我国东中西部地区及城乡社区人群心血管疾病发病率及病死率分析

Incidence and case fatality rates of cardiovascular diseases in urban and rural community-dwelling populations in eastern,central and western regions of China

目的探讨我国东中西部地区城乡社区人群心血管疾病发病率及病死率情况。方法本研究基于前瞻性城乡流行病学研究(PURE)中国队列数据,选取其中基线年龄、性别资料齐全且至少完成1次随访的参与者,收集一般人口学、心血管危险因素、心血管疾病防治情况等信息。采用PURE全球研究统一的标准化病例报告表进行随访采集心血管疾病及死亡事件,以评估我国东中西部地区及城乡社区心血管疾病发病率及病死率。结果共纳入东中西部12个省份115个城乡社区的47262名参与者,年龄(51.1±9.6)岁,女性27529例(58.2%)。在11.9(9.5,12.6)年的随访期中,共记录了2686例死亡事件及5873例心血管事件,心血管疾病发病率为[11.90(95%CI:11.60~12.21)/1000人年]。不同地区心血管疾病发病率及病死率呈现出明显差异(P趋势<0.001)。西部地区心血管疾病发病风险最高[13.99(95%CI:13.33~14.65)/1000人年],东部地区次之[11.92(95%CI:11.52~12.33)/1000人年],中部地区最低[8.87(95%CI:8.25~9.50)/1000人年];而心血管疾病1年病死率呈现出从东到西依次递增的趋势[东部:10.20%(95%CI:6.95~14.73);中部:13.50%(95%CI:9.90~18.14);西部:18.62%(95%CI:14.95~22.94);P趋势<0.001]。农村地区主要心血管疾病发病率在东中西部地区均高于城市地区(东部P<0.001,中部P=0.01,西部P<0.001),1年病死率在东部(P<0.001)及西部(P=0.02)均高于城市地区。结论我国中老年人群心血管疾病发病率和病死率高,其中社会经济水平较低的西部地区以及农村地区尤为明显。

Objective To evaluate the incidence and case fatality rate of cardiovascular disease(CVD)among populations in urban and rural communities in eastern,central and western regions of China.Methods The present study was based on the data of the Prospective Urban and Rural Epidemiology(PURE)-China cohort,which enrolled participants who had at least one follow-up visit and complete information on age and sex.Information on baseline demographics,cardiovascular risk factors,and prevention and treatment for CVD were collected.CVD and mortality events were documented using the standardized case report form of the PURE Global Study to assess the incidence and case fatality rate of CVD among populations in urban and rural communities in eastern,central and western China.Results This study included a total of 47262 community-dwelling participants(age:(51.1±9.6)years;female,n=27529,58.2%)from 115 urban and rural communities in 12 provinces across the eastern,central,and western regions of China.Over a follow-up period of 11.9(9.5,12.6)years,2686 deaths and 5873 cardiovascular events were documented.The incidence of CVD was 11.90(95%CI:11.60-12.21)/1000 person-years.A significant difference in CVD incidence was observed across regions(Ptrend<0.001),which was highest in the western provinces(13.99(95%CI:13.33-14.65)/1000 person-years),intermediate in the eastern provinces(11.92(95%CI:11.52-12.33)/1000 person-years),and lowest in the central provinces(8.87(95%CI:8.25-9.50)/1000 person-years).The 1-year case fatality rate of CVD demonstrated an increasing trend from eastern to western regions(eastern:10.20%(95%CI:6.95-14.73);central:13.50%(95%CI:9.90-18.14);western:18.62%(95%CI:14.95-22.94);Ptrend<0.001).Moreover,the incidence of major CVD was consistently higher in rural areas compared with urban areas across eastern(P<0.001),central(P=0.01)and western(P<0.001)_regions,respectively.The 1-year case fatality rate in rural areas was also significantly higher compared with that in urban areas in both eastern(P<0.001)and western regions(P=0.02).Conclusions The incidence and case fatality rate of CVD were high among middle-aged population in China,especially those in western regions with low socioeconomic levels and in rural areas.