全球、区域和国家缺血性心脏病负担及其归因风险因素,1990-2017 年:2017 年全球疾病负担研究结果。

Global, regional, and national burden of ischaemic heart disease and its attributable risk factors, 1990-2017: results from the Global Burden of Disease Study 2017.

机构信息

Centre for Disease Modelling, Department of Mathematics and Statistics, York University, 4700 Keele Street, Toronto, ON M3J 1P3, Canada.

Department of Cardiology, The Third Xiangya Hospital, Central South University, 138 Tongzipo Road, Changsha 410013, China.

出版信息

Eur Heart J Qual Care Clin Outcomes. 2022 Jan 5;8(1):50-60. doi: 10.1093/ehjqcco/qcaa076.

Abstract

AIMS

The aim of this study was to estimate the burden and risk factors for ischaemic heart disease (IHD) in 195 countries and territories from 1990 to 2017.

METHODS AND RESULTS

Data from the Global Burden of Disease Study 2017 were used. Prevalence, incidence, deaths, years lived with disability (YLDs), and years of life lost (YLLs) were metrics used to measure IHD burden. Population attributable fraction was used to estimate the proportion of IHD deaths attributable to potentially modifiable risk factors. Globally, in 2017, 126.5 million [95% uncertainty interval (UI) 118.6 to 134.7] people lived with IHD and 10.6 million (95% UI 9.6 to 11.8) new IHD cases occurred, resulting in 8.9 million (95% UI 8.8 to 9.1) deaths, 5.3 million (95% UI 3.7 to 7.2) YLDs, and 165.0 million (95% UI 162.2 to 168.6) YLLs. Between 1990 and 2017, despite the decrease in age-standardized rates, the global numbers of these burden metrics of IHD have significantly increased. The burden of IHD in 2017 and its temporal trends from 1990 to 2017 varied widely by geographic location. Among all potentially modifiable risk factors, age-standardized IHD deaths worldwide were primarily attributable to dietary risks, high systolic blood pressure, high LDL cholesterol, high fasting plasma glucose, tobacco use, and high body mass index in 2017.

CONCLUSION

Our results suggested that IHD remains a major public health challenge worldwide. More effective and targeted strategies aimed at implementing cost-effective interventions and addressing modifiable risk factors are urgently needed, particularly in geographies with high or increasing burden.

摘要

目的

本研究旨在估计 1990 年至 2017 年 195 个国家和地区缺血性心脏病(IHD)的负担和风险因素。

方法和结果

使用 2017 年全球疾病负担研究的数据。使用患病率、发病率、死亡率、残疾生命年(YLDs)和生命损失年(YLLs)来衡量 IHD 负担。人群归因分数用于估计可改变的风险因素导致的 IHD 死亡比例。在全球范围内,2017 年有 1.265 亿人(95%不确定区间 [95% UI] 1.186 亿至 1.347 亿)患有 IHD,1060 万例(95% UI 9.6 万至 11.8 万)新发生 IHD 病例,导致 890 万人(95% UI 8.8 万至 9.1 万)死亡,530 万人(95% UI 3.7 万至 7.2 万)YLDs 和 1.65 亿人(95% UI 1.62 亿至 1.68 亿)YLLs。尽管年龄标准化率下降,但自 1990 年至 2017 年,这些 IHD 负担指标的全球数量仍显著增加。2017 年 IHD 的负担及其 1990 年至 2017 年的时间趋势在地理位置上差异很大。在所有可改变的风险因素中,2017 年全球年龄标准化的 IHD 死亡主要归因于饮食风险、收缩压高、低密度脂蛋白胆固醇高、空腹血糖高、吸烟和高身体质量指数。

结论

我们的结果表明,IHD 仍然是全球主要的公共卫生挑战。迫切需要更有效和有针对性的策略,以实施具有成本效益的干预措施,并解决可改变的风险因素,特别是在负担较高或呈上升趋势的地区。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c22c/8728029/805f3b7fb33d/qcaa076fig1.jpg

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