Burden of Cardiovascular Diseases in China, 1990-2016 Findings From the 2016 Global Burden of Disease Study
Burden of Cardiovascular Diseases in China, 1990-2016 Findings From the 2016 Global Burden of Disease Study
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1990-2016年中国心血管疾病负担：2016年全球疾病负担研究结果
DOI：
10.1001/jamacardio.2019.0295
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发表时间：
2019-04-01
期刊：
影响因子：
24
通讯作者：
Zhou, Maigeng
中科院分区：
文献类型：
--
作者：
Liu, Shiwei;Li, Yichong;Zhou, Maigeng
心血管疾病（CVD）仍然是中国的头号死亡原因。据我们所知，在国家以下一级，还没有对心血管疾病负担进行一致和可比的评估，对中国心血管疾病的空间模式和时间趋势了解甚少。目的确定1990年至2016年中国国家和省级心血管疾病负担。根据2016年全球疾病负担研究中使用的方法框架和分析策略，按年龄、性别、年份和10个亚类对中国人群CVD的残疾调整生命年（DIBs）进行分析。结果1990 ~ 2016年，中国大陆、香港、澳门地区心血管病死亡人数从251万人增加到397万人，中国大陆地区心血管病死亡人数从251万人增加到397万人，中国大陆地区心血管病死亡人数从251万人增加到397万人，中国大陆地区心血管病死亡人数从251万人增加到397万人。年标准化死亡率由一九九零年的每十万人431.6人下降至二零一六年的每十万人307.9人，下降了28.7%。自1990年以来，CVD的流行病例翻了一番，2016年达到近9400万。从1990年到2016年，CVD的年龄标准化患病率显著增加了14.7%，缺血性心脏病（19.1%），缺血性中风（36.6%），心肌病和心肌炎（23.1%）以及心内膜炎（26.7%）的患病率也是如此。从1990年到2016年，全国范围内观察到心血管疾病负担（以年龄标准化DALY率衡量）大幅减少，其中女性（43.7%）的减少幅度大于男性（24.7%）。CVD总体及其主要亚类（包括缺血性心脏病、出血性卒中和缺血性卒中）的死亡率、患病率和DRDs的空间模式存在显著差异。经济发达的沿海省份CVD负担较低。从1990年到2016年，CVD相对负担的省际差距有所增加，经济发达省份的下降速度更快。结论和相关性尽管CVD负担相对减少，但中国各省之间CVD总负担和CVD子类别负担的差异仍然存在。需要考虑地理上的目标，以调整未来的战略，以提高整个中国和特定省份的心血管疾病健康。
IMPORTANCE Cardiovascular disease (CVD) remains the top cause of death in China. To our knowledge, no consistent and comparable assessments of CVD burden have been produced at subnational levels, and little is understood about the spatial patterns and temporal trends of CVD in China.OBJECTIVE To determine the national and province-level burden of CVD from 1990 to 2016 in China.DESIGN, SETTING, AND PARTICIPANTS Following the methodology framework and analytical strategies used in the 2016 Global Burden of Disease study, the mortality, prevalence, and disability-adjusted life-years (DALYs) of CVD in the Chinese population were examined by age, sex, and year and according to 10 subcategories. Estimates were produced for all province-level administrative units of mainland China, Hong Kong, and Macao.EXPOSURES Residence in China.MAIN OUTCOMES AND MEASURES Mortality, prevalence, and DALYs of CVD.RESULTS The annual number of deaths owing to CVD increased from 2.51 million to 3.97 million between 1990 and 2016; the age-standardized mortality rate fell by 28.7%, from 431.6 per 100 000 persons in 1990 to 307.9 per 100 000 in 2016. Prevalent cases of CVD doubled since 1990, reaching nearly 94 million in 2016. The age-standardized prevalence rate of CVD overall increased significantly from 1990 to 2016 by 14.7%, as did rates for ischemic heart disease (19.1%), ischemic stroke (36.6%), cardiomyopathy andmyocarditis (23.1%), and endocarditis (26.7%). Substantial reduction in the CVD burden, as measured by age-standardized DALY rate, was observed from 1990 to 2016 nationally, with a greater reduction in women (43.7%) than men (24.7%). There were marked differences in the spatial patterns of mortality, prevalence, and DALYs of CVD overall as well as its main subcategories, including ischemic heart disease, hemorrhagic stroke, and ischemic stroke. The CVD burden appeared to be lower in coastal provinces with higher economic development. The between-province gap in relative burden of CVD increased from 1990 to 2016, with faster decline in economically developed provinces.CONCLUSIONS AND RELEVANCE Substantial discrepancies in the total CVD burden and burdens of CVD subcategories have persisted between provinces in China despite a relative decrease in the CVD burden. Geographically targeted considerations are needed to tailor future strategies to enhance CVD health throughout China and in specific provinces.