中国缺血性心脏病主要危险因素的系统综述

A systematic review of the main risk factors of ischemic heart disease in China

目的分析中国缺血性心脏病(IHD)5大危险因素的流行现状,为制定IHD防控政策措施和进行流行病学深入研究提供依据。方法通过在PubMed、Web of Science、中国知网文献数据库检索2019年1月1日至2023年8月30日发表的有关中国成年人高血压、糖尿病、血脂异常、吸烟、超重及肥胖流行情况的文献,筛选并纳入覆盖全国或多个省份的大样本横断面调查、人群队列或社区筛查相关研究,从中提取文献的标题、作者和出版年份、研究设计及危险因素流行率等信息,并使用软件R 4.1.2对老年人群各危险因素流行情况进行Meta分析。结果本研究共纳入文献26篇,结果显示,2010年以来中国成年人高血压总体患病率呈上升趋势,超半数(50.90%)成年人血压处于正常高值状态(收缩压120~139 mmHg,舒张压80~89 mmHg)。中国糖尿病及糖尿病前期患病人数多达4亿人以上,其中老年人糖尿病患病人数(3550万)居全球首位。中国成年人的血清低密度脂蛋白胆固醇由2010年的2.78 mmol/L上升到2015年的2.87 mmol/L、血脂异常患病率由2012—2015的34.70%增加到2018年的35.60%。中国总人群的吸烟率由2013年的27.50%下降到2018年的25.10%,但男性吸烟率仍居高不下,维持在50.00%左右。近一半(48.90%)的中国成年人超重或肥胖,男性超重与肥胖高峰年龄(超重50~54岁,肥胖35~39岁)小于女性(超重65~69岁,肥胖70~74岁)。Meta分析发现,我国老年人群IHD危险因素流行情况更为严峻,其中高血压是我国老年人群最主要的危险因素(Meta分析高血压患病率为60.58%,95%CI:54.91%~66.25%)。结论2010年以来,我国居民高血压、糖尿病、血脂异常及超重或肥胖的患病率仍呈上升趋势,虽然整体吸烟率有所下降,但男性吸烟率仍很高,应采取积极的预防措施减少主要危险因素以降低IHD疾病负担。

Objective To analyze the prevalence of five risk factors of ischemic heart disease(IHD)in China,so as to provide basis for formulating prevention and control policies and measures of IHD and further epidemiological study.Methods We searched literature published from January 1,2019 to August 30,2023 on the prevalence of hypertension,diabetes,dyslipidemia,smoking,obesity and overweight among adults in China in PubMed,Web of Science and China National Knowledge Infrastructure,and selected and included large-scale cross-sectional surveys,population cohort or community screening studies covering the whole country or multiple provinces,from which.information such as title,author,publication year,research design and prevalence rate of risk factors were extracted.And we used the software R 4.1.2 to analyze the prevalence of various risk factors in the elderly population by meta-analysis.Results A total of 26 articles were included in this study.The results showed that the overall prevalence of hypertension showed an increasing trend,and more than half of Chinese adults(50.90%)had a high normal blood pressure(systolic blood pressure was between 120 and 139 mmHg,and diastolic blood pressure was between 80 and 89 mmHg).There are more than 400 million people with diabetes and prediabetes in China,among which the number of elderly people with diabetes(35.5 million)ranks first in the world.The serum low-density lipoprotein cholesterol of adults in China increased from 2.78 mmol/L in 2010 to 2.87 mmol/L in 2015,and the prevalence of dyslipidemia increased from 34.70%in 2012–2015 to 35.60%in 2018.The smoking rate of the general population in China decreased from 27.50%in 2013 to 25.10%in 2018,but the smoking rate in men remains high,at around 50.00%.Nearly half of adults(48.90%)in China are overweight or obese,and the peak age of overweight and obesity in men(50–54 years old,35–39 years old)is younger than that in women(65–69 years old,70–74 years old).Meta-analysis shows that the prevalence of risk factors of IHD in the Chinese elderly population is more severe,and hypertension is the most prevalent risk factor(the prevalence rate of hypertension in meta-analysis is 60.58%,95%CI:54.91%–66.25%).Conclusion Since 2010,the prevalence of hypertension,diabetes,dyslipidemia and overweight or obesity among Chinese residents is still on the rise.Although the overall smoking rate has decreased,the proportion of male smokers is still high.Active preventive measures should be taken to reduce major risk factors to reduce the burden of IHD.