Cardiovascular health behavior and health factor changes (1988-2008) and projections to 2020: results from the National Health and Nutrition Examination Surveys.
Cardiovascular health behavior and health factor changes (1988-2008) and projections to 2020: results from the National Health and Nutrition Examination Surveys.
复制标题
心血管健康行为和健康因素变化（1988-2008）和2020年的预测：国家健康和营养检查调查的结果。
DOI：
10.1161/circulationaha.111.070722
复制
发表时间：
2012-05-29
期刊：
影响因子：
37.8
通讯作者：
Lloyd-Jones DM
中科院分区：
文献类型：
--
作者：
Huffman MD;Capewell S;Ning H;Shay CM;Ford ES;Lloyd-Jones DM
美国心脏协会的 2020 年战略影响目标目标是通过使用 4 种健康行为（吸烟、饮食、体力活动、体重）和 3 种健康因素（血浆葡萄糖、胆固醇、血压）指标，使整体心血管健康相对改善 20%。我们试图确定心血管健康领域的当前趋势并展望 2020 年。我们纳入了 1988-1994 年国家健康和营养检查调查以及 1999-2008 年随后的 2 年周期中的 35 059 名无心血管疾病的成年人（年龄≥20 岁）。我们计算了人群中不良、中等和理想健康行为和因素的患病率，并计算了所有 7 个指标的综合个人水平心血管健康评分（不良 = 0 分；中间 = 1 分；理想 = 2 分；总范围，0-14 分）。 2008 年，当前和既往吸烟、高胆固醇血症和高血压的患病率有所下降，而肥胖和血糖异常的患病率有所上升。体力活动水平和低饮食质量评分变化甚微。到 2020 年的预测表明，肥胖和空腹血糖受损/糖尿病可能会增加，分别影响 43% 和 77% 的美国男性以及 42% 和 53% 的美国女性。总体而言，如果目前的趋势持续下去，预计到 2020 年，人口心血管健康状况将总体改善 6%。到 2020 年的个人心血管健康评分预测（男性 = 7.4 [95% 置信区间，5.7–9.1]；女性 = 8.8 [95% 置信区间，7.6–9.9]）远低于实现 20% 改善所需的水平（男性 = 9.4；女性 = 10.1）。如果目前的趋势继续下去，美国心脏协会的 2020 年目标将无法实现，即到 2020 年将心血管健康改善 20%。
The American Heart Association’s 2020 Strategic Impact Goals target a 20% relative improvement in overall cardiovascular health with the use of 4 health behavior (smoking, diet, physical activity, body mass) and 3 health factor (plasma glucose, cholesterol, blood pressure) metrics. We sought to define current trends and forward projections to 2020 in cardiovascular health. We included 35 059 cardiovascular disease–free adults (aged ≥20 years) from the National Health and Nutrition Examination Survey 1988–1994 and subsequent 2-year cycles during 1999–2008. We calculated population prevalence of poor, intermediate, and ideal health behaviors and factors and also computed a composite, individual-level Cardiovascular Health Score for all 7 metrics (poor=0 points; intermediate=1 point; ideal=2 points; total range, 0–14 points). Prevalence of current and former smoking, hypercholesterolemia, and hypertension declined, whereas prevalence of obesity and dysglycemia increased through 2008. Physical activity levels and low diet quality scores changed minimally. Projections to 2020 suggest that obesity and impaired fasting glucose/diabetes mellitus could increase to affect 43% and 77% of US men and 42% and 53% of US women, respectively. Overall, population-level cardiovascular health is projected to improve by 6% overall by 2020 if current trends continue. Individual-level Cardiovascular Health Score projections to 2020 (men=7.4 [95% confidence interval, 5.7–9.1]; women=8.8 [95% confidence interval, 7.6–9.9]) fall well below the level needed to achieve a 20% improvement (men=9.4; women=10.1). The American Heart Association 2020 target of improving cardiovascular health by 20% by 2020 will not be reached if current trends continue.