江苏省监测人群1983~1987年动脉粥样硬化性心血管病发病动态的城乡对比分析

1983~1987年参照WHO Monica方案对江苏省42万城乡自然人群进行冠心病急性事件(Coronary event)、脑卒中发病及其防治效果的连续五年同步监测,结果发现南京市区监测人群冠心病急性事件平均年标化发生率为18.6/10万,脑卒中为103.1/10万,均较海门农村为高。在人口死因构成中市区冠心病及脑卒中仅次于恶性肿瘤而居第二位,农村则仅占第四位。市区人群通过1985年以来的高血压防治,冠心病及脑卒中的年死亡率已有下降,而尚未广泛开展防治的农村人群则其年发病率、死亡率及脑卒中的急性期病死率并无明显改变。     

2010 - 2018年潍坊市急性冠心病死亡率及变化趋势分析

目的 分析潍坊市2010 - 2018年急性冠心病死亡特点及变化趋势,为制定综合防治策略提供科学依据。方法 收集2010 - 2018年急性冠心病死亡数据,分别计算粗死亡率、2000年中国人口标化死亡率来描述死亡现状,使用 Joinpoint回归计算年度变化百分比（annual percent change, APC）和年度变化贡献率以描述年度时间趋势。结果 2010 - 2018年潍坊市急性冠心病死亡率和标化死亡率为124.39/10万和65.55/10万,其中男性分别为127.48/10万和70.84/10万,女性分别为121.24/10万和 60.74/10万,男性死亡率高于女性（χ2 = 40.70,P＜0.001）。死亡率随年龄增长而增加,85岁及以上年龄组达峰值。急性心肌梗死死亡率和标化死亡率为118.28/10万和61.92/10万,冠心病猝死死亡率和标化死亡率为6.10/10万 和3.63/10万。急性冠心病总体粗死亡率逐年上升趋势明（APC = 3.04%, t = 4.88, P＜0.001）,而标化死亡率（APC = - 1.61%, t = - 1.04, P = 0.33）呈下降趋势,但差异无统计学意义。急性心肌梗死粗死亡率和标化死亡率变化趋势与急性冠心病总体变化趋势一致,而冠心病猝死粗死亡率（APC = - 6.95%, t = - 3.37, P = 0.01）和标化死亡率下降（APC = - 9.83%, t = - 4.79, P＜0.001）趋势明显。急性心肌梗死各年龄组死亡率除55～64岁组先上升后下降外无明显变化,冠心病猝死各年龄组死亡率逐年下降趋势明显。相比冠心病猝死,急性心肌梗对急性冠心病标化死亡率下降贡献大,约占85%左右。结论 潍坊市急性冠心病死亡下降不显著,仍处于较高水平。男性、老年人群为急性冠心病死亡重点关注人群。     

自然人群中主要心血管疾病的发病趋势分析

本文对辽宁省１９８５－１９８９年在心血管疾病监测人群中发生的急性心肌梗死，冠心病猝死，脑卒中进行了调查分析。调查质量和方法均按ＷＨＯ的统一方法进行。结果表明，五年中ＡＭＩ的平均发病率为１７．２／１０万，冠心病猝死和脑卒中分别为８．９／１０万和１６８．５／１０万。三种疾病的发病率均为男性高于女性，ＲＲ值分别为３．１３，２．９５和２．０２三种疾病的发病率均随年龄的增加而升高；观察期间冠心病猝死及脑卒中     

中关村地区1984-2000年脑卒中死亡率和病死率的流行病学研究

目的探讨脑卒中的死亡率和病死率在中关村地区居民中的变动趋势和流行因素。方法按照WHO-MONICA方案进行脑卒中的监测、统计、分析。结果(1)1984—2000年中关村监测区脑卒中平均死亡率为36.82/10万,其中男性平均死亡率为41.37/10万,女性平均死亡率为32.40/10万。(2)女性脑卒中、亚型脑卒中死亡率均呈下降趋势(P<0.05)。(3)中关村地区人群脑卒中年平均病死率为12.58%,其中男性年平均病死率为10.94%,女性年平均病死率为15.44%。(4)女性总脑卒中、缺血性脑卒中病死率呈下降趋势(P<0.05)。(5)冬季为脑卒中死亡构成比最高季节,72小时内死亡构成比为60.19%,中关村地区死亡病例的住院率为83.50%。结论死亡率受发病率影响,寒冷等气象因素与脑卒中死亡率有关,医疗救治是降低脑卒中病死率最有效的措施。     

40岁以上人群冠心病和脑卒中死亡的危险因素分析

目的　了解 1991- 1999年四川省 4 0岁及以上人群冠心病、脑卒中死亡率水平及其危险因素。方法　对 74 11例随访对象的流行病学调查资料 ,用SPSSV12软件进行数据清理及描述性分析 ,在SASV8 2软件中用非条件logistic回归进行冠心病、脑卒中死亡危险因素的筛选。 结果　1991- 1999年冠心病死亡 2 5人 ,脑卒中死亡 10 0人 ,冠心病累积死亡率 3 4‰ ,脑卒中累积死亡率13 5‰。冠心病按世界标准[1] 标化年死亡率男性为 13 4 / 10万 ,女性为 11 5 / 10万 ,脑卒中标化年死亡率男性为 6 1 0 / 10万 ,女性为 33 4 / 10万。冠心病死亡的危险因素有 :地区、年龄 (按 10岁分组 )、就业情况、高血压家族史和血压水平 (5级 ) ,脑卒中死亡的危险因素有年龄 (按 10岁分组 )、饮酒史、脑卒中既往史和血压水平 (5级 )。结论　四川省 4 0岁及其以上人群冠心病死亡率低于北京地区 ,脑卒中死亡率与国际相比属于较低水平。为减少冠心病、脑卒中死亡危险 ,应重点加强老年人群的血压监测 ,倡导健康生活方式。     

2013-2014年济南市居民脑卒中急性病例监测资料分析

目的了解2013-2014年济南市居民脑卒中急性发病及死亡情况,为制定脑卒中预防措施,在我市全面开展发病监测提供依据和经验。方法收集山东省济南市疾病监测系统报告的济南市居民脑卒中急性发病监测资料,对2013-2014年济南市7个项目区居民脑卒中急性发病和死亡情况进行描述性分析。结果 2013-2014年,济南市7个项目区居民脑卒中累计报告发病26 513例,累计报告死亡6 484例,年均发病率为296.59/10万,年均死亡率为72.53/10万。根据2000年中国标准人口计算,年均标化发病率和死亡率分别为183.29/10万、42.15/10万。2014年同2013年相比,全市监测人群脑卒中粗发病率上升了48.31/10万,标化发病率下降了7.02/10万,差异有统计学意义(P0.01);而年度粗死亡率上升了40.25/10万,标化死亡率上升了14.08/10万,差异有统计学意义(P0.01)。年均男性发病率、死亡率分别为329.58/10万、79.05/10万,均高于女性(发病率为264.24/10万,死亡率为66.14/10万,差异均有统计学意义(P0.01);60岁以上年龄组发病率、死亡率分别为1 343.65/10万、372.91/10万,均高于60岁以下年龄组(发病率为85.59/10万、死亡率为12.00/10万),差异均有统计学意义(P0.01)。发病病例分型为脑梗死者占70.61%,脑出血占17.88%,未分类脑卒中占9.61%,蛛网膜下腔出血占1.90%。结论 2013-2014年济南市居民脑卒中急性发病类型以脑梗死为主。脑卒中发病率随年龄增长上升趋势明显,男性发病率高于女性。     

2016年长沙市心脑血管事件监测结果分析

目的 了解心脑血管疾病的流行特征,为制定防控策略提供科学依据。 方法 从“重点慢性病监测信息系统”导出心脑血管事件数据并进行描述性统计分析。 结果 2016年长沙市心脑血管事件报告发病率为318.09/10万,标化发病率326.40/10万,其中脑卒中报告发病率237.99/10万,标化发病率244.12/10万,发病以脑梗死为主,冠心病报告发病率80.09/10万,标化发病率82.27/10万,发病以急性心肌梗死为主。心脑血管事件报告死亡率132.43/10万,标化死亡率136.21/10万,脑卒中报告死亡率为80.14/10万,标化死亡率为82.34/10万,死亡以脑出血为主,冠心病报告死亡率52.29/10万,标化死亡率53.78/10万,死亡以急性心肌梗死为主。心脑血管事件报告发病率与报告死亡率均随年龄的上升而增加(χ²_发病=64 537.26,P=0.000;χ²_死亡=32 646.53,P=0.000),且男性均高于女性(χ²_发病=194.66,P=0.000;χ²_死亡=178.54,P=0.000),发病与死亡主要发生在60岁及以上人群。心脑血管事件复发率为38.03%。 结论 2016年长沙市心脑血管事件报告发病率、复发率和报告死亡率呈“三高”趋势,报告发病率和报告死亡率随年龄的上升而逐渐增加,防控形势严峻,发病与死亡以脑卒中为主,60岁及以上人群是主要的防控对象。     

2013年济南市居民卒中和冠心病急性发病情况分析

目的了解2013年济南市居民卒中和冠心病急性发病情况。方法参照山东省疾病监测系统报告的济南市居民脑卒中、冠心病急性病例监测资料,分析2013年济南市居民脑卒中、冠心病急性发病情况。采用Excel软件建立数据库,SPSS 13.0统计软件进行描述性分析,P≤0.05为差异有统计学意义。结果 12013年济南市7个项目区居民卒中累计报告发病12 175例,监测区户籍人口发病率为272.4/10万;死亡2 342例,户籍人口死亡率为52.4/10万;根据2000年中国标准人口计算,标化发病率和死亡率分别为187.6/10万和34.5/10万。卒中男性发病率和死亡率均高于女性(χ2=138.20、P<0.01,χ2=15.31、P<0.01);50岁以上年龄组发病率和死亡率均较50岁以下年龄组增加(χ2=24 393.54、P<0.01;χ2=5 006.89、P<0.01)。2 2013年济南市居民累计报告冠心病急性发病4 531例,监测区户籍人口发病率为101.4/10万;累计死亡2 121例,户籍人口死亡率为47.5/10万;标化发病率和死亡率分别为68.3/10万和30.7/10万。冠心病急性发病发病率男性高于女性(χ2=8.87、P<0.01),死亡率男性、女性比较差异无统计学意义(χ2=2.34、P=0.128);50岁以上年龄组发病率和死亡率均高于50岁以下(χ2=9 192.48、P<0.01;χ2=4 558.84、P<0.01)。结论 2013年济南市居民脑卒中合计大于300/10万,冠心病急性病例粗发病率较高,发病率有随年龄增加而增长的趋势。     

2011-2020年山东省沂源县急性冠心病事件流行病学特征分析

目的 了解2011-2020年山东省淄博市沂源县居民急性冠心病事件发病和死亡情况流行病学特点,为制定防治对策措施、评价干预效果等提供科学依据。方法 收集山东省慢性病监测信息系统中2011-2020年沂源县居民急性冠心病事件发病资料,应用描述性流行病学方法分析其流行病学特征。方法 2011-2020年山东省沂源县急性冠心病事件报告发病人数6 141例,发病率为107.78/10万;死亡4 279例,粗死亡率75.10/10万。男性急性冠心病事件发病率为120.24/10万、死亡率为81.49/10万,女性发病率为94.96/10万、死亡率为68.53/10万,男性急性冠心病事件发病率高于女性(P<0.01)。不同年龄组人群急性冠心病事发病率差异有统计学意义(P<0.01),65岁及以上者占总发病人数的70.31%,其中75～84岁发病人数构成比最高,占总发病人数的30.57%。急性心肌梗死是急性冠心病事件监测报告的主要病种,分别占总发病人数的86.21%和总死亡人数的85.70%;冠心病猝死仅占13.79%、14.30%。结论 2011-2020年山东省淄博市沂源县急性冠心病...     

绍兴市2422起冠心病急性事件分析

目的：了解绍兴市2012年冠心病急性事件发生情况。方法从“浙江省慢性病监测信息管理系统”获取资料,分析冠心病急性事件发病与死亡情况。结果绍兴市2012年共报告冠心病急性事件2422例次,报告发病率为55.04/10万,其中男性为62.00/10万,女性为47.97/10万;80岁以上和70～79岁组报告发病率分别为907.36/10万和282.95/10万,40岁以上人群占总发病人数98.10％;急性心肌梗死占74.36％,心性猝死占5.90％,其他原因冠心病死亡占19.74％;死亡1730人,报告死亡率为39.30/10万。结论绍兴市2012年冠心病急性事件主要以40岁以上人群为主,发病率随着年龄增长而升高,男性发病率高于女性。     

Combined oral contraceptives, smoking, and cardiovascular risk

STUDY OBJECTIVE: To assess age specific incidence and mortality of stroke, acute myocardial infarction (AMI), and idiopathic venous thromboembolism (VTE) associated with use of modern low dose combined oral contraceptives (OCs) and the interaction with smoking. DESIGN: Hospital-based case-control study. SETTING: Hospitals in Oxford region in the United Kingdom, which covered a defined population, during the period 1989-1993. METHODS: Relative risk estimates from the WHO Collaborative Study and observed incidence rates from the Oxford region were used to estimate age specific incidence of each disease among women without cardiovascular risk factors and model total cardiovascular incidence and mortality. RESULTS: Among women who did not use OCs, smoke nor had any other cardiovascular risk factors, total incidence of stroke and AMI were less than 2 events per 100,000 woman years in those aged 20-24 years and rose exponentially with age to 8 events per 100,000 among women aged 40-44 years. Incidence of idiopathic VTE among women who did not use OCs rose linearly with age (from 3.3 per 100,000 at ages 20-24 years to 5.8 per 100,000 at ages 40-44 years). The increased risk of idiopathic VTE associated with OC use among non-smokers constituted over 90% of all cardiovascular events for women aged 20-24 years and more than 60% in those aged 40-44 years. Fatal cardiovascular events were dominated by haemorrhagic stroke and AMI, and among OC users who smoked these two diseases accounted for 80% of cardiovascular deaths among women aged 20-24 years, rising to 97% among those aged 40-44 years. Cardiovascular mortality associated with smoking was greater than that associated with OC use at all ages. Attributable risk associated with OC use was 1 death per 370,000 users annually among women aged 20-24 years, 1 per 170,000 at ages 30-34 years, and 1 per 37,000 at ages 40-44 years. Among smokers, the cardiovascular mortality attributable to OC use was estimated to be about 1 per 100,000 users annually among women aged less than 35 years, and about 1 per 10,000 users annually among those above the age of 35 years. CONCLUSION: The incidence of fatal cardiovascular events among women aged less than 35 years is low. The VTE risk associated with OC use is the largest contributor to OC induced adverse effects. The potentially avoidable excess VTE risk associated with the newer progestogens desogestrel and gestodene would account for a substantial proportion of total cardiovascular morbidity in this age group. For women over age 35 years the absolute risks associated with OC use and smoking are greater because of the steeply rising incidence of arterial diseases. The combination of smoking and OC use among such women is associated with particularly increased risks. Any potential reduction in AMI or stroke risk with use of third generation OCs would be a more important consideration among older compared with younger women, particularly if they smoke. However, the mortality associated with smoking is far greater than that associated with OC use (of any type) at all ages.     

Social patterning of myocardial infarction and stroke in Sweden: incidence and survival

Cardiovascular disease morbidity and mortality rates show marked social patterning in industrialized countries. The aim of this study was to analyze if not only incidence but also survival after acute myocardial infarction (AMI) and stroke differ among socioeconomic groups. Within the framework of the population-based World Health Organization's Multinational Monitoring of Trends and Determinants in Cardiovascular Disease (MONICA) Project, all first-ever AMI (ages 25-64 years) and stroke (ages 25-74 years) events were recorded in northern Sweden during the period 1985-1994. The numbers of first-ever AMI and stroke patients included in the study were 3,466 and 4,215, respectively. Incidence rates for both AMI and stroke showed a distinct social pattern, with high rates in workers and self-employed nonprofessionals and low rates in professionals. The pattern was similar in men and women. In men, early survival after an AMI follows the same socioeconomic pattern, whereas it is less clear if socioeconomic differences in survival contribute to explain differences in mortality in AMI among women and mortality in stroke (both sexes). The high case fatality among male workers and self-employed professionals with AMI is, in turn, attributed to a very marked increase in the risk for sudden death.     

Trends in fatal coronary heart disease among people aged 25-74 years in Oita City,Japan, from 1987-1998

Serum cholesterol has been increasing in recent years in Japan. There is concern that risk of coronary heart disease (CHD) may be increasing too, but there is little information on validated fatal CHD trends in the Japanese population. We identified 1,056 deaths from heart disease and other deaths possibly hiding CHD from death certificates of residents aged 25-74 years in Oita City, Japan in 1987-1988, 1992-1993, and 1997-1998 (mean population, 273,000 in 1997-1998). We validated 994 of them by medical record review and physician interviews, classifying them into definite fatal acute myocardial infarction (AMI) and possible fatal AMI or CHD death based on Monitoring Trends and Determinants in Cardiovascular Disease project's criteria. Sudden death was defined to estimate the number of CHD sudden deaths. In men, age-adjusted mortality rates due to validated fatal CHD remained quite stable over 10 years (25.3 per 100,000 [95% CI, 15.0-35.5] in 1987-1988 to 24.2 per 100,000 [95% CI, 16.1-32.3] in 1997-1998). When 50% or all sudden deaths were included as fatal CHD, the rates for men tended to decline. This was due to decreasing out-of-hospital deaths in connection with a declining CHD death rate among men aged 65-74 years, whereas in-hospital CHD deaths were level. In women, the rate of validated fatal CHD was highest in 1992-1993, but the 1997-1998 rate was similar to the 1987-1988 rate. We did not find that fatal CHD rates increased in Oita men and women from 1987-1998. Rather, out-of-hospital fatal CHD tended to decline in Oita men.     

Trends in mortality from stroke in Scotland, 1950-1986.

The Scottish Registrar General's Annual Reports have been used to study trends in mortality from stroke in Scotland during 1950-1986 in those aged 45 to 74. In 1950 the age-adjusted mortality rate was 347.4 per 100,000 population for men and 360.8 for women, falling to 199.6 for men and 155.8 for women in 1986. This downward trend has increased from 1976 for males. The average annual decline in age-adjusted mortality from stroke over the 37-year period was 4.0 per 100,000 in males and 5.5 in females. This reduction in death rates was proportionally higher for women compared with men in all age groups over 55 years. As with cardiovascular deaths, mortality from stroke was lower in the east than in the central region and west of Scotland. The reduction in mortality resulted in a substantial 'saving' of lives, estimated at 12,500 between 1980 and 1984.     

冠心病猝死及其与人群心血管病危险因素水平相关性的研究

本文对1985至1989五年累计2 990 816人群中的冠心病猝死(SCHD)发生率及其与人群心血管病危险因素水平的相关性进行探讨。结果表明SCHD总发生率为12/10万(按1964年标准人口计算标化率为9.5/10万,按1982年人口计算标化率为11.1/10万)。SCHD与人群平均血压水平、高血压患病率、血清总胆固醇水平、体重指数、吸烟率、ECG异常检出率、心血管病患病率均呈正相关(r=0.79~0.99,P<0.01);与血清高密度脂蛋白水平呈负相关(r=-0.81,P<0.01)。     

The lung cancer epidemic in Australia, 1910 to 1989

Deaths that occurred in Australia between 1985 and 1989 that were ascribed to cancers of the respiratory tract and intrathoracic organs were obtained to update Australian lung cancer mortality trends. The age-standardised mortality rate from lung cancer in males decreased significantly from 49/100,000 in 1980-1984 to 46.4/100,000 in 1985-1989 (-5.5%). Lung cancer mortality in females increased significantly to 12.3/100,000 in 1985-1989 from an average of 10.7/100,000 in 1980-1984 (+15%). We conclude that lung cancer mortality in males is declining and although mortality in females continues to increase, there is evidence that the rate of increase has started to slow. The decline in male mortality has been anticipated from their trends in smoking cessation. The slowing increase in women cannot be ascribed to similar patterns of cessation. It is considered more likely to be due to decreasing trends in tar consumption linked to the tar content of preferred brands.     

Increasing mortality among adults in Scotland 1981 to 1999

BACKGROUND: The aim of the study was to describe the change in overall and cause-specific mortality in Scotland between the early 1980s and late 1990s, with particular reference to the mortality experience of young adults. METHOD: The study was based on death records for Scottish residents. Changes in age and cause-specific death rates between 1981-83, 1989-91 and 1997-99 were compared. RESULTS: Between 1981-83 and 1989-91 death rates in Scotland began to rise among young men aged 20-24 while for those aged over 25 rates declined. The greatest fall in rates was experienced at ages 40 to 59. When death rates during 1997-99 were compared to rates in 1989-91 this pattern had changed. During the 1990s death rates among 20 to 34-year-olds increased, with a slight rise at ages 35-44. At older ages overall mortality continued to decline but the greatest fall was at ages 60 and over. Trends among women shared similarities with men. For both men and women falls in mortality from heart disease, stroke, and cancers were being differentially offset by increases in other causes of death across all age groups. The causes of death that contributed to the increased death rate among young adults include to various degrees, suicides, drug deaths, alcohol and violence. CONCLUSION: In Scotland changes in mortality result from a complex combination of different trends in mortality from various causes of death. The rate of decline in mortality among men aged 59 and below is slowing down, and death rates among young men aged 15-44 are increasing. If these trends continue there is a suggestion that future death rates may begin to rise at older ages.     

One-Hour Postload Plasma Glucose and Risks of Fatal Coronary Heart Disease and Stroke among Nondiabetic Men and Women: The Chicago Heart Association Detection Project in Industry (CHA) Study

Associations of baseline one-hour postload plasma glucose with 22-year coronary heart disease, stroke, cardiovascular diseases, and all cause mortality were assessed in five age-specific cohorts of nondiabetic men and women from the Chicago Heart Association Detection Project in Industry: 10,269 men ages 18–39 years; 7993 men ages 40–59 years; 1240 men ages 60–74 years; 6319 women ages 40–59 years; and 932 women ages 60–74 years. Plasma glucose was determined one hour after a 50-gram oral glucose load. Cox regression analyses were used to control for age and other covariates. Generally, higher glucose was significantly associated with mortality from coronary heart disease, stroke, cardiovascular diseases, and all cause mortality in men and women. This large longitudinal study provides evidence that one-hour postload plasma glucose in the absence of clinical diabetes at baseline apparently is an independent risk factor for fatal coronary heart disease and stroke in middle-aged and older nondiabetic men and women, and also for cardiovascular diseases and for all cause mortality.