Gulliford M C
Commonwealth Caribbean Medical Research Council, Port of Spain, Trinidad, Department of Public Health Medicine, Guy's and St. Thomas' Medical and Dental Schools, London SE1 7EH, UK.
Int J Epidemiol. 1996 Apr;25(2):357-65. doi: 10.1093/ije/25.2.357.
This study aimed to describe trends in age-specific mortality from diabetes mellitus, hypertension, cerebrovascular disease and ischaemic heart disease in Trinidad and Tobago between 1953 and 1992 and to relate them to earlier changes in infant mortality rates.
Average annual age-specific mortality rates per 100 000 were calculated for 5-year time periods from 1953-1957 to 1988-1992 and plotted by mid-year of birth for cohorts born 1874-1882 to 1944-1952. Regression analyses were performed to test associations between adult mortality rates, and infant mortality rates for the same birth cohorts and period of death.
Infant mortality declined from 180 per 1000 in 1901 to 10 per 1000 in 1992. Age-standardized mortality from diabetes mellitus increased, in men, from 60 in 1958-1962 to 278 in 1988-1992, in women the increase was from 89 to 303. Mortality from hypertension declined, in men, from 232 in 1953-1957 to 73 in 1988-1992, and in women, from 206 to 67. Cerebrovascular mortality increased, in men, from 341 in 1953-1957 to 451 in 1963-1967 before declining to 224 in 1988-1992. In women cerebrovascular mortality increased from 292 in 1953-1957 to 361 in 1963-1967 before declining to 196 in 1988-1992. There was evidence of a deceleration in cerebrovascular mortality for cohorts born after 1908-1918. Ischaemic heart disease mortality remained constant. Mid-cohort infant mortality rates were not associated with adult mortality after adjusting for age and period of death.
Declining infant mortality was subsequently associated with declining mortality from cerebrovascular disease and hypertensive disease and increasing mortality from diabetes mellitus but there was no association with ischaemic heart disease mortality. These relationships were confounded by secular changes associated with year of death.
本研究旨在描述1953年至1992年期间特立尼达和多巴哥糖尿病、高血压、脑血管疾病及缺血性心脏病的年龄别死亡率趋势，并将其与婴儿死亡率的早期变化相关联。
计算了1953 - 1957年至1988 - 1992年每5年时间段内每10万人的平均年龄别死亡率，并按1874 - 1882年至1944 - 1952年出生队列的年中出生时间绘制图表。进行回归分析以检验同一出生队列和死亡时期的成人死亡率与婴儿死亡率之间的关联。
婴儿死亡率从1901年的每1000例180例降至1992年的每1000例10例。糖尿病的年龄标准化死亡率，男性从1958 - 1962年的60例增至1988 - 1992年的278例，女性从89例增至303例。高血压死亡率，男性从1953 - 1957年的232例降至1988 - 1992年的73例，女性从206例降至67例。脑血管疾病死亡率，男性从1953 - 1957年的3部例增至1963 - 1967年的451例，随后降至1988 - 1992年的224例。女性脑血管疾病死亡率从1953 - 1957年的292例增至1963 - 1967年的361例，随后降至1988 - 1992年的196例。有证据表明1908 - 1918年以后出生队列的脑血管疾病死亡率出现减速。缺血性心脏病死亡率保持稳定。在校正年龄和死亡时期后，队列中年中婴儿死亡率与成人死亡率无关联。
婴儿死亡率下降随后与脑血管疾病和高血压疾病死亡率下降以及糖尿病死亡率上升相关，但与缺血性心脏病死亡率无关。这些关系因与死亡年份相关的长期变化而混淆。
需注意，原文中“3部例”可能有误，未明确正确数据，译文保留原文错误表述。
