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东地中海区域心血管疾病的可避免负担:心血管相关死亡的特定风险因素的作用

Avoidable Burden of Cardiovascular Diseases in the Eastern Mediterranean Region: Contribution of Selected Risk Factors for Cardiovascular-Related Deaths.

作者信息

Mazloumi Ehsan, Poorolajal Jalal, Sarrafzadegan Nizal, Roohafza Hamid Reza, Faradmal Javad, Karami Manoochehr

机构信息

Department of Epidemiology, School of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran.

Research Center for Health Sciences, Hamadan University of Medical Sciences, Hamadan, Iran.

出版信息

High Blood Press Cardiovasc Prev. 2019 Jun;26(3):227-237. doi: 10.1007/s40292-019-00319-3. Epub 2019 Jun 21.

Abstract

INTRODUCTION

Contribution of risk factors for cardiovascular-related deaths in the Eastern Mediterranean Region Organization (EMRO) is not estimated quantitatively.

AIM

To determine the avoidable burden of cardiovascular diseases (CVDs) due to hypertension, diabetes, smoking, overweight, and obesity in countries of EMRO of the WHO.

METHODS

The comparative risk assessment methodology was used to calculate the potential impact fraction (PIF) and percentage of the avoidable burden of CVD-related death due to associated risk factors. Population exposure levels for CVDs and corresponding measures of association were extracted from published studies. The attributable burden was calculated by multiplying the Disability-Adjusted Life-Years (DALYs) for CVDs by the estimated impact fraction of risk factors. DALYs of the CVDs in all countries of the EMRO were extracted from the GBD official website in 2016.

RESULTS

Following reduction of the current prevalence of smoking, obesity, hypertension, diabetes, and overweight to a feasible minimum risk exposure level in Lebanon, about 12.4%, 4.2%, 10.2%, 3.8%, and 5.7% of the burden of CVD-related mortality could be avoidable, respectively. The corresponding values of avoidable burden in selected EMRO countries were 5.1%, 3.5%, 9.4%, 5.9% and 5.3% in Iran and 9.5%, 4.1%, 11%, 8.2% and 5.4% in Egypt.

CONCLUSIONS

Findings suggest that health policy makers of all EMRO countries should take into account the attributable burden of CVD-related mortality due to associated risk factors to effectively develop preventive interventions.

摘要

引言

东地中海区域组织(EMRO)中心血管相关死亡风险因素的贡献尚未进行定量评估。

目的

确定世界卫生组织东地中海区域国家中高血压、糖尿病、吸烟、超重和肥胖导致的心血管疾病(CVD)可避免负担。

方法

采用比较风险评估方法计算潜在影响分数(PIF)以及相关风险因素导致的CVD相关死亡可避免负担的百分比。从已发表的研究中提取CVD的人群暴露水平及相应的关联度量。可归因负担通过将CVD的伤残调整生命年(DALYs)乘以风险因素的估计影响分数来计算。EMRO所有国家CVD的DALYs数据于2016年从全球疾病负担(GBD)官方网站提取。

结果

在黎巴嫩,如果将当前吸烟、肥胖、高血压、糖尿病和超重的患病率降低到可行的最低风险暴露水平,那么CVD相关死亡率负担中约12.4%、4.2%、10.2%、3.8%和5.7%将可避免。在选定的东地中海区域国家中,伊朗可避免负担的相应值分别为5.1%、3.5%、9.4%、5.9%和5.3%,埃及为9.5%、4.1%、11%、8.2%和5.4%。

结论

研究结果表明,所有东地中海区域国家的卫生政策制定者应考虑相关风险因素导致的CVD相关死亡的可归因负担,以有效制定预防干预措施。

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