Liu Yuting, Wang Haochen, Bai Bingqing, Liu Fengyao, Chen Yilin, Wang Yu, Liang Yanting, Shi Xiaohe, Yu Xueju, Wu Chao, Guo Lan, Ma Huan, Geng Qingshan
Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Southern Medical University, Guangzhou 518000, China.
J Clin Med. 2023 Feb 3;12(3):1223. doi: 10.3390/jcm12031223.
Unhealthy lifestyle factors are risk factors for stroke, and they play a key role in stroke secondary prevention. A better understanding of these factors may aid with improvements in public health policy. Our objective was to comprehensively understand the trends in unhealthy lifestyle factors in people who have previously had a stroke in the US. Utilizing data from the biannual United States National Health and Nutrition Examination Surveys (NHANESs) between 1999 and 2018, we collated data on unhealthy lifestyle factors (smoking, alcohol drinking, depression, unhealthy diet, high BMI, physical inactivity, and sedentary behavior) in adults with a history of stroke. The Joinpoint Regression model was used to calculate the annual percentage change (APC) and average annual percentage change (AAPC) to identify trends. Logistic regression modeling was used to identify the influence of sociodemographic factors (age, sex, race/ethnicity, marital status, employment status, family income, and highest education level). The analysis included 2017 respondents with a history of stroke. Current alcohol drinking (39.3% (95% confidence interval: 29.8, 48.7) to 57.4% (45.7, 69.0) = 0.008) and obesity (39.2% (28.3, 50.2) to 49.4% (38.9, 59.8) = 0.029) increased significantly from 1999 to 2018. The prevalence of smoking and depression remained generally stable. The proportion of respondents with an unhealthy diet decreased from 1999 (44.5% (32.4, 56.5)) to 2011 (29.0% (17.5, 40.4) = 0.019), but then returned to its original prevalence in 2018 (42.0% (31.4, 52.7)). From 2007 to 2018, the proportion of respondents who were physically inactive decreased significantly, from 70.4% (64.4, 76.3) to 55.1% (46.1, 64.2; = 0.017). After a gradual increase in sedentary activity from 2007 to 2012, this declined from 2013 to 2018, with no statistical significance. We found stroke survivors who were widowed, divorced, separated, or unemployed were at a higher risk of having unhealthy lifestyles than those who were employed or had other marital statuses. A modest reduction in the prevalence of physical inactivity was observed in Americans with a history of stroke between 1999 and 2018. The prevalences of smoking, drinking, depression, poor diet, obesity, and sedentary behavior were stable or increasing.
不健康的生活方式因素是中风的危险因素，并且在中风二级预防中起关键作用。更好地了解这些因素可能有助于改进公共卫生政策。我们的目标是全面了解美国既往有中风病史人群中不健康生活方式因素的趋势。利用1999年至2018年期间美国国家健康与营养检查调查（NHANESs）的两年一次数据，我们整理了有中风病史成年人的不健康生活方式因素（吸烟、饮酒、抑郁、不健康饮食、高体重指数、身体活动不足和久坐行为）的数据。使用Joinpoint回归模型计算年度百分比变化（APC）和平均年度百分比变化（AAPC）以确定趋势。使用逻辑回归模型确定社会人口统计学因素（年龄、性别、种族/民族、婚姻状况、就业状况、家庭收入和最高教育水平）的影响。该分析纳入了2017名有中风病史的受访者。当前饮酒率（从39.3%（95%置信区间：29.8，48.7）升至57.4%（45.7，69.0）=0.008）和肥胖率（从39.2%（28.3，50.2）升至49.4%（38.9，59.8）=0.029）在1999年至2018年期间显著上升。吸烟和抑郁的患病率总体保持稳定。饮食不健康的受访者比例从1999年（44.5%（32.4，56.5））降至2011年（29.0%（17.5，40.4）=0.019），但在2018年又恢复到原来的患病率（42.0%（31.4，52.7））。从2007年到2018年，身体活动不足的受访者比例显著下降，从70.4%（64.4，76.3）降至55.1%（46.1，64.2；=0.017）。在2007年至2012年久坐活动逐渐增加后，2013年至2018年有所下降，无统计学意义。我们发现丧偶、离婚、分居或失业的中风幸存者比就业或有其他婚姻状况的人有更高的不健康生活方式风险。1999年至2018年期间，有中风病史的美国人身体活动不足的患病率略有下降。吸烟、饮酒、抑郁、饮食不良、肥胖和久坐行为的患病率稳定或上升。
