Cardiovascular Division, University of Minnesota, USA.
Division of Cardiovascular Disease, University of Alabama at Birmingham, USA.
Eur J Prev Cardiol. 2021 Apr 23;28(3):304-312. doi: 10.1177/2047487320905190. Epub 2020 Mar 2.
There are little contemporary data about cardiovascular risk factors among young adults. We defined trends in diabetes mellitus (DM), hypertension, and hypercholesterolemia in American adults aged 18-44 years.
The National Health and Nutrition Examination Study serial cross-sectional surveys were used to define three time periods: 2005-2008, 2009-2012, and 2013-2016. Age-adjusted weighted trends of prevalence, awareness, treatment, and control of DM, hypertension, and hypercholesterolemia were calculated by linear regression modelling in the overall sample, males, and females. Trends were calculated after adjustment for age, race, body mass index, smoking status, education attainment, income, insurance status, and number of healthcare visits.
From 2005-2008 to 2013-2016, 15,171 participants were identified. DM prevalence was stable ∼3%, hypertension prevalence was stable ∼11.0%, and hypercholesterolemia prevalence declined from 11.5% to 9.0% (ptrend = 0.02). DM awareness stayed stable between 61.1 and 74.1%, hypertension awareness increased from 68.7 to 77.7% (ptrend = 0.05), and hypercholesterolemia awareness was stable between 46.8 and 54.1%. DM and hypertension treatment improved markedly (ptrend < 0.001 and 0.05, respectively) but the hypercholesterolemia treatment was stable ∼30%. DM control improved across survey periods (7.7-17.4%, ptrend = 0.04) but hypertension control (∼50%) and hypercholesterolemia control (∼13%) remained stable. Prevalence, awareness, treatment, and control trends also differed between males and females.
There is a stable prevalence of DM, high and stable prevalence of hypertension, and declining prevalence of hypercholesterolemia among young Americans. Despite stable or increasing awareness of diabetes and hypertension, there are inadequate treatment and control trends for DM, hypertension, and hypercholesterolemia.
目前有关年轻人心血管危险因素的当代数据较少。我们定义了美国 18-44 岁成年人中糖尿病（DM）、高血压和高胆固醇血症的趋势。
本研究使用国家健康和营养检查调查的系列横断面调查来定义三个时间段：2005-2008 年、2009-2012 年和 2013-2016 年。通过线性回归模型，在总体样本、男性和女性中计算了 DM、高血压和高胆固醇血症的患病率、知晓率、治疗率和控制率的年龄调整后加权趋势。在调整年龄、种族、体重指数、吸烟状况、教育程度、收入、保险状况和医疗保健就诊次数后，计算了趋势。
2005-2008 年至 2013-2016 年，共确定了 15171 名参与者。DM 患病率稳定在 3%左右，高血压患病率稳定在 11.0%左右，高胆固醇血症患病率从 11.5%下降到 9.0%（ptrend=0.02）。DM 知晓率在 61.1%至 74.1%之间保持稳定，高血压知晓率从 68.7%上升到 77.7%（ptrend=0.05），高胆固醇血症知晓率在 46.8%至 54.1%之间保持稳定。DM 和高血压的治疗明显改善（ptrend<0.001 和 0.05），但高胆固醇血症的治疗保持在 30%左右。DM 控制在各调查期间均有所改善（7.7%-17.4%，ptrend=0.04），但高血压控制（约 50%）和高胆固醇血症控制（约 13%）保持稳定。男性和女性之间的患病率、知晓率、治疗率和控制率趋势也存在差异。
在美国年轻人中，DM 的患病率稳定，高血压的患病率高且稳定，高胆固醇血症的患病率呈下降趋势。尽管糖尿病和高血压的知晓率稳定或有所上升，但 DM、高血压和高胆固醇血症的治疗和控制趋势仍不理想。
