我国居民2002至2016年心血管病死亡率及其变化趋势

Level and trend of cardiovascular disease mortality in China from 2002 to 2016

目的分析我国居民2002至2016年心血管病死亡率及其变化趋势。方法使用中国卫生统计年鉴(2003至2012年)和中国卫生和计划生育统计年鉴(2013至2017年)数据,计算我国居民2002至2016年心血管病年龄标化死亡率(ASMR),并使用Joinpoint回归模型估算心血管病ASMR的年度变化百分比(APC)和平均年度变化百分比(AAPC)。结果(1)2002至2016年,我国心血管病ASMR分别为225.65/10万、242.74/10万、214.63/10万、240.97/10万、195.24/10万、201.50/10万、208.83/10万、248.44/10万、261.38/10万、231.98/10万、210.25/10万、237.80/10万、235.21/10万、237.58/10万和237.25/10万,心血管病ASMR差异无统计学意义(AAPC=0.2%,P>0.05);慢性风湿性心脏病ASMR显著下降(AAPC=-4.5%,P<0.05),脑血管病、高血压性心脏病和缺血性心脏病ASMR差异均无统计学意义(分别为AAPC=0,P>0.05;AAPC=2.0%,P>0.05;AAPC=4.3%,P>0.05)。(2)2002至2016年,城市和农村心血管病ASMR差异均无统计学意义(分别为AAPC=-0.7%,P>0.05;AAPC=0.8%,P>0.05);城市和农村慢性风湿性心脏病ASMR显著下降(分别为AAPC=-4.4%,P<0.05;AAPC=-4.6%,P<0.05)。(3)2002至2016年,男性和女性心血管病ASMR差异均无统计学意义(分别为AAPC=-0.3%,P>0.05;AAPC=-0.2%,P>0.05);女性慢性风湿性心脏病ASMR下降(AAPC=-4.2%,P<0.05);男性和女性缺血性心脏病ASMR升高(分别为AAPC=4.7%,P<0.05;AAPC=5.2%,P<0.05)。(4)2002至2016年,15~34岁居民心血管病ASMR呈上升趋势(AAPC=3.1,P<0.05);35~64岁和≥65岁居民心血管病ASMR差异均无统计学意义(分别为AAPC=-0.1%,P>0.05;AAPC=-0.2%,P>0.05)。结论2002至2016年我国心血管病ASMR总体保持稳定,青年人群心血管病ASMR呈上升趋势。

Objective To investigate the level and trend of cardiovascular disease mortality in China from 2002 to 2016.Methods Using data of China Health Statistics Yearbook (2003-2012) and China′s Health and Family Planning Statistical Yearbook (2013-2017),we calculated the age-standardized mortality rates (ASMR) in China.Joinpoint regression model was employed to estimate the annual percent change (APC) and average annual percent change (AAPC) of cardiovascular disease ASMR.Results (1)The ASMR of cardiovascular disease were 225.65/100 thousands,242.74/100 thousands,214.63/100 thousands,240.97/100 thousands,195.24/100 thousands,201.50/100 thousands,208.83/100 thousands,248.44/100 thousands,261.38/100 thousands,231.98/100 thousands,210.25/100 thousands,237.80/100 thousands,235.21/100 thousands,237.58/100 thousands,and 237.25/100 thousands from 2002 to 2016,and there was no significant difference in ASMR of cardiovascular disease (AAPC=0.2%,P>0.05).The ASMR of chronic rheumatic heart disease decreased significantly (AAPC=-4.5%,P<0.05).There were no significant differences in ASMR of cerebrovascular disease,hypertensive heart disease,and ischemic heart disease (AAPC=0,P>0.05;AAPC=2.0%,P>0.05;AAPC=4.3%,P>0.05,respectively).(2) There were no significant differences in ASMR of cardiovascular disease from 2002 to 2016 in city and country (AAPC=-0.7%,P>0.05;AAPC=0.8%,P>0.05,respectively).The ASMR of chronic rheumatic heart disease decreased significantly in city and rural area (AAPC=-4.4%,P<0.05;AAPC=-4.6%,P<0.05,respectively).(3) There were no significant differences in ASMR of cardiovascular disease from 2002 to 2016 in male and female (AAPC=-0.3%,P>0.05;AAPC=-0.2%,P>0.05,respectively).The ASMR of chronic rheumatic heart disease decreased significantly in female (AAPC=-4.2%,P<0.05).The ASMR of ischemic heart disease increased significantly in male and female (AAPC=4.7%,P<0.05;AAPC=5.2%,P<0.05,respectively).(4) The ASMR of cardiovascular disease showed a significant upward trend in residents aged 15 to 34 from 2002 to 2016 (AAPC=3.1,P<0.05).There were no significant differences in ASMR of cardiovascular disease in residents aged 35 to 64 and ≥65 (AAPC=-0.1%,P>0.05;AAPC=-0.2%,P>0.05,respectively).Conclusion The ASMR of cardiovascular disease in China remains stable during 2002 to 2016,and the ASMR of cardiovascular disease shows upward trend among young people.