孟加拉国农村地区的心血管疾病总体风险评估：由当地社区卫生工作者进行的家庭层面横断面调查。

Estimated total cardiovascular risk in a rural area of Bangladesh: a household level cross-sectional survey done by local community health workers.

机构信息

Research and Publication, WHO Country Office for Bangladesh, Dhaka, Bangladesh

Public Health, Shiga University of Medical Science, Otsu, Japan.

出版信息

BMJ Open. 2021 Aug 4;11(8):e046195. doi: 10.1136/bmjopen-2020-046195.

DOI:10.1136/bmjopen-2020-046195

PMID:34348948

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8340298/

Abstract

OBJECTIVE

The aim of this study was to estimate 10-year cardiovascular disease (CVD) risk among Bangladeshi rural community residents, using the 2014 WHO/International Society of Hypertension (WHO/ISH) risk prediction charts.

STUDY DESIGN

Cross-sectional population-based study done by local community healthcare workers engaging the lowest level facilities of the primary healthcare system.

SETTING AND PARTICIPANTS

A total of 1545 rural adults aged ≥40 years of Debhata upazila of Satkhira district of Bangladesh participated in this survey done in 2015. The community health workers collected data on age, smoking, blood pressure, blood glucose and treatment history of diabetes and hypertension.

PRIMARY OUTCOME MEASURES

We estimated total 10-year CVD risk using the WHO/ISH South East Asia Region-D charts without cholesterol and categorised the risk into low (<10%), moderate (10%-19.9%), high (20%-29.9%) and very high (≥30%).

RESULTS

The participants' mean age (±SD) was 53.9±11.6 years. Overall, the 10-year CVD risks (%, 95% CI) were as follows: low risk (81.6%, 95% CI 78.4% to 84.6%), moderate risk (9.9%, 95% CI 7.4% to 12.1%), high risk (5.8%, 95% CI 4.4% to 7.2%) and very high risk (2.8%, 95% CI 1.5% to 4.1%). In women, moderate to very high risks were higher (moderate 12.1%, high 6.1% and very high 3.7%) compared with men (moderate 7.5%, high 5.5% and very high 1.9%) but none of these were statistically significant. The age-standardised prevalence of very high risk increased from 2.9% (0.7%-5.2%) to 8.5% (5%-12%) when those with anti-hypertensive medication having controlled blood pressure (<140/90 mm Hg) added.

CONCLUSION

The very high-risk estimates could be used for planning resource for CVD prevention programme at upazila level. There is a need for a national level study, covering diversities of rural areas, to contribute to national planning of CVD prevention.

摘要

目的

本研究旨在使用 2014 年世界卫生组织/国际高血压学会（WHO/ISH）风险预测图估算孟加拉国农村社区居民的 10 年心血管疾病（CVD）风险。

研究设计

这是一项由当地社区卫生工作者进行的基于人群的横断面研究，利用初级医疗保健系统的最低级别设施。

研究地点和参与者

共有 1545 名年龄≥40 岁的孟加拉国萨塔赫拉县德巴塔地区的农村成年人参与了 2015 年的这项调查。社区卫生工作者收集了年龄、吸烟、血压、血糖以及糖尿病和高血压治疗史的数据。

主要观察指标

我们使用无胆固醇的 WHO/ISH 东南亚地区-D 图表估算了总 10 年 CVD 风险，并将风险分为低（<10%）、中（10%-19.9%）、高（20%-29.9%）和极高（≥30%）。

结果

参与者的平均年龄（±SD）为 53.9±11.6 岁。总体而言，10 年 CVD 风险（%，95%CI）如下：低风险（81.6%，95%CI 78.4%至 84.6%）、中风险（9.9%，95%CI 7.4%至 12.1%）、高风险（5.8%，95%CI 4.4%至 7.2%）和极高风险（2.8%，95%CI 1.5%至 4.1%）。女性中，中至高风险较高（中风险 12.1%，高风险 6.1%，极高风险 3.7%），而男性则较低（中风险 7.5%，高风险 5.5%，极高风险 1.9%），但均无统计学意义。当纳入降压药物治疗且血压控制在<140/90mmHg 的高血压患者时，标准化后的极高风险患病率从 2.9%（0.7%至 5.2%）增加到 8.5%（5%至 12%）。