Trends in risk factors for cardiovascular disease in Canada: temporal, socio-demographic and geographic factors
Trends in risk factors for cardiovascular disease in Canada: temporal, socio-demographic and geographic factors
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DOI：
10.1503/cmaj.081629
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发表时间：
2009-08-04
影响因子：
14.6
通讯作者：
Tu, Jack V.
中科院分区：
文献类型：
--
作者：
Lee, Douglas S.;Chiu, Maria;Tu, Jack V.
背景：心血管疾病危险因素的时间趋势以及社会经济状况对这些危险因素的影响仍不清楚。方法：利用全国人口健康调查和加拿大社区健康调查的数据，我们研究了 1994 年至 2005 年全国心脏病、高血压、糖尿病、肥胖和吸烟流行率的趋势，并调整了年龄和性别。我们按收入充足类别、体重指数和居住地区对数据进行分层。 结果：估计 2005 年有 129 万加拿大人患有心脏病，与 1994 年相比，男性增加了 19%，女性增加了 2%。心脏病在最低收入类别（增加 27%）、中低收入类别（增加 37%）和中上收入类别（增加 12%）中显着增加；然而，最高收入群体的增幅仅为 6%。除最高收入群体外，其他所有群体的糖尿病患病率均有所增加：最低收入群体的糖尿病患病率增加了 56%，中低收入群体的糖尿病患病率增加了 93%，中高收入群体的糖尿病患病率增加了 59%。所有收入组的高血压发病率均有所增加：最低收入组增加85%，中低收入组增加80%，中上收入组增加91%，最高收入组增加117%。所有收入群体的肥胖率均有所增加：最低收入群体增加了 20%，中低收入群体增加了 25%，中上收入群体增加了 33%，最高收入群体增加了 37%。除了社会经济地位之外，肥胖和超重也改变了危险因素的趋势。肥胖参与者（增加 61%）和超重参与者（增加 25%）的糖尿病发病率增加幅度更大，高血压的发病率也在肥胖个体中增加 80%，在超重个体中增加 74%。所有省份的糖尿病、高血压和肥胖趋势都是一致的。解读：在研究期间，加拿大所有或大多数收入群体的心脏病、高血压、糖尿病和肥胖都有所增加。需要采取进一步的干预措施来支持改变生活方式和危险因素，以预防未来的心血管疾病。
Background: Temporal trends in risk factors for cardiovascular disease and the impact of socio-economic status on these risk factors remain unclear.Methods: Using data from the National Population Health Survey and the Canadian Community Health Survey, we examined national trends in heart disease, hypertension, diabetes mellitus, obesity and smoking prevalence from 1994 to 2005, adjusting for age and sex. We stratified data by income adequacy category, body mass index and region of residence.Results: An estimated 1.29 million Canadians reported having heart disease in 2005, representing increases of 19% for men and 2% for women, relative to 1994. Heart disease increased significantly in the lowest income category (by 27%), in the lower middle income category (by 37%) and in the upper middle income category (by 12%); however, it increased by only 6% in the highest income group. Diabetes increased in all but the highest income group: by 56% in the lowest income group, by 93% in the lower middle income group and by 59% in the upper middle income group. Hypertension increased in all income groups: by 85% in the lowest income group, by 80% in the lower middle income group, by 91% in the upper middle income group and by 117% in the highest income group. Obesity also increased in all income groups: by 20% in the lowest income group, by 25% in the lower middle income group, by 33% in the upper middle income group and by 37% in the highest income group. In addition to socio-economic status, obesity and overweight also modified the trends in risk factors. Diabetes increased to a greater extent among obese participants (61% increase) and overweight participants (25% increase), as did hypertension, which increased by 80% among obese individuals and by 74% among overweight individuals. Trends in diabetes, hypertension and obesity were consistent for all provinces.Interpretation: During the study period, heart disease, hypertension, diabetes and obesity increased for all or most income groups in Canada. Further interventions supporting modification of lifestyle and risk factors are needed to prevent future cardiovascular disease.