Cardiovascular hospitalizations and mortality among adults aged 25-64 years in the USA.
Cardiovascular hospitalizations and mortality among adults aged 25-64 years in the USA.
复制标题
美国 25-64 岁成年人因心血管疾病住院和死亡率。
DOI：
10.1093/eurheartj/ehad772
复制
发表时间：
2024
影响因子：
39.3
通讯作者：
Wadhera,RishiK
中科院分区：
文献类型：
--
作者：
Henry,ChantalM;Oseran,AndrewS;Zheng,ZhaoNian;Dong,Huaying;Wadhera,RishiK
背景和目的自2011年以来，美国心血管疾病死亡率的下降一直停滞不前。人们越来越担心这些模式反映了年轻人心血管健康状况的恶化。然而，很少有人知道如何负担的急性心血管住院和死亡率已经改变了这一人群。年龄在25-64岁的成年人心血管住院和死亡率的变化进行了评估，整体和社区一级income.MethodsUsing the National Inpatient Sample，年龄标准化的年住院率和院内死亡率急性心肌梗死（AMI），心力衰竭，缺血性中风，确定在25-64岁的成年人。拟泊松和拟二项式回归模型拟合，以比较居住在低收入和高收入社区的个人之间的结果。结果在2008年至2019年期间，年轻人AMI的年龄标准化住院率从155.0（95%置信区间：154.6，155.4）/100 000至160.7（160.3，161.1）/100 000（绝对变化+5.7 [5.0，6.3]，P< .001）。心力衰竭住院率也有所增加（165.3 [164.8，165.7]至225.3 [224.8，225.8]，绝对变化+60.0（59.3，60.6），P< .001），缺血性卒中住院（76.3 [76.1，76.7]至108.1 [107.8，108.5]，绝对变化+31.7（31.2，32.2），P< .001）。在所有情况下，与高收入社区相比，居住在低收入社区的年轻人的住院率显着较高，并且各组之间的差异并没有缩小。在研究期间，所有条件下的住院死亡率都有所下降。结论2008年至2019年，美国年轻人的心血管住院率惊人地增加，居住在低收入和高收入社区的人之间的差异并没有缩小。
Background and AimsDeclines in cardiovascular mortality have stagnated in the USA since 2011. There is growing concern that these patterns reflect worsening cardiovascular health in younger adults. However, little is known about how the burden of acute cardiovascular hospitalizations and mortality has changed in this population. Changes in cardiovascular hospitalizations and mortality among adults aged 25–64 years were evaluated, overall and by community-level income.MethodsUsing the National Inpatient Sample, age-standardized annual hospitalization and in-hospital mortality rates for acute myocardial infarction (AMI), heart failure, and ischaemic stroke were determined among adults aged 25–64 years. Quasi-Poisson and quasi-binominal regression models were fitted to compare outcomes between individuals residing in low- and higher-income communities.ResultsBetween 2008 and 2019, age-standardized hospitalization rates for AMI increased among younger adults from 155.0 (95% confidence interval: 154.6, 155.4) per 100 000 to 160.7 (160.3, 161.1) per 100 000 (absolute change +5.7 [5.0, 6.3],P< .001). Heart failure hospitalizations also increased (165.3 [164.8, 165.7] to 225.3 [224.8, 225.8], absolute change +60.0 (59.3, 60.6),P< .001), as ischaemic stroke hospitalizations (76.3 [76.1, 76.7] to 108.1 [107.8, 108.5], absolute change +31.7 (31.2, 32.2),P< .001). Across all conditions, hospitalizations rates were significantly higher among younger adults residing in low-income compared with higher-income communities, and disparities did not narrow between groups. In-hospital mortality decreased for all conditions over the study period.ConclusionsThere was an alarming increase in cardiovascular hospitalizations among younger adults in the USA from 2008 to 2019, and disparities between those residing in low- and higher-income communities did not narrow.