Khaltaev Nikolai, Axelrod Svetlana
Global Alliance against Chronic Respiratory Diseases Geneva Switzerland.
Institute for Leadership and Health Management I.M. Sechenov First Moscow State University (Sechenov University) Moscow Russia.
Chronic Dis Transl Med. 2022 Nov 8;9(1):44-53. doi: 10.1002/cdt3.49. eCollection 2023 Mar.
Noncommunicable diseases (NCDs) place a heavy burden on populations globally and in particular, on lower-income countries (LIC). WHO identified a package of 16 "best buy" lifestyle and management interventions that are cost-effective and applicable in all settings. The purpose of this study was to evaluate and compare NCD risk factors in all WHO countries and make preliminary assessment of "best buy" interventions.
Risk factors estimation was made in 188 countries. NCD attributable "best buys" concern tobacco use, unhealthy diet, physical inactivity, and harmful use of alcohol. Management issues are based on the availability of the national NCD guidelines and provision of drug therapy.
Every fourth adult in high-income countries (HIC) has raised blood pressure (RBP). Prevalence of RBP in lower-middle-income countries (LMIC) and LIC is 22%-23% (HIC/LMIC: = , < ). Prevalence of diabetes in LIC is less than half of that in HIC and upper-middle-income countries (UMIC) UMIC/LIC: , . Obesity prevalence is gradually decreasing from HIC to LIC (HIC/LIC: , ). Highest level of physical inactivity is seen in HIC, which then gradually declines to LIC (17%). Tobacco prevalence in LIC is almost less than half of that in HIC and UMIC (HIC/LIC: , ). There is a gradual decline in the implementation of "best buys" from HIC to LIC.
Wealthier countries have better implementation of the WHO NCD prevention strategy.
非传染性疾病给全球人口带来了沉重负担,尤其是对低收入国家而言。世界卫生组织确定了一套16项“最佳购买”生活方式和管理干预措施,这些措施具有成本效益且适用于所有环境。本研究的目的是评估和比较世卫组织所有国家的非传染性疾病风险因素,并对“最佳购买”干预措施进行初步评估。
对188个国家的风险因素进行了估计。与非传染性疾病相关的“最佳购买”涉及烟草使用、不健康饮食、身体活动不足和有害使用酒精。管理问题基于国家非传染性疾病指南的可用性和药物治疗的提供情况。
在高收入国家,每四名成年人中就有一人血压升高。中低收入国家和低收入国家的血压升高患病率为22%-23%(高收入国家/中低收入国家:=,<)。低收入国家的糖尿病患病率不到高收入国家和中高收入国家的一半(中高收入国家/低收入国家:,)。肥胖患病率从高收入国家到低收入国家逐渐下降(高收入国家/低收入国家:,)。身体活动不足水平最高的是高收入国家,然后逐渐下降到低收入国家(17%)。低收入国家的烟草患病率几乎不到高收入国家和中高收入国家的一半(高收入国家/低收入国家:,)。从高收入国家到低收入国家,“最佳购买”措施的实施情况逐渐下降。
较富裕的国家在实施世卫组织非传染性疾病预防战略方面做得更好。