Mortality From Ischemic Heart Disease Analysis of Data From the World Health Organization and Coronary Artery Disease Risk Factors From NCD Risk Factor Collaboration
Mortality From Ischemic Heart Disease Analysis of Data From the World Health Organization and Coronary Artery Disease Risk Factors From NCD Risk Factor Collaboration
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DOI：
10.1161/circoutcomes.118.005375
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发表时间：
2019-06-01
影响因子：
6.9
通讯作者：
Al-Lamee, Rasha
中科院分区：
文献类型：
--
作者：
Nowbar, Alexandra N.;Gitto, Mauro;Al-Lamee, Rasha
背景：缺血性心脏病（IHD）被认为是全球死亡的首要原因。然而，各国的比率不同，而且随着时间的推移发生了变化。方法和结果：我们分析了2005年至2015年各国提交给世界卫生组织的死亡率数据。我们探讨了与年龄、性别和收入的关系，并计算了每个国家的年龄标准化死亡率以及粗死亡率。在提供详细数据的5个国家中，我们分析了IHD和3种非传染性疾病（肺癌、中风和慢性下呼吸道疾病）的死亡率趋势，并检查了重要心血管危险因素的同时趋势。在提供数据的国家中，俄罗斯、美国和乌克兰的绝对死亡人数最多。在5个说明性国家（英国、美国、巴西、哈萨克斯坦和乌克兰）中，IHD是最主要的死亡原因，但IHD的死亡率从2005年到2015年逐渐下降。乌克兰（324）和哈萨克斯坦（97）每年每10万人的IHD标准化死亡率远高于美国（60），巴西（54）和英国（46），其他死亡原因的差异要小得多。所有5个国家的IHD死亡率均呈逐步下降趋势，吸烟和高血压下降，肥胖和II型糖尿病上升。结论：IHD仍然是所有收入组国家的单一最大死因。各国的比率不同，大多数国家的比率都在下降，这表明有进一步提高的巨大潜力。在地平线上，未来的改善可能会受到一些发展中国家高血压增加的限制，更重要的是全球肥胖症的增长。
Background: Ischemic heart disease (IHD) has been considered the top cause of mortality globally. However, countries differ in their rates and there have been changes over time. Methods and Results: We analyzed mortality data submitted to the World Health Organization from 2005 to 2015 by individual countries. We explored patterns in relationships with age, sex, and income and calculated age-standardized mortality rates for each country in addition to crude death rates. In 5 illustrative countries which provided detailed data, we analyzed trends of mortality from IHD and 3 noncommunicable diseases (lung cancer, stroke, and chronic lower respiratory tract diseases) and examined the simultaneous trends in important cardiovascular risk factors. Russia, United States, and Ukraine had the largest absolute numbers of deaths among the countries that provided data. Among 5 illustrative countries (United Kingdom, United States, Brazil, Kazakhstan, and Ukraine), IHD was the top cause of death, but mortality from IHD has progressively decreased from 2005 to 2015. Age-standardized IHD mortality rates per 100 000 people per year were much higher in Ukraine (324) and Kazakhstan (97) than in United States (60), Brazil (54), and the United Kingdom (46), with much less difference in other causes of death. All 5 countries showed a progressive decline in IHD mortality, with a decline in smoking and hypertension and in all cases a rise in obesity and type II diabetes mellitus. Conclusions: IHD remains the single largest cause of death in countries of all income groups. Rates are different between countries and are falling in most countries, indicating great potential for further gains. On the horizon, future improvements may become curtailed by increasing hypertension in some developing countries and more importantly global growth in obesity.