Cardiovascular risk factor trends and potential for reducing coronary heart disease mortality in the United States of America
Cardiovascular risk factor trends and potential for reducing coronary heart disease mortality in the United States of America
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DOI：
10.2471/blt.08.057885
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发表时间：
2010-02-01
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影响因子：
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通讯作者：
Labarthe, Darwin R
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文献类型：
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作者：
Capewell, Simon;Ford, Earl S;Labarthe, Darwin R
目的研究在美国降低心血管危险因素的潜力，使年龄调整的冠心病（CHID）死亡率下降20%（从2000年基线数字），到2010年，根据健康人2010年倡议的目标。综合CHD死亡率模型（称为IMPACT），该模型整合了所有主要心血管风险因素的趋势，按年龄和性别分层，我们计算了2000年至2010年美国25-84岁的预计人口（1.98亿）中CHID死亡率将下降多少。我们在三种假设情况下这样做：（i）如果最近的风险因素趋势持续到2010年;（ii）成功达到所有健康人群2010年风险因素目标，（iii）风险因素进一步下降，达到低风险阶层已经看到的水平。2010年，约有388000人死于冠心病。第一种情况：如果最近的风险因素趋势持续到2010年，死亡人数将比2000年减少约19 000人。虽然总胆固醇的改善、男性血压的降低、吸烟的减少和体力活动的增加将使死亡人数减少约51 000人，但这些将被肥胖和糖尿病以及女性血压的不利趋势所增加的约32 000人死亡所抵消。第二种情况：如果达到2010年健康人群心血管风险因素目标，大约188，000例冠心病死亡将得到预防。场景三：如果达到低风险人群的心血管风险水平，约372 000 CHD死亡将被prevented.Conclusion实现健康人群2010年心血管风险因素的目标，将几乎减半预测CHD死亡率。主要危险因素的进一步减少可以预防或推迟大幅增加的CHD死亡。
Objective To examine the potential for reducing cardiovascular risk factors in the United States of America enough to cause age-adjusted coronary heart disease (CHID) mortality rates to drop by 20% (from 2000 baseline figures) by 2010, as targeted under the Healthy People 2010 initiative.Methods Using a previously validated, comprehensive CHD mortality model known as IMPACT that integrates trends in all the major cardiovascular risk factors, stratified by age and sex, we calculated how much CHID mortality would drop between 2000 and 2010 in the projected population of the United States aged 25-84 years (198 million). We did this for three assumed scenarios: (i) if recent risk factor trends were to continue to 2010; (ii) success in reaching all the Healthy People 2010 risk factor targets, and (iii) further drops in risk factors, to the levels already seen in the low-risk stratum.Findings If age-adjusted CHD mortality rates observed in 2000 remained unchanged, some 388 000 CHD deaths would occur in 2010. First scenario: if recent risk factor trends continued to 2010, there would be approximately 19 000 fewer deaths than in 2000. Although improved total cholesterol, lowered blood pressure in men, decreased smoking and increased physical activity would account for some 51 000 fewer deaths, these would be offset by approximately 32 000 additional deaths from adverse trends in obesity and diabetes and in blood pressure in women. Second scenario: If Healthy People 2010 cardiovascular risk factor targets were reached, approximately 188 000 CHD deaths would be prevented. Scenario three: If the cardiovascular risk levels of the low-risk stratum were reached, approximately 372 000 CHD deaths would be prevented.Conclusion Achievement of the Healthy People 2010 cardiovascular risk factor targets would almost halve the predicted CHD death rates. Additional reductions in major risk factors could prevent or postpone substantially more deaths from CHD.