 1.3[1.1-1.6]，俄罗斯联邦为 3.8[2.9-5.0]），此外，高血压也是五个国家（墨西哥除外）中风的危险因素。低或中度体力活动与中国的心绞痛有关，与除加纳和印度以外的所有国家的中风也密切相关。肥胖与俄罗斯联邦和中国的心绞痛关系更密切（比值比分别为 1.5[1.1-2.0]和 1.2[1.0-1.5]），且增加了中国中风的风险。吸烟与印度和南非的心绞痛有关（比值比分别为 1.6[1.0-2.4]和 2.1[1.2-3.6]），且也是南非中风的危险因素。我们观察到，在印度，频繁大量饮酒与中风之间的关联更强。家庭收入与中国、印度和俄罗斯联邦心绞痛的几率降低有关，但南非家庭收入较高是心绞痛的危险因素。
结论
虽然这些国家中特定的危险因素组合以不同的方式导致了疾病的流行，但在多部门努力降低当今社会 CVD 的高负担时，都应将这些因素作为目标。
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