Widespread recent increases in county-level heart disease mortality across age groups
Widespread recent increases in county-level heart disease mortality across age groups
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DOI：
10.1016/j.annepidem.2017.10.012
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发表时间：
2017-12-01
影响因子：
5.6
通讯作者：
Casper, Michele
中科院分区：
文献类型：
--
作者：
Vaughan, Adam S.;Ritchey, Matthew D.;Casper, Michele
目的：最近的全国趋势显示心脏病死亡率下降速度正在放缓，特别是在年轻人中。国家趋势可能掩盖了地域和年龄的差异。我们按年龄组检查了县级心脏病死亡率的最新趋势。方法：使用贝叶斯统计模型和国家生命统计系统数据，我们估计了 2010 年至 2015 年美国 3098 个县的四个年龄组（35-44、45-54、55-64 和 65-74 岁）心脏病死亡率的总体比率和百分比变化。结果：在全国范围内，除年龄外，每个年龄组的心脏病死亡率均有所下降55-64岁。按年龄组划分的县级趋势显示出地理上广泛的增长，其中 52.3%、58.5%、69.1% 和 42.0% 的县出现增长，35-44 岁、45-54 岁、55-64 岁和 65-74 岁的中位百分比变化分别为 0.6%、2.2%、4.6% 和 -1.5%。在最初心脏病死亡率较高的县和大都市地区以外，心脏病死亡率增加的可能性更大。结论：最近的全国趋势掩盖了心脏病死亡率的局部增加。这些增长，尤其是 65 岁以下的成年人，对全国各地的社区构成了挑战。扭转这些趋势可能需要加强一级和二级预防，重点关注年轻人口，特别是那些生活在城市较少县的年轻人口的政策、战略和干预措施。由爱思唯尔公司出版
Purpose: Recent national trends show decelerating declines in heart disease mortality, especially among younger adults. National trends may mask variation by geography and age. We examined recent county level trends in heart disease mortality by age group.Methods: Using a Bayesian statistical model and National Vital Statistics Systems data, we estimated overall rates and percent change in heart disease mortality from 2010 through 2015 for four age groups (35-44, 45-54, 55-64, and 65-74 years) in 3098 US counties.Results: Nationally, heart disease mortality declined in every age group except ages 55-64 years. County level trends by age group showed geographically widespread increases, with 52.3%, 58.5%, 69.1%, and 42.0% of counties experiencing increases with median percent changes of 0.6%, 2.2%, 4.6%, and -1.5% for ages 35-44, 45-54, 55-64, and 65-74 years, respectively. Increases were more likely in counties with initially high heart disease mortality and outside large metropolitan areas.Conclusions: Recent national trends have masked local increases in heart disease mortality. These increases, especially among adults younger than age 65 years, represent challenges to communities across the country. Reversing these trends may require intensification of primary and secondary prevention focusing policies, strategies, and interventions on younger populations, especially those living in less urban counties. Published by Elsevier Inc.