我国心血管疾病流行和负担.pptx

Click to edit Master title style,Click to edit Master text styles,Second level,Third level,Fourth level,Fifth level,#,Click to edit Master title style,Click to edit Master text styles,Second level,Third level,Fourth level,Fifth level,#,单击此处编辑母版标题样式,单击此处编辑母版文本样式,第二级,第三级,第四级,第五级,#,我国心血管疾病流行和负担,我国心血管疾病流行和负担,第1页,背 景,我国当前面临低出生率、低死亡率和较高期望寿命（,73,岁）,和人口老龄化，在,年底，,8.0%,人口年纪,65,岁,达,1,亿。,主要心脑肺血管疾病患病率和危险原因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。,我国当前正处于人口、社会和经济高速发展改变阶段，这将深入加重心血管病负担。,我国心血管疾病流行和负担,第2页,中国高血压患病率全国性调查,1959-,我国心血管疾病流行和负担,第3页,中国高血压知晓率、治疗和控制率,1991,National BP Survey Cooperative Group Chinese J Hypertension Gu D Hypertension,1995,3(suppl):9-13 40:920-927,(%)-,30,24,6,(%)1991 VS,Age 15-74 Age 35-74,我国心血管疾病流行和负担,第4页,Men,Women,在过去,20,年，年纪调整高胆固醇血症患病率改变趋势,*,=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,29(2):74-79.,男 性,女 性,我国心血管疾病流行和负担,第5页,中国,35-74,岁成年人中血清胆固醇公布百分比,-,240,He J,Gu D.Circulation,;110:405-11,我国心血管疾病流行和负担,第6页,Hazard ratio,Mean usual total cholesterol(mmol/l),血清胆固醇,和心血管病关系,4.5,5.0,5.5,6.0,6.5,+1 mmol/L:1.32(1.20-1.46),0.7,1.0,1.4,2.0,TC,和,CHD,4.5,5.0,5.5,6.0,6.5,+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),4.5,5.0,5.5,6.0,6.5,0.50,1.00,2.00,4.00,TC,和缺血性中风,TC,上升,+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,我国心血管疾病流行和负担,第7页,中国,18,成年人,年纪调整超重肥胖患病率,全国营养和健康调查,我国心血管疾病流行和负担,第8页,中国成年人吸烟率,男,女,Number of,Participants,%,%,1984,258,422,61.0,261,178,4.2,1996,65,000,63.0,57,000,3.8,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 Technology Press,1997.,C:Wang L,ed.Series report#1,Chinese Nutrition and Health Status Report,p49,Number of,Participants,73,193,53.9,87,360,3.1,我国心血管疾病流行和负担,第9页,中美人群,CVD,危险原因年纪标化患病率,*,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,29(2):74-79.,我国心血管疾病流行和负担,第32页,Percentage Distribution of Serum Total Cholesterol in Adult Population Aged 35-74 Years in China,-,240,He J,Gu D.Circulation,;110:405-11,我国心血管疾病流行和负担,第33页,TC and fatal CHD,fatal and non fatal ischemic and haemorrhagic stroke in Asia,Hazard ratio,Mean usual total cholesterol(mmol/l),4.5,5.0,5.5,6.0,6.5,+1 mmol/L:1.32(1.20-1.46),0.7,1.0,1.4,2.0,TC and CHD,4.5,5.0,5.5,6.0,6.5,+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),4.5,5.0,5.5,6.0,6.5,0.50,1.00,2.00,4.00,TC and ischemic stroke,TC incresing+1 mmol/L,CHD risk 32,ischemic stroke risk 23,haemorrhagic stroke 19,Circulation.;110:2678-86,Ann Epidemiol;15:504-13,我国心血管疾病流行和负担,第34页,Age-standardized Prevalence of Overweight/Obesity among Adults,Aged,18,China,National Nutrition and Health Survey,我国心血管疾病流行和负担,第35页,Prevalence of Smoking in China,Men,Women,Number of,Participants,%,%,1984,258,422,61.0,261,178,4.2,1996,65,000,63.0,57,000,3.8,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 Technology Press,1997.,C:Wang L,ed.Series report#1,Chinese Nutrition and Health Status Report,p49,Number of,Participants,73,193,53.9,87,360,3.1,我国心血管疾病流行和负担,第36页,Age-Standardized Prevalence of Major,CVD,Risk Factors in China and the United States,*,p,0.001,Standardized on the basis of the year age distribution of the Chinese population.,我国心血管疾病流行和负担,第37页,CVD Incidence and Mortality and,Their Trends in China,我国心血管疾病流行和负担,第38页,Proportionate Mortality for the Ten Leading Causes of Death in China,1957-,He J 11:1124-1134,1957,Heart disease,stroke,我国心血管疾病流行和负担,第39页,Age-standardized Mortality for the Five Leading Causes of Death in Adults,He J 11:1124-1134,Women,Men,我国心血管疾病流行和负担,第40页,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,我国心血管疾病流行和负担,第41页,Number of Patients with cardiovascular diseases in Adult Population Aged 35-74 Years in China,-,我国心血管疾病流行和负担,第42页,*,*,*,*,*,30%causes of death by CVD World-wide,CVD mortality rate/100,000,：,China 12th,，,400/100,000;,USA 15th,，,360/100,000;,我国心血管疾病流行和负担,第43页,Number of Patients with Diabetics and Hypertension Discharged from Hospitals,1980-,Diabetics,Hypertension,China Health Statistics Yearbook(1980-).Ministry of Health,P.R.China,我国心血管疾病流行和负担,第44页,Number of Patients with Five Major Heart Diseases Discharged from Hospitals,1980-,我国心血管疾病流行和负担,第45页,Number of Patients with CVD and CBVD Discharged from Hospitals,1980-,Hemorrhagic,Ischemic,我国心血管疾病流行和负担,第46页,Hemorrhagic,Ischemic,我国心血管疾病流行和负担,第47页,1991-1999 Trends in CHD Incidence and Mortality,in Comparison to Total Mortality:,China MUCA Study,All death,CHD death,CHD incidence,我国心血管疾病流行和负担,第48页,Burden and Challenges:,Major,Public Health Issues,in,Adults,China,26 m.DM,200 m.Dyslipidemia,200 m.Hypertension,260 m.Overweight/OB,300 m.Smoking,National Nutrition and Health Survey,InterAsia Study-,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,我国心血管疾病流行和负担,第49页,Projected Global 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,Whelton M,Reynolds K,Muntner P,Whelton PK,He J.Lancet;365:217-223,我国心血管疾病流行和负担,第50页,Annual CHD deaths in Chinese men 35-64 and 65-84 years old forecasted from-2029,Moran A,Zhao D,Gu D,et al.BMC Public Health.;8(1):394,我国心血管疾病流行和负担,第51页,Conclusions,Secular Trends of CVD in China,Increasing trends of CVD risk factors in past 20 years were observed.,These trends predicted that the incidence of stroke and CHD events will increase markedly in the 21st century,mainly due to aging.,我国心血管疾病流行和负担,第52页,Conclusions,Awareness,treatment,and control rates among patients with hypertension and,dyslipidemia,were unacceptably low.,Prevention,detection,and treatment of hypertension,dyslipidemia,diabetes,smoking,and overweight may greatly reduce the future burden of CVD in China.,我国心血管疾病流行和负担,第53页,