心血管疾病流行病學研究

EpidemiologyofCardiovascularDiseaseMajorTypesofCardiovascular

Disease(CVD)AdaptedfromMackayJ,MensahG,eds.TheAtlasofHeartDiseaseandStroke.TheWHOandtheUSCDC,2004.Coronaryheartdisease(CHD)RheumaticheartdiseaseCongenitalheartdiseaseStrokeAorticaneurysm

anddissectionDeepvenousthrombosisandpulmonaryembolismPeripheralarterydiseaseDeathsDuetoCHDandStroke

inEuropeAdaptedfromAllenderS,etal.EuropeanCardiovascularStatistics,2008./files/statistics%202008%20web-161229A.pdf.Accessed9November2008.960,632494,188963,404744,5500200,000400,000600,000800,0001,000,0001,200,000CHDStrokeTotalNumberofDeathsin

LatestAvailableYearMenWomenDeathsDuetoCVDvsOtherDiseasesinEuropeMenAdaptedfromAllenderS,etal.EuropeanCardiovascularStatistics,2008./files/statistics%202008%20web-161229A.pdf.Accessed9November2008.Injuriesand

poisoningAllother

causesStrokeCHDRespiratory

diseaseStomach

cancerColorectal

cancerOther

cancerOther

CVDLung

cancer17%12%7%11%6%2%2%11%11%21%Injuriesand

poisoningAllother

causesStrokeCHDRespiratory

diseaseStomach

cancerColorectal

cancerOther

cancerOther

CVDLung

cancer18%5%6%9%2%2%1%15%17%22%Breast

cancer3%WomenCardiovascularMortalityIncreasesSharplyWithSerumCholesterolConcentrationinPatientsWithDiabetesAdaptedfromStamlerJ,etal.Diabetes

Care.1993;16:434–444.Deathsper10,000Person-Years100500CholesterolLevel150<180mg/dL200–219mg/dL240–259mg/dL280mg/dL(n=62,448)(n=1105)(n=75,122)(n=1038)(n=40,090)(n=529)(n=17,604)(n=353)NodiabetesDiabetesIHD=ischemicheartdisease.aDefinedin1971–1975,followedupthrough1982–1984;bDefinedin1982–1984,followedupthrough1992–1993.AdaptedfromGuK,etal.JAMA.1999;281(14):1291–1297.IHDMortality:LessSubstantial

DeclineinDiabetesPatientsVsNondiabeticSubjects–43.8%P<0.001–20.4%P=NS–16.6%P=NS+10.7%P=NSNondiabeticSubjectsPatientsWithDiabetes024681012141618MenWomenMenWomenMortalityRate,

per1000Person-Years1970’sCohort(n=10,649)a1980’sCohort(n=9233)bMajorModifiableRiskFactorsforCVD

LDL-C=low-densitylipoproteincholesterol;HDL-C=high-densitylipoproteincholesterol.AdaptedfromMackayJ,MensahG,eds.TheAtlasofHeartDiseaseandStroke.TheWHOandtheUSCDC,2004;PadwalRetal.BMJ.2001;322:977–980.RiskFactorRelativeRiskHypertension2–3DyslipidemiaTotalcholesterolLDL-CHDL-C1.01foreach1%increase1.01foreach1%increase1.01foreach1%decreaseDiabetesMellitusM