1990年至2015年全球、区域和国家10种心血管疾病病因负担
Global, Regional, and National Burden of Cardiovascular Diseases for 10 Causes, 1990 to 2015.
作者信息
Roth Gregory A, Johnson Catherine, Abajobir Amanuel, Abd-Allah Foad, Abera Semaw Ferede, Abyu Gebre, Ahmed Muktar, Aksut Baran, Alam Tahiya, Alam Khurshid, Alla François, Alvis-Guzman Nelson, Amrock Stephen, Ansari Hossein, Ärnlöv Johan, Asayesh Hamid, Atey Tesfay Mehari, Avila-Burgos Leticia, Awasthi Ashish, Banerjee Amitava, Barac Aleksandra, Bärnighausen Till, Barregard Lars, Bedi Neeraj, Belay Ketema Ezra, Bennett Derrick, Berhe Gebremedhin, Bhutta Zulfiqar, Bitew Shimelash, Carapetis Jonathan, Carrero Juan Jesus, Malta Deborah Carvalho, Castañeda-Orjuela Carlos Andres, Castillo-Rivas Jacqueline, Catalá-López Ferrán, Choi Jee-Young, Christensen Hanne, Cirillo Massimo, Cooper Leslie, Criqui Michael, Cundiff David, Damasceno Albertino, Dandona Lalit, Dandona Rakhi, Davletov Kairat, Dharmaratne Samath, Dorairaj Prabhakaran, Dubey Manisha, Ehrenkranz Rebecca, El Sayed Zaki Maysaa, Faraon Emerito Jose A, Esteghamati Alireza, Farid Talha, Farvid Maryam, Feigin Valery, Ding Eric L, Fowkes Gerry, Gebrehiwot Tsegaye, Gillum Richard, Gold Audra, Gona Philimon, Gupta Rajeev, Habtewold Tesfa Dejenie, Hafezi-Nejad Nima, Hailu Tesfaye, Hailu Gessessew Bugssa, Hankey Graeme, Hassen Hamid Yimam, Abate Kalkidan Hassen, Havmoeller Rasmus, Hay Simon I, Horino Masako, Hotez Peter J, Jacobsen Kathryn, James Spencer, Javanbakht Mehdi, Jeemon Panniyammakal, John Denny, Jonas Jost, Kalkonde Yogeshwar, Karimkhani Chante, Kasaeian Amir, Khader Yousef, Khan Abdur, Khang Young-Ho, Khera Sahil, Khoja Abdullah T, Khubchandani Jagdish, Kim Daniel, Kolte Dhaval, Kosen Soewarta, Krohn Kristopher J, Kumar G Anil, Kwan Gene F, Lal Dharmesh Kumar, Larsson Anders, Linn Shai, Lopez Alan, Lotufo Paulo A, El Razek Hassan Magdy Abd, Malekzadeh Reza, Mazidi Mohsen, Meier Toni, Meles Kidanu Gebremariam, Mensah George, Meretoja Atte, Mezgebe Haftay, Miller Ted, Mirrakhimov Erkin, Mohammed Shafiu, Moran Andrew E, Musa Kamarul Imran, Narula Jagat, Neal Bruce, Ngalesoni Frida, Nguyen Grant, Obermeyer Carla Makhlouf, Owolabi Mayowa, Patton George, Pedro João, Qato Dima, Qorbani Mostafa, Rahimi Kazem, Rai Rajesh Kumar, Rawaf Salman, Ribeiro Antônio, Safiri Saeid, Salomon Joshua A, Santos Itamar, Santric Milicevic Milena, Sartorius Benn, Schutte Aletta, Sepanlou Sadaf, Shaikh Masood Ali, Shin Min-Jeong, Shishehbor Mehdi, Shore Hirbo, Silva Diego Augusto Santos, Sobngwi Eugene, Stranges Saverio, Swaminathan Soumya, Tabarés-Seisdedos Rafael, Tadele Atnafu Niguse, Tesfay Fisaha, Thakur J S, Thrift Amanda, Topor-Madry Roman, Truelsen Thomas, Tyrovolas Stefanos, Ukwaja Kingsley Nnanna, Uthman Olalekan, Vasankari Tommi, Vlassov Vasiliy, Vollset Stein Emil, Wakayo Tolassa, Watkins David, Weintraub Robert, Werdecker Andrea, Westerman Ronny, Wiysonge Charles Shey, Wolfe Charles, Workicho Abdulhalik, Xu Gelin, Yano Yuichiro, Yip Paul, Yonemoto Naohiro, Younis Mustafa, Yu Chuanhua, Vos Theo, Naghavi Mohsen, Murray Christopher
机构信息
University of Washington, Seattle, Washington.
University of Washington, Seattle, Washington.
出版信息
J Am Coll Cardiol. 2017 Jul 4;70(1):1-25. doi: 10.1016/j.jacc.2017.04.052. Epub 2017 May 17.
BACKGROUND
The burden of cardiovascular diseases (CVDs) remains unclear in many regions of the world.
OBJECTIVES
The GBD (Global Burden of Disease) 2015 study integrated data on disease incidence, prevalence, and mortality to produce consistent, up-to-date estimates for cardiovascular burden.
METHODS
CVD mortality was estimated from vital registration and verbal autopsy data. CVD prevalence was estimated using modeling software and data from health surveys, prospective cohorts, health system administrative data, and registries. Years lived with disability (YLD) were estimated by multiplying prevalence by disability weights. Years of life lost (YLL) were estimated by multiplying age-specific CVD deaths by a reference life expectancy. A sociodemographic index (SDI) was created for each location based on income per capita, educational attainment, and fertility.
RESULTS
In 2015, there were an estimated 422.7 million cases of CVD (95% uncertainty interval: 415.53 to 427.87 million cases) and 17.92 million CVD deaths (95% uncertainty interval: 17.59 to 18.28 million CVD deaths). Declines in the age-standardized CVD death rate occurred between 1990 and 2015 in all high-income and some middle-income countries. Ischemic heart disease was the leading cause of CVD health lost globally, as well as in each world region, followed by stroke. As SDI increased beyond 0.25, the highest CVD mortality shifted from women to men. CVD mortality decreased sharply for both sexes in countries with an SDI >0.75.
CONCLUSIONS
CVDs remain a major cause of health loss for all regions of the world. Sociodemographic change over the past 25 years has been associated with dramatic declines in CVD in regions with very high SDI, but only a gradual decrease or no change in most regions. Future updates of the GBD study can be used to guide policymakers who are focused on reducing the overall burden of noncommunicable disease and achieving specific global health targets for CVD.
背景
在世界许多地区，心血管疾病（CVD）的负担仍不明确。
目的
全球疾病负担（GBD）2015研究整合了疾病发病率、患病率和死亡率数据，以得出关于心血管负担的一致、最新估计值。
方法
心血管疾病死亡率根据生命登记和口头尸检数据进行估算。心血管疾病患病率使用建模软件以及来自健康调查、前瞻性队列、卫生系统管理数据和登记处的数据进行估算。失能生存年数（YLD）通过患病率乘以失能权重来估算。寿命损失年数（YLL）通过特定年龄的心血管疾病死亡人数乘以参考预期寿命来估算。根据人均收入、教育程度和生育率为每个地区创建了社会人口学指数（SDI）。
结果
2015年，估计有4.227亿例心血管疾病（95%不确定区间：4.1553亿至4.2787亿例）和1792万例心血管疾病死亡（95%不确定区间：1759万至1828万例心血管疾病死亡）。1990年至2015年期间，所有高收入国家和一些中等收入国家的年龄标准化心血管疾病死亡率均有所下降。缺血性心脏病是全球以及每个世界区域心血管疾病健康损失的主要原因，其次是中风。随着SDI超过0.25，最高的心血管疾病死亡率从女性转移到男性。在SDI>0.75的国家，男女心血管疾病死亡率均大幅下降。
结论
心血管疾病仍然是世界所有地区健康损失的主要原因。过去25年的社会人口学变化与SDI非常高的地区心血管疾病的显著下降有关，但在大多数地区仅逐渐下降或没有变化。GBD研究的未来更新可用于指导专注于减轻非传染性疾病总体负担并实现心血管疾病特定全球健康目标的政策制定者。
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