Modelling the decreasing coronary heart disease mortality in Sweden between 1986 and 2002
Modelling the decreasing coronary heart disease mortality in Sweden between 1986 and 2002
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DOI：
10.1093/eurheartj/ehn554
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发表时间：
2009-05-01
影响因子：
39.3
通讯作者：
Capewell, Simon
中科院分区：
文献类型：
--
作者：
Bjorck, Lena;Rosengren, Annika;Capewell, Simon
自20世纪80年代以来，瑞典的冠心病（CHD）死亡率一直在下降。我们使用先前验证的IMPACT CHD模型来研究瑞典1986年至2002年间死亡率下降的多少可归因于内科和外科治疗，以及心血管危险因素的变化。IMPACT死亡率模型用于联合收割机并分析瑞典心脏病治疗的吸收和有效性以及危险因素趋势的数据。主要数据来源是官方统计数据、国家护理质量登记册、已发表的试验和荟萃分析以及国家人口调查。1986年至2002年期间，瑞典25-84岁男性和女性的冠心病死亡率分别下降了53.4%和52.0%。这导致2002年死亡人数减少13 180人。其中约36%的下降归因于个体治疗，55%归因于人群风险因素的降低。在1986年至2002年期间，瑞典冠心病死亡率的大幅下降有一半以上归因于主要危险因素的减少，主要是血清总胆固醇的大幅下降。这些发现强调了促进初级预防和循证医学治疗，特别是二级预防的综合战略的价值。
Coronary heart disease (CHD) mortality rates have been falling in Sweden since the 1980s. We used the previously validated IMPACT CHD model to examine how much of the mortality decrease in Sweden between 1986 and 2002 could be attributed to medical and surgical treatments, and how much to changes in cardiovascular risk factors.The IMPACT mortality model was used to combine and analyse data on uptake and effectiveness of cardiological treatments and risk factor trends in Sweden. The main data sources were official statistics, national quality of care registers, published trials and meta-analyses, and national population surveys. Between 1986 and 2002, CHD mortality rates in Sweden decreased by 53.4% in men and 52.0% in women aged 25-84 years. This resulted in 13 180 fewer deaths in 2002. Approximately 36% of this decrease was attributed to treatments in individuals and 55% to population risk factor reductions. Adverse trends were seen for diabetes and overweight.More than half of the substantial CHD mortality decrease in Sweden between 1986 and 2002 was attributable to reductions in major risk factors, mainly a large decrease in total serum cholesterol. These findings emphasize the value of a comprehensive strategy that promotes primary prevention and evidence-based medical treatments, especially secondary prevention.