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2005-2020 年中国心血管疾病的死亡率和寿命损失年数:来自国家死亡率监测系统的实证证据。

Mortality and years of life lost of cardiovascular diseases in China, 2005-2020: Empirical evidence from national mortality surveillance system.

机构信息

National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China.

National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China.

出版信息

Int J Cardiol. 2021 Oct 1;340:105-112. doi: 10.1016/j.ijcard.2021.08.034. Epub 2021 Aug 26.

Abstract

OBJECTIVES

Cardiovascular disease (CVD) is leading cause of death in China. We aimed to provide national and subnational estimates and its change of premature mortality burden of CVD during 2005-2020.

METHODS

Data from multi-source on the basis of national mortality surveillance system (NMSS) was used to estimate mortality and years of life lost (YLL) of total CVD and its subcategories in Chinese population across 31 provinces during 2005-2020.

RESULTS

Estimated CVD deaths increased from 3.09 million in 2005 to 4.58 million in 2020; the age-standardized mortality rate (ASMR) decreased from 286.85 per 100,000 in 2005 to 245.39 per 100,000 in 2020. A substantial reduction of 19.27% of CVD premature mortality burden, as measured by age-standardized YLL rate, was observed. Ischemic heart disease (IHD), hemorrhagic stroke (HS) and ischemic stroke (IS) were leading 3 causes of CVD death. Marked differences were observed in geographical patterns for total CVD and its subcategories, and it appeared to be lower in areas with higher economic development. Population ageing was dominant driver contributed to CVD deaths increase, followed by population growth. And, age-specific mortality shifts contributed largely to CVD deaths decline in most provinces.

CONCLUSION

Substantial discrepancies were demonstrated in CVD premature mortality burden across China. Targeted considerations were needed to integrate primary care with clinical care through intensifying further strategies for reducing CVD mortality among specific subcategories, high risk population and regions with inadequate healthcare resources.

摘要

目的

心血管疾病(CVD)是中国的主要死亡原因。本研究旨在提供 2005-2020 年期间 CVD 导致的过早死亡率负担的国家和省级估计值及其变化情况。

方法

利用基于国家死亡率监测系统(NMSS)的多源数据,估计了 2005-2020 年期间中国 31 个省的全因 CVD 及其亚组的死亡率和生命损失年(YLL)。

结果

CVD 死亡人数从 2005 年的 309 万增加到 2020 年的 458 万;年龄标准化死亡率(ASMR)从 2005 年的每 10 万人 286.85 下降到 2020 年的每 10 万人 245.39。CVD 过早死亡率负担的降幅为 19.27%,这是通过年龄标准化 YLL 率来衡量的。缺血性心脏病(IHD)、脑出血(HS)和缺血性中风(IS)是导致 CVD 死亡的前 3 大原因。全因 CVD 及其亚组的地理模式存在显著差异,在经济发展水平较高的地区,这种差异似乎较低。人口老龄化是导致 CVD 死亡人数增加的主要驱动因素,其次是人口增长。并且,大多数省份的特定年龄死亡率变化对 CVD 死亡人数的下降做出了很大贡献。

结论

中国的 CVD 过早死亡率负担存在显著差异。需要有针对性地考虑将初级保健与临床护理相结合,通过进一步加强针对特定亚组、高危人群和医疗资源不足地区的 CVD 死亡率降低策略来实现这一目标。

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