Statistical methods for the analysis of trends in coronary heart disease

冠心病趋势分析的统计方法

• 批准号: nhmrc : 100954
• 负责人: Prof Annette Dobson
• 金额: $ 7.52万
• 依托单位国家: 澳大利亚
• 项目类别: NHMRC Project Grants
• 财政年份: 2000
• 资助国家: 澳大利亚
• 起止时间: 2000-01-01 至 2001-12-31
• 项目状态: 已结题
• 来源: https://researchdata.edu.au/statistical-methods-analysis-heart-disease/77506
• 关键词: Statistical; methods; analysis; trends; coronary

Coronary heart disease is a leading cause of mortality, morbidity and medical costs in Australia. During the 1950's and 1960's, rates of coronary disease increased rapidly, then in the late 1960's they started to decline. This decrease has continued steadily for 30 years. While some other westernised countries have had this same experience, in Eastern Europe and in many developing countries coronary disease is increasing. There is a huge amount of evidence from experimental studies in animal and human subjects and population studies in many countries that the major determinants of coronary disease are high blood pressure, cigarette smoking and high cholesterol (and other lipids) as well as dietary factors, obesity and physical inactivity. Recently several large multicentre studies have found unexpectedly weaker associations between heart risk factors and disease rates. It is hypothesised that this is due to inappropriate analyses in which data from populations at different stages of the coronary epidemic have been combined. The aim of this study is to develop improved statistical methodology to help understand recent findings from large scale studies, such as the World Health Organization's MONICA Project, the US ARIC study and the Seven Countries study. It will provide new theoretical results and statistical software for their implementation. From a public health perspective the most important outcome will be clarification of recent apparently anomalous findings about the importance of established risk factors and effective treatments in reducing coronary disease at the population level.

在澳大利亚，冠心病是死亡率、发病率和医疗费用的主要原因。在20世纪50年代和60年代，冠心病的发病率迅速上升，然后在60年代后期开始下降。这种下降持续了30年。虽然其他一些西方国家也有同样的经历，但在东欧和许多发展中国家，冠状动脉疾病正在增加。从动物和人类受试者的实验研究以及许多国家的人口研究中获得的大量证据表明，冠心病的主要决定因素是高血压、吸烟和高胆固醇（和其他脂质）以及饮食因素、肥胖和缺乏身体活动。最近，几项大型多中心研究发现，心脏病风险因素与疾病发生率之间的关联出乎意料地减弱。据推测，这是由于不适当的分析，其中数据的人群在不同阶段的冠状动脉流行病已合并。本研究的目的是开发改进的统计方法，以帮助了解最近的大规模研究，如世界卫生组织的MONICA项目，美国ARIC研究和七个国家的研究结果。这将为它们的实施提供新的理论结果和统计软件。从公共卫生的角度来看，最重要的结果将是澄清最近明显异常的发现，即确定的危险因素和有效的治疗方法在人群水平上减少冠心病的重要性。