我国心血管疾病：流行和负担

1、 我国心血管疾病：我国心血管疾病： 流行和负担流行和负担 顾东风顾东风 中国医学科学院阜外心血管病医院中国医学科学院阜外心血管病医院 卫生部心血管病防治研究中心卫生部心血管病防治研究中心 背 景 我国目前面临低出生率、低死亡率和较高期望 寿命（73岁）, 和人口老龄化，在2007年底， 8.0% 的人口年龄 65 岁, 达1亿。 重要心脑肺血管疾病患病率和危险因素水平在 发达国家已经降低，如高血压和吸烟患病率但 我国还在继续上升。 我国目前正处于人口、社会和经济高速发展变 化的阶段，这将进一步加重心血管病负担。 9.4 13.6 17.7 5.1 7.7 12.4 7.5 0 2 4 6 8

2、10 12 14 16 18 20 1959197919912002 prevalence(%) 中国高血压患病率全国性调查中国高血压患病率全国性调查 1959-2002 National BP Survey Cooperative Group Chinese J Hypertension Gu D Hypertension 2002 1995, 3(suppl):9-13 40:920-927 30 24 6 Age 15-74 Age 35-74 Men Women 在过去20年，年龄调整的高胆固醇血症患病率变化趋势 * =200 mg/dl. BJ: Beijing worker BJF

3、: Beijing farmer SYF: Shanxi farmer SZF: Shaanxi farmer JJF: Jiangsu farmer GWF: Guangxi farmer GZW: Guangzhou workerGZF: Guangzhou farmer ZZFs:Zhejiang fishermen Wu YF. Chinese Journal of Cardiology 2001, 29(2):74-79. 男男 性性 女女 性性 中国35-74 岁成年人中血清胆固醇发布 百分比, 2000-2001 240 He J, Gu D. Circulation 2004;

4、110 :405-11 Hazard ratio Mean usual total cholesterol (mmol/l) 血清胆固醇和心血管病关系 4.55.05.56.06.5 +1 mmol/L: 1.32 (1.20- 1.46) 0.7 1.0 1.4 2.0 TC和CHD 4.55.05.56.06.5 +1 mmol/L: 0.81 (0.72-0.92) 0.25 0.50 1.00 2.00 4.00 TC和出血性中风 +1 mmol/L: 1.23 (1.12-1.35) 4.55.05.56.06.5 0.50 1.00 2.00 4.00 TC和缺血性中风 TC TC

5、 上升上升 +1 mmol/L+1 mmol/L 冠心病危险 32上升 缺血性中风危险上升 23 出血性中风下降 19 中国中国18成年人的成年人的年龄调整的超重肥胖患病率年龄调整的超重肥胖患病率 全国营养和健康调查全国营养和健康调查, 2002 16.1 21.6 25 4.8 7.2 10.6 0 10 20 30 40 Rural S.cityL.city Population Rate(%) 中国成年人吸烟率中国成年人吸烟率 男男女女 Number of Participants % % 1984258,42261.0261,178 4.2 1996 65,00063.0 57,000

6、 3.8 a: Weng X, et al: Data from 1984 National Smoking Survey. b: Yang G. Smoking and Health in China: 1996 National Prevalence Survey of Smoking Pattern. Beijing, China Science and Technology Press, 1997. C: Wang L, ed. Series report #1, Chinese Nutrition and Health Status Report, p49, 2005 Number

7、of Participants 200273,19353.9 87,360 3.1 中美人群CVD危险因素年龄标化患病率 *p=200 mg/dl. BJ: Beijing worker BJF: Beijing farmer SYF: Shanxi farmer SZF: Shaanxi farmer JJF: Jiangsu farmer GWF: Guangxi farmer GZW: Guangzhou workerGZF: Guangzhou farmer ZZFs:Zhejiang fishermen Wu YF. Chinese Journal of Cardiology 200

8、1, 29(2):74-79. Percentage Distribution of Serum Total Cholesterol in Adult Population Aged 35- 74 Years in China, 2000-2001 240 He J, Gu D. Circulation 2004;110 :405-11 TC and fatal CHD, fatal and non fatal ischemic and haemorrhagic stroke in Asia Hazard ratio Mean usual total cholesterol (mmol/l)

9、4.55.05.56.06.5 +1 mmol/L: 1.32 (1.20- 1.46) 0.7 1.0 1.4 2.0 TC and CHD 4.55.05.56.06.5 +1 mmol/L: 0.81 (0.72- 0.92) 0.25 0.50 1.00 2.00 4.00 TC and haemorrhagic stroke +1 mmol/L: 1.23 (1.12- 1.35) 4.55.05.56.06.5 0.50 1.00 2.00 4.00 TC and ischemic stroke TC incresing +1 mmol/L CHD risk 32 ischemic

10、 stroke risk 23 haemorrhagic stroke 19 Circulation. 2004;110:2678- 86 Ann Epidemiol 2005;15:504-13 Age-standardized Prevalence of Overweight/ Obesity among Adults Aged18, China National Nutrition and Health Survey, 2002 16.1 21.6 25 4.8 7.2 10.6 0 10 20 30 40 Rural S.cityL.city Population Rate(%) Pr

11、evalence of Smoking in China MenWomen Number of Participants % % 1984258,42261.0261,178 4.2 1996 65,00063.0 57,000 3.8 a: Weng X, et al: Data from 1984 National Smoking Survey. b: Yang G. Smoking and Health in China: 1996 National Prevalence Survey of Smoking Pattern. Beijing, China Science and Tech

12、nology Press, 1997. C: Wang L, ed. Series report #1, Chinese Nutrition and Health Status Report, p49, 2005 Number of Participants 200273,19353.9 87,360 3.1 Age-Standardized Prevalence of Major CVD Risk Factors in China and the United States *p0.001 Standardized on the basis of the year 2000 age dist

13、ribution of the Chinese population. CVD Incidence and Mortality and Their Trends in China Proportionate Mortality for the Ten Leading Causes of Death in China, 1957-2000 He J 353;11:1124-1134 1957 2000 Heart disease stroke Age-standardized Mortality for the Five Leading Causes of Death in Adults He

14、J 353;11:1124-1134 WomenMen CPHD-chronic pulmonary heart disease; CHD-coronary heart disease; HF-heart failure; RHD-rheumatic heart disease Age-standardized Mortality for the Five Leading Causes of Vascular Death Number of Patients with cardiovascular diseases in Adult Population Aged 35-74 Years in

15、 China, 2000-2001 * * * * * 30% causes of death by CVD World-wide CVD mortality rate /100,000 ： China 12th，400/100,000; USA 15th，360/100,000; Number of Patients with Diabetics and Hypertension Discharged from Hospitals, 1980-2006 Diabetics Hypertension China Health Statistics Yearbook (1980-2007). M

16、inistry of Health, P.R.China Number of Patients with Five Major Heart Diseases Discharged from Hospitals, 1980- 2006 Number of Patients with CVD and CBVD Discharged from Hospitals, 1980-2006 Hemorrhagic Ischemic Hemorrhagic Ischemic 1991-1999 Trends in CHD Incidence and Mortality, in Comparison to T

17、otal Mortality: China MUCA Study 0 10 20 30 40 50 60 70 80 90 100 1991 1993 1995 1997 1999 Male Femal e All deathCHD death 0 100 200 300 400 500 600 700 800 900 1000 1991 1993 1995 1997 1999 Male Female 0 10 20 30 40 50 60 1991 1993 1995 1997 1999 Male Female CHD incidence Burden and Challenges: Maj

18、or Public Health Issues in Adults, China 26 m.DM 200 m. Dyslipidemia 200 m. Hypertension 260 m. Overweight/OB 300 m.Smoking 2002 National Nutrition and Health Survey 2002 InterAsia Study 2000-2001 77 m.MS 3 m.MI (0.6 %) 7 m.Stroke (1.4 %) 4 m.Heart Failure 3.2 m. die of CVD per year Projected Global

19、 Burden of Hypertension in 2025 The number of adults with hypertension in 2025 was predicted to increase by about 60% to a total of 1.56 billion (1.54-1.58 billion). Most of this rise can be attributed to an expected increase in economically developing countries (1.15 billion or 80%) Kearney PM, Whe

20、lton M, Reynolds K, Muntner P, Whelton PK, He J. Lancet 2005;365:217-223 Annual CHD deaths in Chinese men 35-64 and 65-84 years old forecasted from 2000-2029 Moran A, Zhao D, Gu D, et al. BMC Public Health. 2008;8(1):394 Conclusions Secular Trends of CVD in China Conclusions dyslipidemia Prevention,

21、 detection, and treatment of hypertension, dyslipidemia, diabetes, smoking, and overweight may greatly reduce the future burden of CVD in China. Thank you US#%oa+n1k6xEj7el5q8TOO!LbKE5KC*NMX)h-xkz&j&aQHTA#CQQq-cCm4!Jtk)MJzkZjq4!vNXLA)l9!YWqGW$L5CI%uMRVLjnvAO$pwX-80AiUmr5DvV%ZFc0ndWGVFoHGFd*HY%(#gc(B

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