Donici Valentina, Stahlman Shauna L, Fan Michael T, Langton Richard S
Uniformed University of the Health Sciences, Bethesda, MD.
Epidemiology and Analysis Branch, Armed Forces Health Surveillance Division, Defense Health Agency, U.S. Department of Defense.
MSMR. 2024 Nov 20;31(11):14-19.
This study summarizes trends from 2014 through 2023 in the incidence of ischemic heart disease and cerebrovascular heart disease among U.S. active component female service members and identifies potential military-specific risk factors for these conditions. Female-specific risk factors, such as mental health, for ischemic heart and cerebrovascular diseases have only recently been recognized. Crude incidence rates were assessed for each outcome and Poisson regression was used to calculate adjusted incidence rates, controlling for multiple covariates. After adjustment, non-Hispanic Black active component U.S. service women had higher rates for both ischemic heart disease and cerebrovascular disease compared to non-Hispanic White service women (IRR=1.68 and 1.24, respectively). A prior diagnosis of depressive or anxiety disorder resulted in a 90% increased rate of ischemic heart disease and 70% increased rate of cerebrovascular disease. Air Force members had a 55% increased rate of ischemic heart disease. This study identifies both military-specific and demographic risk factors for these 2 cardiovascular diseases and demonstrates potential opportunity for early age preventive care, even among a relatively young and healthy population. Among active component U.S. service women, incidence of ischemic heart disease increased between 2014 (31.2 per 100,000 person-years) and 2019 (54.7 per 100,000 p-yrs), while incidence of cerebrovascular disease decreased during that period and increased between 2019 (28.5 per 100,000 p-yrs) and 2023 (46.4 per 100,000 p-yrs). Older age, non-Hispanic Black race and ethnicity, and prior depressive or anxiety disorder diagnosis were identified as potential risk factors for both outcomes.
本研究总结了2014年至2023年美国现役女性军人缺血性心脏病和脑血管心脏病的发病趋势，并确定了这些疾病潜在的军事特有风险因素。缺血性心脏病和脑血管疾病的女性特有风险因素，如心理健康，直到最近才被认识到。评估了每种结局的粗发病率，并使用泊松回归计算调整后的发病率，同时控制多个协变量。调整后，非西班牙裔黑人现役美国女性军人患缺血性心脏病和脑血管疾病的比率均高于非西班牙裔白人女性军人（缺血性心脏病和脑血管疾病的发病率比值分别为1.68和1.24）。先前被诊断为抑郁或焦虑症会使缺血性心脏病的发病率增加90%，使脑血管疾病的发病率增加70%。空军成员患缺血性心脏病的比率增加了55%。本研究确定了这两种心血管疾病的军事特有和人口统计学风险因素，并表明即使在相对年轻和健康的人群中，也有进行早期预防性护理的潜在机会。在美国现役女性军人中，缺血性心脏病的发病率在2014年（每10万人年31.2例）至2019年（每10万人年54.7例）之间有所上升，而在此期间脑血管疾病的发病率下降，在2019年（每10万人年28.5例）至2023年（每10万人年46.4例）之间有所上升。年龄较大、非西班牙裔黑人种族和族裔以及先前被诊断为抑郁或焦虑症被确定为这两种结局的潜在风险因素。
