Life-years-gained from population risk factor changes and modern cardiology treatments in Ireland
Life-years-gained from population risk factor changes and modern cardiology treatments in Ireland
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DOI：
10.1093/eurpub/ckl090
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发表时间：
2007-04-01
影响因子：
4.4
通讯作者：
Capewell, Simon
中科院分区：
文献类型：
--
作者：
Kabir, Zubair;Bennett, Kathleen;Capewell, Simon
背景资料：自20世纪80年代中期以来，爱尔兰的冠心病（CHD）死亡率已减半，成人预期寿命也稳步提高。这项研究估计了冠心病治疗和心血管危险因素水平变化所获得的生命年。研究方法：使用先前验证的Irish IMPACT CHD死亡率模型整合了大量数据，包括（i）患者数量，（ii）治疗吸收，（iii）风险因素趋势，（iv）心脏病治疗和风险因素降低的有效性，以及（v）CHD患者和非CHD患者的中位生存期，所有数据均按年龄和性别分层。结果进行了严格的敏感性分析。结果：与基准年1985年相比，2000年冠心病死亡人数比预期减少了3763人。这导致25-84岁人群的寿命增加了44060年。2000年，冠心病患者接受的特殊内科和外科治疗总共增加了14505生命年。人口胆固醇和吸烟水平的变化约占32705生命年的增加，其中66%来自胆固醇的降低。肥胖和糖尿病的不利变化导致了类似于3670生命年的损失。结论：从1985年到2000年，在爱尔兰使用现代心脏病治疗获得了数千个生命年。然而，主要危险因素的相对适度减少产生了两倍的生命年。有效的政策，如促进健康饮食和减轻体重，以及最近在全国范围内禁止工作场所吸烟，对于保持和进一步加强健康成果至关重要。
Background: Coronary heart disease (CHD) mortality rates in Ireland have halved since the mid-1980s, and adult life expectancy has also steadily improved. This study estimated the life-years-gained by CHD treatments and by changes in cardiovascular risk factor levels. Methods: A previously validated Irish IMPACT CHD mortality model was used to integrate large amounts of data on (i) patient numbers, (ii) treatment uptake, (iii) risk factor trends, (iv) effectiveness of cardiology treatments and risk factor reductions, and (v) median survival in patients with and without CHD, all stratified by age and sex. Results were tested in rigorous sensitivity analyses. Results: There were 3763 fewer CHD deaths than expected in 2000 compared with the base year, 1985. This resulted in similar to 44 060 life-years-gained among people aged 25-84. Specific medical and surgical treatments given in 2000 for CHD patients together gained similar to 14 505 life-years. Population changes in cholesterol and smoking levels accounted for some 32 705 life-years-gained, 66% from reductions in cholesterol alone. Adverse changes in obesity and diabetes resulted in a loss of similar to 3670 life-years. Conclusions: Use of modern cardiology treatments in Ireland from 1985 to 2000 gained many thousands of life-years. However, twice as many life-years were generated by relatively modest reductions in major risk factors. Effective policies, such as the promotion of healthy diets, and weight reduction, together with the recent nationwide workplace smoking ban, will be essential to maintain and further enhance health gain.