中国居民高血压造成冠心病和脑卒中的经济负担研究

目的评价中国居民高血压造成冠心病和脯卒中的直接经济负担，分析高血压知晓率和治疗率的相关关系，为制订人群高血压防治策略提供科学依据，确定知晓率作为社区高血压防治效果的评价指标。方法利用2002年中国居民营养与健康状况调查、2003年第二次国家卫生服务调查等相关资料，分别计算高血压、冠心病和脑卒中的直接疾病负担；根据人群归因危险度百分比计算高血压造成的冠心病和脑卒中的直接经济负担。利用2002年调查数据分析高血压知晓率和治疗率的关系。结果2003年中国35～74岁人群高血压、冠心病和脑卒中的直接经济负担分别为201．5、157．1和242．9亿元人民币，其中由高血压导致的冠心病和脑卒中的直接经济负扭达190．8亿元人民币，占这两种疾病直接疾病负担的47.7％。高血压知晓率与治疗率呈高度相天（r=0．9777，P〈0．0001），知晓率是影响治疗率的关键。结论中国居民高血压所造成冠心病和脑卒中的直接经济负担，已占该两种疾病直接疾病负担的近50％。以知晓率作为社区高血压防治效果的评价指标具有实用价值。

Economic burden of coronary heart disease and stroke attributable to hypertension in China

Objective 1) To estimate annual direct medical costs of coronary heart disease (CHD) and stroke attributable to hypertension among Chinese adults aged 35-74 years in China, 2) to analyze the correlation between the hypertension awareness and hypertension treatment rate. Methods 2003 National Health Services Survey (n = 93 018) was used to derive direct medical costs including costs for outpatient visits, physician services, inpatient stays, rehabilitation services, nurses fees, and medications. The medical costs of CHD and stroke attributable to hypertension were estimated by multiplying population attributable risk proportion by corresponding disease costs. Using 2002 National Nutrition and Health Survey (n= 148 804), the prevalence of hypertension awareness and hypertension treatment rate in 132 survey sites were calculated. Correlation was used to analyze the correlation between the two variables. Results The direct medical costs of hypertension, CHD and stroke were 20.2, 15.7 and 24. 3 billion Yuan, respectively. The medical costs attributable to hypertension were estimated at 19.1 billion Yuan (RMB), accounting for 47.7% of the total medical costs of the two chronic diseases. The prevalence of hypertension awareness is highly correlated with hypertension treatment rate (r=0. 9777, P<0. 0001) . Conclusion The economic burden of CHD and stroke attributable to hypertension is very high, reaching about 50% of the total medical costs of the two diseases. The prevalence of hypertension awareness could be used as an important indicator to evaluate the effectiveness of hypertension prevention and control at community level.