Falkeborn M, Persson I, Terént A, Bergström R, Lithell H, Naessén T
Department of Geriatrics, University of Uppsala, Sweden.
Epidemiology. 1996 Jan;7(1):67-74. doi: 10.1097/00001648-199601000-00012.
We studied the trends from 1969 to the mid-1980s in the incidence and mortality of acute myocardial infarction and stroke in Swedish women residing in the Uppsala Health Care Region. We used data from the Inpatient Care and Causes of Death registers to obtain total first event incidence and mortality rates. In our population, there were 20,182 acute myocardial infarctions and 30,462 stroke events, and 17,359 and 21,336 deaths, respectively. We found an average overall annual increase of 1.3% in the age-standardized incidence of acute myocardial infarction during the 1970s, followed by decreasing rates during the early 1980s. Mortality was virtually unchanged. Notably, among women 45-49 years of age, we observed a rising trend during the whole period, whereas in the oldest age groups, the increase slowed and reversed in the latter years. Both the incidence and mortality for stroke declined steadily: the age-standardized incidence fell by an average of 2.1% per year for all stroke and 7.8% for intracerebral hemorrhage. The falling rate of stroke was best explained by birth cohort effects, with a 30% reduction in women born in 1920 and later as compared with those born in 1890. We conclude that important changes in Swedish women's cardiovascular health have taken place and that increasing cigarette smoking and hypertensive treatment are major determinants.
我们研究了1969年至20世纪80年代中期居住在乌普萨拉医疗保健地区的瑞典女性急性心肌梗死和中风的发病率及死亡率趋势。我们使用住院治疗和死亡原因登记数据来获取首次事件的总发病率和死亡率。在我们的研究人群中，分别有20182例急性心肌梗死和30462例中风事件，以及17359例和21336例死亡。我们发现，20世纪70年代急性心肌梗死的年龄标准化发病率平均每年总体上升1.3%，随后在80年代初发病率下降。死亡率几乎没有变化。值得注意的是，在45 - 49岁的女性中，我们观察到在整个时期呈上升趋势，而在最年长的年龄组中，后期增长放缓并出现逆转。中风的发病率和死亡率均稳步下降：所有中风的年龄标准化发病率平均每年下降2.1%，脑出血下降7.8%。中风发病率下降的最佳解释是出生队列效应，与1890年出生的女性相比，1920年及以后出生的女性中风发病率降低了30%。我们得出结论，瑞典女性的心血管健康发生了重大变化，吸烟增加和高血压治疗是主要决定因素。
