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孟加拉国人使用世界卫生组织非实验室风险图表预测的十年心血管风险:一项全国代表性调查的结果。

Ten-years cardiovascular risk among Bangladeshi population using non-laboratory-based risk chart of the World Health Organization: Findings from a nationally representative survey.

机构信息

Centre for Non-Communicable Diseases and Nutrition, BRAC James P Grant School of Public Health, BRAC University, Dhaka, Bangladesh.

National Nutrition Services (NNS), Institute of Public Health Nutrition (IPHN), Dhaka, Bangladesh.

出版信息

PLoS One. 2021 May 26;16(5):e0251967. doi: 10.1371/journal.pone.0251967. eCollection 2021.

Abstract

The World Health Organization (WHO) has recently developed a non-laboratory based cardiovascular disease (CVD) risk chart considering the parameters age, sex, current smoking status, systolic blood pressure, and body mass index. Using the chart, we estimated the 10-years CVD risk among the Bangladeshi population aged 40-74 years. We analyzed data from a nationally representative survey conducted in 2018-19. The survey enrolled participants from 82 clusters (57 rural, 15 non-slum urban, and 10 slums) selected by multistage cluster sampling. Using the non-laboratory-based CVD risk chart of the World Health Organization (WHO), we categorized the participants into 5 risk groups: very low (<5%), low (5% to <10%), moderate (10% to <20%), high (20% to <30%) and very high (> = 30%) risk. We performed descriptive analyses to report the distribution of CVD risk and carried out univariable and multivariable logistic regression to identify factors associated with elevated CVD risk (> = 10% CVD risk). Of the 7,381 participants, 46.0% were female. The median age (IQR) was 59.0 (48.0-64.7) years. Overall, the prevalence of very low, low, moderate, high, and very high CVD risk was 34.7%, 37.8%, 25.9%, 1.6%, and 0.1%, respectively. Elevated CVD risk (> = 10%) was associated with poor education, currently unmarried, insufficient physical inactivity, smokeless tobacco use, and self-reported diabetes in both sexes, higher household income, and higher sedentary time among males, and slum-dwelling and non-Muslim religions among females. One in every four Bangladeshi adults had elevated levels of CVD risk, and males are at higher risk of occurring CVD events. Non-laboratory-based risk prediction charts can be effectively used in low resource settings. The government of Bangladesh and other developing countries should train the primary health care workers on the use of WHO non-laboratory-based CVD risk charts, especially in settings where laboratory tests are not available.

摘要

世界卫生组织(WHO)最近制定了一种基于非实验室的心血管疾病(CVD)风险图表,考虑了年龄、性别、当前吸烟状况、收缩压和体重指数等参数。我们使用该图表估计了 40-74 岁孟加拉国人的 10 年 CVD 风险。我们分析了 2018-19 年进行的一项全国代表性调查的数据。该调查通过多阶段聚类抽样从 82 个集群(57 个农村、15 个非贫民窟城市和 10 个贫民窟)中招募了参与者。我们使用世界卫生组织(WHO)的基于非实验室的 CVD 风险图表,将参与者分为 5 个风险组:极低(<5%)、低(5%-<10%)、中度(10%-<20%)、高(20%-<30%)和极高(>=30%)风险。我们进行了描述性分析,报告 CVD 风险的分布情况,并进行了单变量和多变量逻辑回归,以确定与 CVD 风险升高(>=10% CVD 风险)相关的因素。在 7381 名参与者中,46.0%为女性。中位数年龄(IQR)为 59.0(48.0-64.7)岁。总体而言,极低、低、中、高和极高 CVD 风险的患病率分别为 34.7%、37.8%、25.9%、1.6%和 0.1%。升高的 CVD 风险(>=10%)与受教育程度低、未婚、身体活动不足、使用无烟烟草以及男女双方报告的糖尿病有关,与家庭收入较高和男性久坐时间较长以及女性居住在贫民窟和非穆斯林宗教有关。每四个孟加拉成年人中就有一个人患有升高的 CVD 风险,男性发生 CVD 事件的风险更高。基于非实验室的风险预测图表可以在资源匮乏的环境中有效地使用。孟加拉国政府和其他发展中国家应培训初级卫生保健工作者使用世界卫生组织的基于非实验室的 CVD 风险图表,特别是在没有实验室测试的情况下。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d14f/8153482/a4f636c0adc5/pone.0251967.g001.jpg

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