Desai Rupak, Patel Upenkumar, Parekh Tarang, Hanna Bishoy, Sitammagari Kranthi, Fong Hee Kong, Lodhi Muhammad Uzair, Varma Yash, Damarlapally Nanush, Doshi Rajkumar, Savani Sejal, Kumar Gautam, Sachdeva Rajesh
From the Division of Cardiology, Atlanta Veterans Affairs Medical Center, Decatur, Georgia, the Department of Internal Medicine, Nassau University Medical Center, East Meadow, New York, the Department of Health Administration and Policy, George Mason University, Fairfax, Virginia, the Division of Cardiology, Morehouse School of Medicine, Atlanta, Georgia, the Department of Internal Medicine, Atrium Health Union, Monroe, North Carolina, the Division of Cardiology, University of California, Davis Medical Center, Sacramento, the Department of Internal Medicine, Eastern Idaho Regional Medical Center, Idaho Falls, the Department of Medicine, Bhavnagar Medical College, Gujarat, India, the Department of Health Sciences, Coleman College of Health Sciences, Houston, Texas, the Department of Internal Medicine, University of Nevada, Reno School of Medicine, Reno, and the Department of Public Health, New York University, New York, New York.
South Med J. 2020 Jun;113(6):311-319. doi: 10.14423/SMJ.0000000000001106.
Prevalence and trends in all cardiovascular disease (CVD) risk factors among young adults (18-39 years) have not been evaluated on a large scale stratified by sex and race. The aim of this study was to establish the prevalence and temporal trend of CVD risk factors in US inpatients younger than 40 years of age from 2007 through 2014 with racial and sex-based distinctions. In addition, the impact of these risk factors on inpatient outcomes and healthcare resource utilization was explored.
A cross-sectional nationwide analysis of all hospitalizations, comorbidities, and complications among young adults from 2007 to 2014 was performed. The primary outcomes were frequency, trends, and race- and sex-based differences in coexisting CVD risk factors. Coprimary outcomes were trends in all-cause mortality, acute myocardial infarction, arrhythmia, stroke, and venous thromboembolism in young adults with CVD risk factors. Secondary outcomes were demographics and resource utilization in young adults with versus without CVD risk factors.
Of 63 million hospitalizations (mean 30.5 [standard deviation 5.9] years), 27% had at least one coexisting CVD risk factor. From 2007 to 2014, admission frequency with CVD risk factors increased from 42.8% to 55.1% in males and from 16.2% to 24.6% in females. Admissions with CVD risk were higher in male (41.4% vs 15.9%) and white (58.4% vs 53.8%) or African American (22.6% vs 15.9%) patients compared with those without CVD risk. Young adults in the Midwest (23.9% vs 21.1%) and South (40.8% vs 37.9%) documented comparatively higher hospitalizations rates with CVD risk. Young adults with CVD risk had higher all-cause in-hospital mortality (0.4% vs. 0.3%) with a higher average length of stay (4.3 vs 3.2 days) and charges per admission ($30,074 vs $20,124).
Despite modern advances in screening, management, and interventional measures for CVD, rising trends in CVD risk factors across all sex and race/ethnic groups call for attention by preventive cardiologists.
尚未大规模评估18至39岁年轻成年人中所有心血管疾病（CVD）风险因素的患病率及趋势，且未按性别和种族进行分层。本研究的目的是确定2007年至2014年美国40岁以下住院患者中CVD风险因素的患病率及时间趋势，并区分种族和性别。此外，还探讨了这些风险因素对住院结局和医疗资源利用的影响。
对2007年至2014年所有年轻成年人的住院情况、合并症和并发症进行全国性横断面分析。主要结局是并存CVD风险因素的频率、趋势以及基于种族和性别的差异。共同主要结局是患有CVD风险因素的年轻成年人的全因死亡率、急性心肌梗死、心律失常、中风和静脉血栓栓塞的趋势。次要结局是有和没有CVD风险因素的年轻成年人的人口统计学和资源利用情况。
在6300万次住院治疗中（平均年龄30.5岁[标准差5.9岁]），27%的患者至少并存一种CVD风险因素。从2007年到2014年，有CVD风险因素的男性入院频率从42.8%增至55.1%，女性从16.2%增至24.6%。与无CVD风险的患者相比，有CVD风险的男性（41.4%对15.9%）、白人（58.4%对53.8%）或非裔美国人（22.6%对15.9%）患者入院率更高。中西部（23.9%对21.1%）和南部（40.8%对37.9%）的年轻成年人记录到有CVD风险的住院率相对较高。有CVD风险因素的年轻成年人全因住院死亡率更高（0.4%对0.3%），平均住院时间更长（4.3天对3.2天），每次入院费用更高（30074美元对20124美元）。
尽管在CVD的筛查、管理和干预措施方面取得了现代进展，但所有性别和种族/族裔群体中CVD风险因素的上升趋势仍需预防心脏病专家予以关注。
