Analysing the decline in the British Coronary Heart Disease epidemic

分析英国冠心病疫情下降情况

• 批准号: G0501307/1
• 负责人: Richard Morris
• 金额: $ 16.65万
• 依托单位: University College London
• 依托单位国家: 英国
• 项目类别: Research Grant
• 财政年份: 2006
• 资助国家: 英国
• 起止时间: 2006 至 无数据
• 项目状态: 已结题
• 来源: https://gtr.ukri.org/projects?ref=G0501307%2F1
• 关键词: Analysing; decline; British; Coronary; Heart

Death rates for coronary heart disease (CHD) in the UK have halved since 1980, but CHD is still the commonest cause of death. The decrease since 1980 may be because fewer people now get CHD in the first place, or because more people survive after experiencing CHD, or both. If fewer people now get CHD, this may be due to changes in risk factors in the population (for example, fewer people now smoke). If survival after CHD is better, it will mainly be due to more effective treatment by hospitals or by family doctors, or both. Since 2000, the National Health Service has greatly increased its expenditure on CHD, and the UK spends more per head than any other European country. However most of the spending increase has been concentrated on facilities for people in hospital with CHD. It is therefore important that we understand the main reasons why CHD has fallen in the last two decades. Then government departments will be able to make informed choices about how they best allocate future expenditure, to bring about further decreases in deaths due to CHD. We will analyse three data sets; (i) the British Regional Heart Study which has followed up over 7000 British men for 25 years; (ii) the General Practice Research Database (and the similar THIN database), which has captured computer-recorded information on patients from hundreds of general practices since 1990, and (iii) the Health Survey for England (HSE), which surveys about 19,000 people every year, and in 1994, 1998 and 2003 concentrated on issues concerning cardiovascular disease. From these studies, we will describe trends in heart disease rates, in risk factors, treatment rates, and survival rates after heart disease. Using a computer model called IMPACT, we will then estimate the contribution of changes in risk factors, and increases in treatment, in decreasing the CHD epidemic. We will work with the National Heart Forum, a well-established and influential advocacy group concerning government health policy, to help guide our analysis, and to disseminate our findings.

自1980年以来，英国冠心病（CHD）的死亡率已经减半，但CHD仍然是最常见的死亡原因。自1980年以来的下降可能是因为现在首先得到CHD的人更少，或者因为更多的人在经历CHD后存活下来，或者两者兼而有之。如果现在患冠心病的人减少了，这可能是由于人群中危险因素的变化（例如，现在吸烟的人减少了）。如果冠心病后的生存率更好，主要是由于医院或家庭医生的治疗更有效，或者两者兼而有之。自2000年以来，英国国家卫生服务体系大大增加了对冠心病的支出，英国的人均支出超过任何其他欧洲国家。然而，大部分支出增长集中在冠心病住院患者的设施上。因此，重要的是我们要了解CHD在过去二十年中下降的主要原因。然后，政府部门将能够就如何最好地分配未来支出做出明智的选择，以进一步减少冠心病死亡。我们将分析三个数据集：（i）英国区域心脏研究，该研究对7000多名英国男性进行了25年的随访;（ii）全科医学研究数据库（以及类似的THIN数据库），该数据库自1990年以来已从数百个普通诊所获取了计算机记录的患者信息，以及（iii）英格兰健康调查（HSE），该调查调查了约19个，在1994年、1998年和2003年，该中心集中讨论了有关心血管疾病的问题。从这些研究中，我们将描述心脏病发病率、危险因素、治疗率和心脏病后生存率的趋势。使用一个名为IMPACT的计算机模型，我们将估计危险因素的变化和治疗的增加对降低CHD流行的贡献。我们将与国家心脏论坛（National Heart Forum）合作，这是一个关于政府卫生政策的成熟且有影响力的倡导组织，以帮助指导我们的分析，并传播我们的研究结果。