MMWR Morb Mortal Wkly Rep. 2018 Sep 7;67(35):983-991. doi: 10.15585/mmwr.mm6735a4.
Despite decades-long reductions in cardiovascular disease (CVD) mortality, CVD mortality rates have recently plateaued and even increased in some subgroups, and the prevalence of CVD risk factors remains high. Million Hearts 2022, a 5-year initiative, was launched in 2017 to address this burden. This report establishes a baseline for the CVD risk factors targeted for reduction by the initiative during 2017-2021 and highlights recent changes over time.
Risk factor prevalence among U.S. adults was assessed using data from the National Health and Nutrition Examination Survey, National Survey on Drug Use and Health, and National Health Interview Survey. Multivariate analyses were performed to assess differences in prevalence during 2011-2012 and the most recent cycle of available data, and across subgroups.
During 2013-2014, the prevalences of aspirin use for primary and secondary CVD prevention were 27.4% and 74.9%, respectively, and of statin use for cholesterol management was 54.5%. During 2015-2016, the average daily sodium intake was 3,535 mg/day and the prevalences of blood pressure control, combustible tobacco use, and physical inactivity were 48.5%, 22.3%, and 29.1%, respectively. Compared with 2011-2012, significant decreases occurred in the prevalences of combustible tobacco use and physical inactivity; however, a decrease also occurred for aspirin use for primary or secondary prevention. Disparities in risk factor prevalences were observed across age groups, genders, and racial/ethnic groups.
Millions of Americans have CVD risk factors that place them at increased risk for having a cardiovascular event, despite the existence of proven strategies for preventing or managing CVD risk factors. A concerted effort to implement these strategies will be needed to prevent one million acute cardiovascular events during the 5-year initiative.
尽管心血管疾病（CVD）死亡率在过去几十年中有所下降，但最近 CVD 死亡率已经趋于平稳，甚至在某些亚组中有所上升，CVD 风险因素的患病率仍然很高。“百万心脏 2022”是一项为期 5 年的倡议，于 2017 年启动，旨在应对这一负担。本报告为该倡议在 2017-2021 年期间针对降低的 CVD 风险因素建立了一个基准，并重点介绍了最近随时间的变化。
使用来自全国健康和营养调查、全国药物使用和健康调查以及全国健康访谈调查的数据评估美国成年人的风险因素患病率。进行多变量分析，以评估 2011-2012 年和最近一轮可用数据期间以及各亚组之间的患病率差异。
在 2013-2014 年，阿司匹林用于一级和二级 CVD 预防的使用率分别为 27.4%和 74.9%，他汀类药物用于胆固醇管理的使用率为 54.5%。在 2015-2016 年，平均每日钠摄入量为 3535 毫克/天，血压控制、可燃烟草使用和身体活动不足的患病率分别为 48.5%、22.3%和 29.1%。与 2011-2012 年相比，可燃烟草使用和身体活动不足的患病率显著下降；然而，用于一级或二级预防的阿司匹林使用率也有所下降。在年龄组、性别和种族/族裔群体之间观察到风险因素患病率的差异。
尽管存在预防或管理 CVD 风险因素的既定策略，但仍有数百万美国人存在心血管疾病风险因素，使他们面临发生心血管事件的风险增加。在为期 5 年的倡议期间，需要齐心协力地实施这些策略，以预防一百万人发生急性心血管事件。
