医院心血管流病状况.ppt

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1、2006 中国慢性病报告Gu DF,NEJM 2006;353:1124-1134 30岁岁组出现明显增高，占总组出现明显增高，占总DALY值的值的 28.94%70岁岁和和80岁岁年龄组最高年龄组最高,占总占总DALY值的值的 49.33%中国公共卫生中国公共卫生 2008;24(1):1449-50504030201000 5 15 30 45 60 70 80年龄（岁）Daly（人年/千人）男性女性http:/ 1997;349:134719902020疾病组分类疾病组分类DALY(%)疾病组分类疾病组分类DALY(%)神经精神失调神经精神失调无意识的损害无意识的损害心血管疾病心血管疾病

2、呼吸道疾病呼吸道疾病恶性肿瘤恶性肿瘤14.212.911.010.78.7恶性肿瘤恶性肿瘤心血管疾病心血管疾病呼吸道疾病呼吸道疾病无意识的损害无意识的损害18.716.316.315.613.6Murray&Lopez.Lancet 1997;349:134719902020Disease groupDALY(%)Disease GroupDALY(%)Neuropsychiatric disordersUnintentional injuriesCardiovascular diseasesRespiratory diseasesMalignant neoplasms14.212.911.0

3、10.78.7Malignant neoplasmsCardiovascular diseasesRespiratory diseasesNeuropsychiatric disordersUnintentional injuries18.716.316.315.613.6心血管病直接医疗费用支出急剧增加心血管病直接医疗费用支出急剧增加1993年：年：187.44亿亿2003年：年：1301.17亿（亿（6.94倍）倍）Chinese CVD statistics 2005我国心血管死亡与危险因素的形势严峻我国心血管死亡与危险因素的形势严峻Risk factorPARSmoking36%Dia

4、betes12%Hypertension23%Abdominal obesity34%Psychosocial29%Veg/fruit daily13%Exercise26%Alcohol intake14%ApoB/ApoA-1ratio(5vs1)54%All above combined90%Yusuf et al,on behalf of the INTERHEART Study Investigators Lancet,2004;364 Pages 937-9521684211-56-1011-1516-2021-2526-3031-4041NeverOdds ratio(99%CI

5、)Numbers smoked per dayNumber of controlsNumber of casesOdds ratio748972710314461058962301685642234691021162318322545384592181-382-102-993-835-805-266-349-161210120612081207121012091207120812084354966100-437207908931063119613660-530-600-660-720-850-931-041-28120917570-78Number of controlsNumber of c

6、asesMedianOdds ratio(99%CI)0-75234567891101248ApoB/A1 ratio(deciles)Risk factorPAR抽烟 36%糖尿病 12%高血压 23%下腹肥胖症 34%精神性疾病 29%每日的蔬菜/水果13%运动减少26%酒精摄入14%ApoB/ApoA-1ratio(5vs1)54%所有上述综合累加 90%Yusuf et al,on behalf of the INTERHEART Study Investigators Lancet,2004;364 Pages 937-9521684211-56-1011-1516-2021-252

7、6-3031-4041NeverOdds ratio(99%CI)Numbers smoked per dayNumber of controlsNumber of casesOdds ratio748972710314461058962301685642234691021162318322545384592181-382-102-993-835-805-266-349-161210120612081207121012091207120812084354966100-437207908931063119613660-530-600-660-720-850-931-041-28120917570

8、-78Number of controlsNumber of casesMedianOdds ratio(99%CI)0-75234567891101248ApoB/A1 ratio(deciles)高血压高血压 35%抽烟抽烟32%高胆固醇血症高胆固醇血症11%糖尿病糖尿病3%*调节年龄调节年龄、性别之后、性别之后OtherHypertension 35%Smoking32%Hypercholesterolemia11%Diabetes3%*Adjusted for age,sexOtherRisk factor%#estimated nation-wide(million)抽烟抽烟 25.

9、8310超重超重23.2270高血压高血压18.8160Dyslipidemia18.6160糖尿病糖尿病2.623Risk factor%#estimated nation-wide(million)Smoking 25.8310Overweight/Obesity23.2270Hypertension18.8160Dyslipidemia18.6160Diabetes2.623Prevalence(%)Increase(%)1958-1959 5.1 -1979-1980 7.7 411991 13.6 542002 18.8 31(%)Wang Longde.Report of Nati

10、onal Survey of Nutrition and Health Status 2002 第四次全国膳食和营养调查第四次全国膳食和营养调查我国高血压现状：三高三低2004年中国居民营养与健康状况调查报告 三高三高三低三低05101520253035知晓率治疗率控制率百分比（）百分比（）30.224.7 6.1 患病率高（超过1.6亿）增长趋势高危害性高治疗率低知晓率低控制率低数据来自数据来自WHO网站网站（n=451）（n=210）（n=399）%不同疾病患者治疗后达标率不同疾病患者治疗后达标率陶寿淇.中华心血管病杂志.2001;29:15-17依据2007中国成人血脂异常防治指南标准进

11、行分组第二次中国临床血脂控制达标率及影响因素多中心协作研究。中华心血管病杂志。2007;35(5):420-427.LDL达标率中国抽烟流行情况中国抽烟流行情况男男女女抽烟人数抽烟人数%1984258,42261.0261,178 4.21996 65,00063.0 57,000 3.8a: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

12、 Science and Technology Press,1997.C:Wang L,ed.Series report#1,Chinese Nutrition and Health Status Report,p49,2005抽烟人数抽烟人数200273,19353.9 87,360 3.1Prevalence of Smoking in ChinaMenWomenNumber ofParticipants%1984258,42261.0261,178 4.21996 65,00063.0 57,000 3.8a:Weng X,et al:Data from 1984 National Sm

13、oking 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,p49,2005Number ofParticipants200273,19353.9 87,360 3.1抽烟抽烟 Overweight/ObesityDys

14、lipidemiaDiabetes危险因素危险因素35%35%32%32%67%67%中国烟草消耗量列中国烟草消耗量列全球之首全球之首1997年世界烟草消耗量统计Overweight:29.9BMI25 Obesity:BMI30Overweight:27.9BMI24 Obesity:BMI 28Wang Y,et al.Int J Obes(Lond).2007;31(1):177-88.Time Magazine 2002糖尿病危害日趋严重Source:IDF 2005Number of People with Diabetes(000)0100002000030000400005000

15、0600007000080000Australia中国中国IndonesiaJapanKoreaMalaysiaPhilippinesSingaporeTaiwanThailand印度印度20252003He Y et al,JACC 37;2006010304050Prevalence (%)206060-69 yrs70 yrs60-69 yrs70 yrsMenWomenTotal2,3341,391943ES.Ford et al.N Engl J Med 2007;356:2388-98ES.Ford et al.N Engl J Med 2007;356:2388-982007ES

16、C CVD 预防指南Part I.The total risk approachto prevention of cardiovascular diseasePart II.Recommendations for prevention ofcardiovascular disease强调多重危险因素的全面控制Kannel WB.Am J Hypertens.2000;13(1 Pt 2):3S-10S.中国中国35-6435-64岁人群岁人群2 2种种心血管病心血管病危险因素危险因素的组合构成的组合构成 28%17%16%10%8%6%5%5%4%2%中国中国35-6435-64岁人群岁人群3 3种种心血管病心血管病危险因素危险因素的组合构成的组合构成 23%21%11%10%10%9%6%5%4%2%Kannel WB.In:Genest J,et al,eds.Hypertension:Physiopathology and Treatment.New York,NY:McGraw Hill;1977:888-910.血脂异常血脂异常TC 5.4 mmol/L(210 mg/dL)