Hinton William, McGovern Andrew, Coyle Rachel, Han Thang S, Sharma Pankaj, Correa Ana, Ferreira Filipa, de Lusignan Simon
Section of Clinical Medicine & Ageing, Department of Clinical & Experimental Medicine, University of Surrey, Guildford, UK.
Institute of Cardiovascular Research, Royal Holloway University of London, Egham, UK.
BMJ Open. 2018 Aug 20;8(8):e020282. doi: 10.1136/bmjopen-2017-020282.
To describe incidence and prevalence of cardiovascular disease (CVD), its risk factors, medication prescribed to treat CVD and predictors of CVD within a nationally representative dataset.
Cross-sectional study of adults with and without CVD.
The Royal College of General Practitioners (RCGP) Research and Surveillance Centre (RSC) is an English primary care sentinel network. RCGP RSC is over 50 years old and one of the oldest in Europe. Practices receive feedback about data quality. This database is primarily used to conduct surveillance and research into influenza, infections and vaccine effectiveness but is also a rich resource for the study of non-communicable disease (NCD). The RCGP RSC network comprised 164 practices at the time of study.
Data were extracted from the records of 1 275 174 adults. Approximately a fifth (21.3%; 95% CI 21.2% to 21.4%) had CVD (myocardial infarction (MI), angina, atrial fibrillation (AF), peripheral arterial disease, stroke/transient ischaemic attack (TIA), congestive cardiac failure) or hypertension. Smoking, unsafe alcohol consumption and obesity were more common among people with CVD. Angiotensin system modulating drugs, 3-hydroxy-3-methylglutaryl-coenzyme (HMG-CoA) reductase inhibitors (statins) and calcium channel blockers were the most commonly prescribed CVD medications. Age-adjusted and gender-adjusted annual incidence for AF was 28.2/10 000 (95% CI 27.8 to 28.7); stroke/TIA 17.1/10 000 (95% CI 16.8 to 17.5) and MI 9.8/10 000 (95% CI 9.5 to 10.0). Logistic regression analyses confirmed established CVD risk factors were associated with CVD in the RCGP RSC network dataset.
The RCGP RSC database provides comprehensive information on risk factors, medical diagnosis, physiological measurements and prescription history that could be used in CVD research or pharmacoepidemiology. With the exception of MI, the prevalence of CVDs was higher than in other national data, possibly reflecting data quality. RCGP RSC is an underused resource for research into NCDs and their management and welcomes collaborative opportunities.
在一个具有全国代表性的数据集中，描述心血管疾病（CVD）的发病率和患病率、其风险因素、用于治疗CVD的药物以及CVD的预测因素。
对患有和未患有CVD的成年人进行横断面研究。
皇家全科医师学院（RCGP）研究与监测中心（RSC）是一个英国基层医疗哨点网络。RCGP RSC已有50多年历史，是欧洲最古老的之一。各医疗机构会收到有关数据质量的反馈。该数据库主要用于对流感、感染和疫苗效果进行监测和研究，但也是研究非传染性疾病（NCD）的丰富资源。在研究时，RCGP RSC网络由164个医疗机构组成。
从1275174名成年人的记录中提取数据。约五分之一（21.3%；95%CI 21.2%至21.4%）的人患有CVD（心肌梗死（MI）、心绞痛、心房颤动（AF）、外周动脉疾病、中风/短暂性脑缺血发作（TIA）、充血性心力衰竭）或高血压。吸烟、不安全饮酒和肥胖在患有CVD的人群中更为常见。血管紧张素系统调节药物、3-羟基-3-甲基戊二酰辅酶（HMG-CoA）还原酶抑制剂（他汀类药物）和钙通道阻滞剂是最常用的治疗CVD的药物。AF的年龄和性别调整后的年发病率为28.2/10000（95%CI 27.8至28.7）；中风/TIA为17.1/10000（95%CI 16.8至17.5），MI为9.8/10000（95%CI 9.5至10.0）。逻辑回归分析证实，已确定的CVD风险因素与RCGP RSC网络数据集中的CVD相关。
RCGP RSC数据库提供了有关风险因素、医学诊断、生理测量和用药史的全面信息，可用于CVD研究或药物流行病学研究。除MI外，CVD的患病率高于其他国家数据，这可能反映了数据质量。RCGP RSC是一个未得到充分利用的非传染性疾病及其管理研究资源，欢迎合作机会。
