Epidemiology of Atherosclerosis and the Potential to Reduce the Global Burden of Atherothrombotic Disease
Epidemiology of Atherosclerosis and the Potential to Reduce the Global Burden of Atherothrombotic Disease
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DOI：
10.1161/circresaha.115.307611
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发表时间：
2016-02-19
影响因子：
20.1
通讯作者：
Lewington, Sarah
中科院分区：
文献类型：
--
作者：
Herrington, William;Lacey, Ben;Lewington, Sarah
动脉粥样硬化是世界范围内血管疾病的主要原因。其主要临床表现为缺血性心脏病、缺血性脑卒中和外周动脉疾病。在高收入国家，自20世纪中叶以来，缺血性心脏病和缺血性中风的发病率和死亡率急剧下降。例如，在联合王国，中年男子（35-69岁）死于血管疾病的概率从1950年的22%下降到2010年的6%。大多数低收入和中等收入国家也报告说，在过去几十年里，中风死亡率有所下降，但缺血性心脏病死亡率的趋势则各不相同，有些国家报告下降，有些国家报告上升（特别是东欧和亚洲国家）。动脉粥样硬化的许多主要可改变的危险因素已经被确定，一些危险因素的因果关系现在已经很好地确立了（包括但不限于吸烟、肥胖、血压、血胆固醇和糖尿病）。健康行为的广泛改变和针对这些危险因素的治疗方法的使用是高收入国家血管死亡率急剧下降的一些原因。为了使这些下降趋势继续下去，并在不太富裕的国家得到反映，需要加大努力，解决这些主要风险因素，特别是吸烟和日益流行的肥胖问题。
Atherosclerosis is a leading cause of vascular disease worldwide. Its major clinical manifestations include ischemic heart disease, ischemic stroke, and peripheral arterial disease. In high-income countries, there have been dramatic declines in the incidence and mortality from ischemic heart disease and ischemic stroke since the middle of the 20th century. For example, in the United Kingdom, the probability of death from vascular disease in middle-aged men (35-69 years) has decreased from 22% in 1950 to 6% in 2010. Most low- and middle-income countries have also reported declines in mortality from stroke over the last few decades, but mortality trends from ischemic heart disease have been more varied, with some countries reporting declines and others reporting increases (particularly those in Eastern Europe and Asia). Many major modifiable risk factors for atherosclerosis have been identified, and the causal relevance of several risk factors is now well established (including, but not limited to, smoking, adiposity, blood pressure, blood cholesterol, and diabetes mellitus). Widespread changes in health behaviors and use of treatments for these risk factors are responsible for some of the dramatic declines in vascular mortality in high-income countries. In order that these declines continue and are mirrored in less wealthy nations, increased efforts are needed to tackle these major risk factors, particularly smoking and the emerging obesity epidemic.