Sex Differences in the Prevalence of, and Trends in, Cardiovascular Risk Factors, Treatment, and Control in the United States, 2001 to 2016
Sex Differences in the Prevalence of, and Trends in, Cardiovascular Risk Factors, Treatment, and Control in the United States, 2001 to 2016
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DOI：
10.1161/circulationaha.118.035550
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发表时间：
2019-02-19
期刊：
影响因子：
37.8
通讯作者：
Woodward, Mark
中科院分区：
文献类型：
--
作者：
Peters, Sanne A. E.;Muntner, Paul;Woodward, Mark
背景：在美国，一些但不是全部主要心血管危险因素的治疗和控制已经取得了进展。目前尚不清楚女性和男性是否同样受益。方法：使用2001 - 2002年至2015 - 2016年美国国家健康与营养检查调查的数据，调查对象为20 - 79岁的成年人。我们评估了收缩压、体重指数、吸烟状况、高密度脂蛋白和总胆固醇以及血红蛋白a1c水平的时间趋势的性别差异。对高血压、糖尿病和血脂异常的治疗和控制率趋势也进行了评估。结果：总共纳入35 416名参与者（51%为女性）。收缩压、吸烟状况、高密度脂蛋白胆固醇和血红蛋白a1c的趋势在两性之间相似。女性的身体质量指数高于男性（P= 0.006）。2001年至2004年和2013年至2016年，女性的平均水平分别为28.1和29.6 kg/m2，男性为27.9和29.0 kg/m2。男性总胆固醇的下降幅度大于女性（P= 0.002）： 2001年至2004年和2013年至2016年，女性的平均水平分别为203和194 mg/dL，男性为201和188 mg/dL。在控制高血压、糖尿病和血脂异常方面的改善在两性之间是相似的；然而，性别差异依然存在。2013年至2016年，高血压患者的控制率为30%对22%，糖尿病患者为30%对20%，血脂异常患者为51%对63%。结论：除了总胆固醇和体重指数外，心血管危险因素水平的时间趋势在两性之间大致相似。在控制高血压、糖尿病和血脂异常方面存在性别差异，需要进一步努力缩小这种差异。
BACKGROUND: Improvements have been made in the treatment and control of some but not all major cardiovascular risk factors in the United States. It remains unclear whether women and men have benefited equally.METHODS: Data from the 2001 to 2002 through the 2015 to 2016 US National Health and Nutrition Examination Survey on adults aged 20 to 79 years were used. We assessed sex differences in temporal trends in the levels of systolic blood pressure, body mass index, smoking status, high-density lipoprotein and total cholesterol, and hemoglobin A 1c. Trends in treatment and control rates of hypertension, diabetes mellitus, and dyslipidemia were also assessed.RESULTS: Overall, 35 416 participants (51% women) were included. Trends in systolic blood pressure, smoking status, high-density lipoprotein cholesterol, and hemoglobin A 1c were similar between the sexes. Body mass index increased more in women than men (P= 0.006). Mean levels were 28.1 and 29.6 kg/m2 in women and 27.9 and 29.0 kg/m2 in men in 2001 to 2004 and 2013 to 2016, respectively. Total cholesterol decreased more in men than women (P= 0.002): mean levels in 2001 to 2004 and 2013 to 2016, respectively, were 203 and 194 mg/dL in women and 201 and 188 mg/dL in men. Improvements in the control of hypertension, diabetes mellitus, and dyslipidemia were similar between the sexes; however, sex differences persisted. In 2013 to 2016, control rates in women versus men were 30% versus 22% for hypertension, 30% versus 20% for diabetes mellitus, and 51% versus 63% for dyslipidemia.CONCLUSIONS: Temporal trends in cardiovascular risk factor levels were broadly similar between the sexes, except for total cholesterol and body mass index. Sex differences in the control of hypertension, diabetes mellitus, and dyslipidemia persist, and further efforts are required to reduce this differential.