The future impact of population growth and aging on coronary heart disease in China: projections from the Coronary Heart Disease Policy Model-China.
The future impact of population growth and aging on coronary heart disease in China: projections from the Coronary Heart Disease Policy Model-China.
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DOI：
10.1186/1471-2458-8-394
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发表时间：
2008-11-27
影响因子：
4.5
通讯作者：
Goldman L
中科院分区：
文献类型：
--
作者：
Moran A;Zhao D;Gu D;Coxson P;Chen CS;Cheng J;Liu J;He J;Goldman L
未来几十年，中国成年人口将全面增长并进入老龄化阶段。我们使用计算机模型来预测这些人口变化对中国冠心病（CHD）的未来影响。CHD政策模型是一个经过验证的国家过渡，CHD在全国范围内的计算机模拟。纳入了中国特有的CHD危险因素、发病率、病死率和患病率数据，并从中国队列研究中生成CHD预测模型，并根据中国特定年龄的死亡率进行校准。使用标准方法计算冠心病所致的残疾调整生命年（Disability-adjusted life years，DADs）。输入中国35-84岁的预计人口，并模拟2000-2029年的CHD事件、死亡和糖尿病。除年龄和病死率外的冠心病风险因素保持在2000年的水平。敏感性分析测试了CHD死亡率编码、CHD占总死亡人数的比例和病死率的不确定性。我们预测，与2000-2009年相比，2020-2029年的十年中将有780万例CHD事件（增加69%）和340万例CHD死亡（增加64%）。到2030年，我们预测每年近100万例CHD死亡中有71%将发生在≥65岁的人群中，而每年不断增长的CHD死亡和残疾负担中有67%将由<65岁的成年人承担。替代替代CHD死亡率假设导致2000-2029年CHD死亡预测增加17-20%，尽管CHD事件和死亡随时间增加的模式仍然存在。我们预测2010-2029年中国冠心病事件和死亡的绝对数量将急剧增加，仅由于人口的增长和老龄化。最近的数据表明CHD危险因素水平正在增加，因此我们的预测可能低估了中国潜在CHD流行的程度。
China will experience an overall growth and aging of its adult population in coming decades. We used a computer model to forecast the future impact of these demographic changes on coronary heart disease (CHD) in China. The CHD Policy Model is a validated state-transition, computer simulation of CHD on a national scale. China-specific CHD risk factor, incidence, case-fatality, and prevalence data were incorporated, and a CHD prediction model was generated from a Chinese cohort study and calibrated to age-specific Chinese mortality rates. Disability-adjusted life years (DALYs) due to CHD were calculated using standard methods. The projected population of China aged 35–84 years was entered, and CHD events, deaths, and DALYs were simulated over 2000–2029. CHD risk factors other than age and case-fatality were held at year 2000 levels. Sensitivity analyses tested uncertainty regarding CHD mortality coding, the proportion of total deaths attributable to CHD, and case-fatality. We predicted 7.8 million excess CHD events (a 69% increase) and 3.4 million excess CHD deaths (a 64% increase) in the decade 2020–2029 compared with 2000–2009. For 2030, we predicted 71% of almost one million annual CHD deaths will occur in persons ≥65 years old, while 67% of the growing annual burden of CHD death and disability will weigh on adults <65 years old. Substituting alternate CHD mortality assumptions led to 17–20% more predicted CHD deaths over 2000–2029, though the pattern of increases in CHD events and deaths over time remained. We forecast that absolute numbers of CHD events and deaths will increase dramatically in China over 2010–2029, due to a growing and aging population alone. Recent data suggest CHD risk factor levels are increasing, so our projections may underestimate the extent of the potential CHD epidemic in China.