Department of Global Health, University of Washington, Seattle, WA, USA.
Division of Data, Analytics, and Delivery for Impact, World Health Organization, Geneva, Switzerland.
Nat Med. 2022 Aug;28(8):1693-1699. doi: 10.1038/s41591-022-01890-4. Epub 2022 Jul 18.
As the leading cause of death worldwide, cardiovascular diseases (CVDs) present major challenges for health systems. In this study, we analyzed the effects of better population blood pressure control in the context of a proposed 80-80-80 target: 80% of individuals with hypertension are screened and aware of their diagnosis; 80% of those who are aware are prescribed treatment; and 80% of those on treatment have achieved guideline-specified blood pressure targets. We developed a population CVD model using country-level evidence on CVD rates, blood pressure levels and hypertension intervention coverage. Under realistic implementation conditions, most countries could achieve 80-80-80 targets by 2040, reducing all-cause mortality by 4-7% (76-130 million deaths averted over 2022-2050) and slowing the rise in CVD expected from population growth and aging (110-200 million cases averted). Although populous middle-income countries would account for most of the reduced CVD cases and deaths, low-income countries would experience the largest reductions in disease rates.
心血管疾病(CVD)是全球主要的死亡原因,对卫生系统构成重大挑战。本研究在拟议的 80-80-80 目标背景下分析了更好地控制人群血压的效果:80%的高血压患者接受筛查并知晓自身诊断;80%知晓的患者接受治疗;80%接受治疗的患者达到指南规定的血压目标。我们使用 CVD 发病率、血压水平和高血压干预覆盖的国家层面证据,开发了一个人群 CVD 模型。在现实实施条件下,大多数国家到 2040 年可实现 80-80-80 目标,减少全因死亡率 4-7%(2022-2050 年避免 7600 万至 1.3 亿人死亡),减缓人口增长和老龄化导致的 CVD 上升(避免 1.1 亿至 2 亿例)。虽然人口众多的中等收入国家将占减少的 CVD 病例和死亡人数的大部分,但低收入国家的疾病发病率降幅最大。