文章摘要
张梦妮,李茂婷,职心乐,朱红,张欣,谢娟.1990-2019年中国动脉粥样硬化心血管病疾病负担变化及其危险因素分析[J].中华流行病学杂志,2021,42(10):1797-1803
1990-2019年中国动脉粥样硬化心血管病疾病负担变化及其危险因素分析
Trends of a burden on atherosclerotic cardiovascular disease and its related risk factors in China, 1990 to 2019
收稿日期:2020-12-08  出版日期:2021-10-23
DOI:10.3760/cma.j.cn112338-20201208-01390
中文关键词: 动脉粥样硬化性心血管病;疾病负担;人口老龄化;危险因素
英文关键词: Atherosclerotic cardiovascular disease;Burden of disease;Population aging;Risk factors
基金项目:国家自然科学基金(81602922);天津医科大学教育教学研究(2019ZJ002)
作者单位E-mail
张梦妮 天津医科大学公共卫生学院/天津市环境营养与人群健康重点实验室/环境营养与人群健康国际联合研究中心 300070  
李茂婷 天津医科大学公共卫生学院/天津市环境营养与人群健康重点实验室/环境营养与人群健康国际联合研究中心 300070  
职心乐 天津医科大学公共卫生学院/天津市环境营养与人群健康重点实验室/环境营养与人群健康国际联合研究中心 300070  
朱红 天津医科大学公共卫生学院/天津市环境营养与人群健康重点实验室/环境营养与人群健康国际联合研究中心 300070  
张欣 天津医科大学公共卫生学院/天津市环境营养与人群健康重点实验室/环境营养与人群健康国际联合研究中心 300070  
谢娟 天津医科大学公共卫生学院/天津市环境营养与人群健康重点实验室/环境营养与人群健康国际联合研究中心 300070 xiejuan@tmu.edu.cn 
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中文摘要:
      目的 量化分析1990-2019年我国动脉粥样硬化心血管病(ASCVD)疾病负担及其主要危险因素影响的变化趋势。方法 利用2019年全球疾病负担(GBD2019)研究结果,以伤残调整寿命年(DALY)及其年龄标准化率为指标,分析1990-2019年我国ASCVD疾病负担和危险因素归因疾病负担的变化情况,并采用Gupta建立的分解法对人口增长、老龄化、年龄别患病率和疾病严重程度所致的DALY变化进行了量化分析。结果 2019年我国61.00%的心血管病疾病负担由ASCVD所致,缺血性心脏病的DALY较1990年增长了133.66%,其中29.57%可归因于人口增长、108.74%归因于人口老龄化、8.87%归因于年龄别患病率的增加、-13.53%归因于疾病严重程度;缺血性卒中的DALY较1990年增长了138.64%,归因于上述4部分的变化率依次为30.95%、123.38%、55.80%和-71.49%。2019年高血压依然是ASCVD首要危险因素,其次是高LDL-C,归因于饮酒的年龄标准化DALY率较1990年增幅最大(486.01%),年均增长10.93%。结论 1990-2019年,人口老龄化是我国ASCVD疾病负担大幅增长最主要的原因,而其他可改变危险因素的不利趋势,特别是代谢性危险因素的持续流行同样不容忽视。
英文摘要:
      Objective To quantitatively analyze the effects of population aging and other risk factors on the burden of atherosclerosis cardiovascular disease (ASCVD) in China from 1990 to 2019. Methods Disability adjusted life years (DALY) and age-standardized rates obtained from the Global Burden of Disease Study 2019 (GBD2019) were used to describe the temporal trend of a burden on ASCVD. And a decomposition method established by Gupta was applied to quantify the burden related to population growth, aging, age-specific prevalence, and the severity of the disease.Results In 2019, 61.00% of the burden of cardiovascular disease in China was caused by ASCVD. The DALY of ischemic heart disease increased by 133.66% compared with that in 1990, with 29.57% of the increase attributed to population growth, 108.74% due to population aging, and 8.87% due to the rise of age-specific prevalence and -13.53% benefited from changes in disease severity. The DALY of ischemic stroke increased by 138.64% compared with 1990, and the proportions attributable to the above four parts were 30.95%, 123.38%, 55.80%, and -71.49%, respectively. Hypertension remained the leading risk factor for ASCVD in 2019, followed by high LDL cholesterol. The age-standardized DALY rate attributable to drinking had the most significant increase (486.01%) from 1990, with an average annual growth of 10.93%. Conclusions Aging population seems responsible for the main reason for the considerable increase in the burden of ASCVD in China. Still, the adverse trends of other avoidable risk factors, especially metabolic risk factors, can not be ignored.
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