The George Institute for Global Health, University of Oxford, Oxford, UK (S.A.E.P., M.W.).
Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, Netherlands (S.A.E.P.).
Circulation. 2019 Feb 19;139(8):1025-1035. doi: 10.1161/CIRCULATIONAHA.118.035550.
Improvements have been made in the treatment and control of some but not all major cardiovascular risk factors in the United States. It remains unclear whether women and men have benefited equally.
Data from the 2001 to 2002 through the 2015 to 2016 US National Health and Nutrition Examination Survey on adults aged 20 to 79 years were used. We assessed sex differences in temporal trends in the levels of systolic blood pressure, body mass index, smoking status, high-density lipoprotein and total cholesterol, and hemoglobin A. Trends in treatment and control rates of hypertension, diabetes mellitus, and dyslipidemia were also assessed.
Overall, 35 416 participants (51% women) were included. Trends in systolic blood pressure, smoking status, high-density lipoprotein cholesterol, and hemoglobin A were similar between the sexes. Body mass index increased more in women than men ( P=0.006). Mean levels were 28.1 and 29.6 kg/m in women and 27.9 and 29.0 kg/m in men in 2001 to 2004 and 2013 to 2016, respectively. Total cholesterol decreased more in men than women ( P=0.002): mean levels in 2001 to 2004 and 2013 to 2016, respectively, were 203 and 194 mg/dL in women and 201 and 188 mg/dL in men. Improvements in the control of hypertension, diabetes mellitus, and dyslipidemia were similar between the sexes; however, sex differences persisted. In 2013 to 2016, control rates in women versus men were 30% versus 22% for hypertension, 30% versus 20% for diabetes mellitus, and 51% versus 63% for dyslipidemia.
Temporal trends in cardiovascular risk factor levels were broadly similar between the sexes, except for total cholesterol and body mass index. Sex differences in the control of hypertension, diabetes mellitus, and dyslipidemia persist, and further efforts are required to reduce this differential.
美国在一些但不是所有主要心血管风险因素的治疗和控制方面已经取得了进步。目前尚不清楚女性和男性是否同样受益。
本研究使用了 2001 年至 2002 年至 2015 年至 2016 年美国全国健康和营养调查中年龄在 20 至 79 岁的成年人的数据。我们评估了男性和女性在收缩压、体重指数、吸烟状况、高密度脂蛋白和总胆固醇以及血红蛋白 A 水平随时间的变化趋势方面的性别差异。还评估了高血压、糖尿病和血脂异常的治疗和控制率的变化趋势。
共有 35416 名参与者（51%为女性）纳入本研究。男性和女性的收缩压、吸烟状况、高密度脂蛋白胆固醇和血红蛋白 A 的变化趋势相似。体重指数在女性中增加得更多（P=0.006）。女性的平均水平分别为 28.1 和 29.6kg/m，男性的平均水平分别为 27.9 和 29.0kg/m，分别为 2001 年至 2004 年和 2013 年至 2016 年。男性的总胆固醇降低得更多（P=0.002）：2001 年至 2004 年和 2013 年至 2016 年，女性的平均水平分别为 203 和 194mg/dL，男性的平均水平分别为 201 和 188mg/dL。男女两性高血压、糖尿病和血脂异常的控制改善情况相似；然而，性别差异仍然存在。在 2013 年至 2016 年，女性与男性的高血压控制率分别为 30%和 22%，糖尿病控制率分别为 30%和 20%，血脂异常控制率分别为 51%和 63%。
除了总胆固醇和体重指数之外，男性和女性的心血管风险因素水平的随时间变化趋势基本相似。高血压、糖尿病和血脂异常控制方面的性别差异仍然存在，需要进一步努力缩小这种差异。
