Wang Baohua, Li Peiyao, He Fengdie, Sha Yuting, Wan Xia, Wang Lijun
National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, 27 Nanwei Road, Xicheng District, Beijing, 100050, P.R. China.
China and Japan Friendship Hospital, Yinghua East Street 2#, Chaoyang District, Beijing, P.R. China.
BMC Public Health. 2021 Jan 4;21(1):9. doi: 10.1186/s12889-020-10019-6.
To explore the relationship between geographical differences of mortality and related risk factors in ischemic heart disease (IHD) in China.
Data were collected from the nationally representative China Mortality Surveillance System to calculate annual IHD mortality counts (2010-2015). Descriptive analysis was used to analyze the IHD mortality among Chinese population from 2010 to 2015. Negative binomial regression was used to investigate potential spatiotemporal variation and correlations with age, gender, urbanization, and region.
The overall IHD mortality was 221.17/100,000, accounting for 1.51 million deaths in 2015. The standardized IHD mortality rate increased by 5.51% from 2010 to 2015 among people aged 40 years and older. Multilevel analysis indicated significant differences in gender, regions, and age. High urbanization rate (risk ratio [RR] = 0.728, 95% confidence interval [CI] = (0.631, 0.840)) and average high-density lipoprotein (HDL) (RR = 0.741, 95%CI: 0.616,0.891) were negatively associated with IHD mortality. IHD mortality was significantly higher in populations with a low rate of medical insurance coverage (RR = 1.218, 95%CI: 1.007, 1.473), as well as the average body mass index (BMI) (RR = 1.436, 95%CI: 1.135, 1.817) and systolic blood pressure (SBP) (RR = 1.310, 95%CI: 1.019, 1.684). While the relationship with current smoking rate, excessive intake of red meat, insufficient vegetable or fruits intake didn't show the statistical significance. The negative correlation between the average sedentary time and IHD mortality was not conclusive due to the possible deviation of the data.
The mortality of IHD showed an upward trend for people aged 40 years and older in China during 2010-2015, which should be paid attention to. Therefore, some risk factors should be controlled, such as SBP, overweight/obesity. HDL is a protective factor, as well as higher urbanization rate, family income level, and medical insurance coverage.
探讨中国缺血性心脏病（IHD）死亡率的地理差异与相关危险因素之间的关系。
从具有全国代表性的中国死亡率监测系统收集数据，以计算2010 - 2015年IHD的年度死亡人数。采用描述性分析来分析2010年至2015年中国人群中的IHD死亡率。使用负二项回归来研究潜在的时空变化以及与年龄、性别、城市化和地区的相关性。
2015年IHD总体死亡率为221.17/10万，占死亡人数151万。2010年至2015年，40岁及以上人群的标准化IHD死亡率上升了5.51%。多水平分析表明性别、地区和年龄存在显著差异。高城市化率（风险比[RR]=0.728，95%置信区间[CI]=(0.631, 0.840)）和平均高密度脂蛋白（HDL）（RR = 0.741，95%CI：0.616,0.891）与IHD死亡率呈负相关。医疗保险覆盖率低的人群（RR = 1.218，95%CI：1.007, 1.473）、平均体重指数（BMI）（RR = 1.436，95%CI：1.135, 1.817）和收缩压（SBP）（RR = 1.310，95%CI：1.019, 1.684）人群的IHD死亡率显著更高。而与当前吸烟率、红肉摄入过多、蔬菜或水果摄入不足之间的关系未显示出统计学意义。由于数据可能存在偏差，平均久坐时间与IHD死亡率之间的负相关关系尚无定论。
2010 - 2015年中国40岁及以上人群的IHD死亡率呈上升趋势，应予以关注。因此，应控制一些危险因素，如收缩压、超重/肥胖。HDL是一个保护因素，高城市化率、家庭收入水平和医疗保险覆盖率也是如此。
