《中国心血管病报告2018》概要

  目的  了解湖北省居民1990 — 2017年心血管病（CVD）疾病负担变化情况，为该地区居民CVD的精准防控提供科学依据。  方法  收集2017年全球疾病负担（GBD 2017）中湖北省居民死亡数、标化死亡率、过早死亡损失寿命年（YLLs）、标化YLLs率、伤残损失寿命年（YLDs）、标化YLDs率、伤残调整寿命年（DALYs）和标化DALYs率等指标来分析湖北省居民1990 — 2017年CVD疾病负担变化情况。  结果  湖北省居民1990 — 2017年CVD的死亡数、YLLs、YLDs、标化YLDs率和DALYs分别增长了77.53 %、40.79 %、122.17 %、16.82 % 和46.69 %，但标化死亡率、标化YLLs率和标化DALYs率则分别降低了23.70 %、32.84 % 和29.62 %；男性居民2017年CVD的DALYs和1990 — 2017年增长率分别为225.28万人年和57.65 %，均高于女性的171.17万人年和34.38 %；1990年和2017年湖北省15～49岁、50～69岁和 ≥ 70岁居民CVD的标化DALYs率分别为1535.02/10万和1285.31/10万、16300.29/10万和10864.47/10万、57409.87/10万和45105.46/10万，均随年龄增高而升高；湖北省居民1990年和2017年CVD死亡标化率居于前5位的均为脑出血、缺血性心脏病、高血压心脏病、缺血性脑卒中和蛛网膜下腔出血，但顺位不同，2017年脑出血和高血压心脏病分别由1990年的第1位和第3位降至第2位和第4位，缺血性心脏病和缺血性脑卒中分别由1990年的第2位和第4位升至第1位和第3位；湖北省居民1990年和2017年CVD标化DALYs率居于前5位的均为缺血性心脏病、脑出血、缺血性脑卒中、高血压心脏病和蛛网膜下腔出血，顺位略有不同，脑出血由1990年的第1位降至第2位，缺血性心脏病由1990年的第2位升至第1位。  结论  湖北省居民CVD疾病负担持续增长，应重点加强男性及老年人群的CVD防控工作。

Prevalence,incidence, and mortality of stroke in China: results from a nationwide population-based survey of 480 687 adults

  Objective  To examine changes in disease burden of cardiovascular diseases (CVD) among residents in Hubei province between 1990 and 2017 and to provide evidences for the precise prevention and control of CVD in the province.   Methods   The mortality, adjusted mortality rate, years of life loss with premature death (YLLs), adjusted YLLs rate, years lived with disability (YLDs), adjusted YLDs rate, disability adjusted of life years (DALYs) and adjusted DALYs rate were adopted in the study. The estimates of the indicators for CVD among the residents of Hubei province in 2017 were based on the data from Global Burden of Diseases Study 2017 (GBD 2017) and those in 1990 were based on the reports issued in National Yearbook of Health and Family Planning, national information systems of disease surveillance, death registry, and women and children health care and published research literatures.   Results   Compared to those indicators for disease burden of CVD in 1990, we observed increases in total mortality (by 77.53%), YLLs (40.79%), YLDs (122.17%), adjusted YLDs rate (16.82%), and DALYs (46.69%) but decreases in adjusted mortality rate (23.70%), adjusted YLLs rate (32.84%), and adjusted DALYs (29.62%) among the residents in the province in 2017. The increase in DALY and DALY increasing rate in 2017 among the male residents were 225.28/10 000 person-years and 57.65% and were higher than those among the female residents (171.17/10 000 person-years, 34.38%). The adjusted DALYs rate of CVD (1/100 000) increased with the increment of age, with the values of 1535.02, 16300.29, and 57409.87 in 1990 and 1285.31, 10864.47, and 45105.46 in 2017 for the residents aged 15 – 69, 50 – 69, and ≥ 70 years, respectively. In the terms of adjusted mortality rate, the top five CVDs were cerebral hemorrhage, ischemic heart disease, hypertensive heart disease, ischemic stroke and subarachnoid hemorrhage in 1990 and 2017; while, the rank of the five diseases varied between 1990 and 2017, with the decreased rank from top one to top two for cerebral hemorrhage and from top three to top four for hypertensive heart disease and the increased rank from top two to top one for ischemic heart disease and from top four to top three for ischemic stroke, respectively. In terms of adjusted DALYs rate, the top file CVDs were ischemic heart disease, cerebral hemorrhage, ischemic stroke, hypertension heart disease and subarachnoid hemorrhage in 1990 and 2017; the rank of the five diseases changed slightly between 1990 and 2017, with cerebral hemorrhage descending from top one in 1990 to top two in 2017 and ischemic heart disease ascending from top two to top one.   Conclusion  Disease burden of cardiovascular diseases increased among residents in Hubei province between 1990 and 2017; the male and aged people are key populations for control and prevention of cardiovascular diseases.