Association Between Aging of the US Population and Heart Disease Mortality From 2011 to 2017
Association Between Aging of the US Population and Heart Disease Mortality From 2011 to 2017
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DOI：
10.1001/jamacardio.2019.4187
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发表时间：
2019-12-01
期刊：
影响因子：
24
通讯作者：
Rana, Jamal S.
中科院分区：
文献类型：
--
作者：
Sidney, Stephen;Go, Alan S.;Rana, Jamal S.
重要性 据报道，2011 年至 2014 年间心脏病 (HD) 死亡率下降速度有所放缓。在65岁及以上成年人口迅速增加的背景下，将HD死亡率检查延长至2017年对公共卫生和医疗保健具有潜在的重要影响。 目的 结合同期美国人口规模的变化，检查2011年至2017年HD子类别中年龄调整死亡率和死亡人数的变化。 设计、设置和参与者 在这项质量改进研究中，美国疾病控制与预防中心流行病学研究广泛在线数据 (CDC WONDER) 数据集用于确定 2011 年 1 月 1 日至 2017 年 12 月 31 日期间美国 65 岁及以上人口以及年龄调整死亡率和因 HD、冠心病 (CHD)、心力衰竭和其他 HD 潜在原因列出的死亡人数的全国变化。 主要结果和措施2011 年至 2017 年按性别和种族/族裔划分的美国人口以及按年龄调整的死亡率和因 HD、CHD、心力衰竭（作为根本原因和促成原因）以及其他 HD 的根本原因列出的死亡人数的变化（按性别和种族/民族划分）。 结果 1 月 1 日期间，美国 65 岁及以上成年人口的总规模从 4140 万增加到 5090 万，增加了 22.9%。 2011年和2017年12月31日，65岁以下成年人口仅增长1.7%。在此期间，HD 的年龄调整死亡率下降了 5.0%，CHD 下降了 14.9%，而心力衰竭的死亡率上升了 20.7%，其他 HD 的死亡率上升了 8.4%。 HD 的死亡人数增加了 8.5%，心力衰竭的死亡人数增加了 38.0%，其他 HD 的死亡人数增加了 23.4%，而 CHD 的死亡人数减少了 2.5%。总共 80% 的 HD 死亡发生在 65 岁及以上的成年人群体中。 结论和相关性 尽管一般人群的 HD 死亡率缓慢下降，但 HD 风险最高的 65 岁及以上成年人群体增长率的大幅增加与该群体 HD 死亡人数的增加有关。从 2017 年到 2030 年，65 岁及以上的成年人数量预计将增加 44%，因此需要创新和有效的方法来预防和治疗 HD，特别是心力衰竭发病率的大幅上升。
IMPORTANCE A deceleration in the rate of decrease of heart disease (HD) mortality between 2011 and 2014 has been reported. In the context of the rapid increase in the population of adults aged 65 years and older, extending the examination of HD mortality through 2017 has potentially important implications for public health and medical care.OBJECTIVE To examine changes in the age-adjusted mortality rate and the number of deaths within subcategories of HD from 2011 to 2017 in conjunction with the change in the size of the US population during the same period.DESIGN, SETTING, AND PARTICIPANTS In this quality improvement study, the Centers for Disease Control and Prevention Wide-Ranging Online Data for Epidemiologic Research (CDC WONDER) data set was used to identify national changes in the US population aged 65 years and older and in the age-adjusted mortality rates and number of deaths that were listed with an underlying cause of HD, coronary heart disease (CHD), heart failure, and other HDs from January 1, 2011, to December 31, 2017.MAIN OUTCOMES AND MEASURES Changes from 2011 to 2017 in the US population and in age-adjusted mortality rates and number of deaths that were listed with an underlying cause of HD, CHD, heart failure (both as an underlying and a contributing cause), and other HDs overall, by sex and race/ethnicity.RESULTS The total size of this population of US adults aged 65 years and older increased 22.9% from 41.4 million to 50.9 million between January 1, 2011, and December 31, 2017, while the population of adults younger than 65 years increased by only 1.7%. During this period, the age-adjusted mortality rate decreased 5.0% for HD and 14.9% for CHD while increasing 20.7% for heart failure and 8.4% for other HDs. The number of deaths increased 8.5% for HD, 38.0% for heart failure, and 23.4% for other HDs while decreasing 2.5% for CHD. A total of 80% of HD deaths occurred in the group of adults aged 65 years and older.CONCLUSIONS AND RELEVANCE The substantial increase in the growth rate of the group of adults aged 65 years and older who have the highest risk of HD was associated with an increase in the number of HD deaths in this group despite a slowly declining HD mortality rate in the general population. With the number of adults aged 65 years and older projected to increase an additional 44% from 2017 to 2030, innovative and effective approaches to prevent and treat HD, particularly the substantially increasing rates of heart failure, are needed.