Substantial potential for reductions in coronary heart disease mortality in the UK through changes in risk factor levels
Substantial potential for reductions in coronary heart disease mortality in the UK through changes in risk factor levels
复制标题
DOI：
10.1136/jech.57.4.243
复制
发表时间：
2003-04-01
影响因子：
6.3
通讯作者：
Capewell, S
中科院分区：
文献类型：
--
作者：
Critchley, JA;Capewell, S
研究目的：英国政府呼吁到2010年将75岁以下人群的心血管疾病死亡率降低40%。本文探讨了潜在的心血管危险因素的变化，以减少冠心病死亡在苏格兰，然后推断的结果，以英国population.Design：二次分析发表的数据，使用以前验证的死亡率模型。该模型将治疗的吸收和有效性与性别和年龄组的风险因素趋势相结合。它被用来估计冠心病死亡率的预期降低：（a）如果最近的风险因素趋势只是继续;（B）如果额外的风险因素降低达到与斯堪的纳维亚和美国一致。一个“极端的分析”敏感性analysis.Setting：苏格兰和英国。参与者：预计苏格兰人口45岁以上，在2010年（240万）和英国人口2680万。主要结果：继续目前的趋势将导致2169少冠状动脉死亡在2010年（最低估计1191从敏感性分析最大3870）。减少4749人死亡（最低3085人，最高7155人）可以通过以下方式实现：（a）将吸烟率从30%降至18%（死亡人数减少约1668人）;（B）平均人群胆固醇从6.2 mmol/l降至5.2 mmol/l（死亡人数减少约2167人）;（c）舒张压下降3.7毫米汞柱（死亡人数减少约914人）。从苏格兰人口到英国的外推表明，2010年死亡人数减少24 000，如果目前的趋势继续下去，或53 000死亡人数减少额外reductions.Conclusions：与额外的干预措施，它将有可能几乎减半目前英国冠心病死亡率。即使没有医疗方面的收益，英国政府2010年减少28000例死亡的目标似乎也没有挑战性。
Study objective: The UK government called for a 40% reduction in cardiovascular disease mortality in those aged under 75 by 2010. This paper examines the potential for cardiovascular risk factor changes to reduce coronary heart disease deaths in Scotland, and then extrapolates the findings to the UK population.Design: Secondary analysis of published data using a previously validated mortality model. The model combines uptake and effectiveness of treatments with risk factor trends by sex and age group. It was used to estimate the expected reductions in coronary heart disease mortality: (a) if recent risk factor trends simply continued; (b) if additional risk factor reductions were achieved in line with Scandinavia and the United States. An "analysis of extremes" sensitivity analysis was then carried out.Setting: Scotland and UK.Participants: Projected Scottish population aged 45+ in 2010 (2.4 million) and UK population of 26.8 million.Main results: Continuation of current trends would result in 2169 fewer coronary deaths in 2010 (minimum estimate 1191 from sensitivity analyses to maximum 3870). About 4749 fewer deaths (minimum 3085, maximum 7155) could be achieved by: (a) a reduction in smoking prevalence from 30% to 18% (about 1668 fewer deaths); (b) a mean population cholesterol reduction from 6.2 to 5.2 mmol/l (about 2167 fewer deaths); (c) a 3.7 mm Hg fall in diastolic blood pressure (about 914 fewer deaths). Extrapolation from the Scottish population to the UK suggests 24 000 fewer deaths in 2010 if current trends continue, or 53 000 fewer deaths with the additional reductions.Conclusions: With additional interventions it would be possible to almost halve current UK coronary heart disease mortality. Even without gains from medical treatments, the UK government target of 28 000 fewer deaths in 2010 does not seem challenging.