心血管健康水平与全因死亡及心血管疾病死亡风险的关联研究  

Correlation between cardiovascular health level and risk of all-cause death or death from cardiovascular disease

作　　者：薛涛涛 王丽敏[1] 赵振平[1] 张笑[1] 李纯[1] 齐金蕾[2] 殷鹏[2] 王黎君[2] 王蓝 于梦婷 张梅[1] XUE Taotao;WANG Limin;ZHAO Zhenping;ZHANG Xiao;LI Chun;QI Jinlei;YIN Peng;WANG Lijun;WANG Lan;YU Mengting;ZHANG Mei(Division of Chronic Disease and Risk Factor Surveillance,National Center for Chronic and Non-communicable Disease Control and Prevention,Chinese Center for Disease Control and Prevention,Beijing 100050,China;不详)

机构地区：[1]中国疾病预防控制中心慢性非传染性疾病预防控制中心慢病危险因素监测室,北京100050 [2]中国疾病预防控制中心慢性非传染性疾病预防控制中心生命登记与死因监测室,北京100050

出　　处：《中国慢性病预防与控制》2024年第5期321-326,共6页Chinese Journal of Prevention and Control of Chronic Diseases

基　　金：国家重点研发计划(2018YFC1311702)。

摘　　要：目的探讨中国居民心血管健康与全因死亡及心血管疾病死亡风险的关联,为制定心血管疾病防控措施提供参考。方法数据来源于2015年中国居民慢性病及危险因素监测,该监测采用多阶段分层整群随机抽样方法在全国31个省(自治区、直辖市)的298个监测点抽取调查对象,该研究选取其中64987名参与膳食调查的居民作为研究对象。按照生命八要素(Life's Essential 8)评分标准,计算心血管健康评分、健康行为评分和健康因素评分。使用SAS 9.4和R 4.3.1软件进行数据清理和统计分析。采用加权Cox比例风险回归模型分析心血管健康水平与全因死亡及心血管疾病死亡风险的关联。使用限制性立方样条模型估计心血管健康评分与全因和心血管疾病死亡风险的关联。结果共纳入64987名研究对象,基线心血管健康水平较高、中等和较低者分别为17980人(27.7%)、44368人(68.3%)和2639人(4.0%)。加权Cox比例风险回归分析结果显示,与心血管健康水平较低的研究对象相比,心血管健康水平较高者的全因死亡和心血管疾病死亡风险均较低(HR=0.30,95%CI:0.21~0.42;HR=0.19,95%CI:0.10~0.36)。心血管健康评分每增加10分,全因和心血管疾病死亡风险分别降低24%(HR=0.76,95%CI:0.70~0.82)和33%(HR=0.67,95%CI:0.58~0.77)。研究对象的全因死亡和心血管疾病死亡风险随心血管健康评分的增加而降低(P_(非线性)>0.05)。结论倡导健康的生活方式,加强慢性病危险因素管理和控制,获得更高的心血管健康水平,有助于降低成年居民的全因和心血管疾病死亡风险。Objective To explore the correlation between cardiovascular health(CVH)level and risk of all-cause death or death from cardiovascular disease(CVD)in Chinese residents,and provide the reference for the prevention and control of CVD.Methods The study included 64987 subjects from the 2015 China Chronic Disease and Risk Factors Surveillance(CCDRFS)who participated in the dietary survey.The 2015 CCDRFS used a multi-stage stratified cluster random sampling method to select the residents from 298 monitoring sites in 31 provinces(autonomous regions and municipalities directly under the Central Government).According to evaluation standards of Life's Essential 8(LE8),CVH score,health behavior score and health factor score were calculated.Software SAS 9.4 and software R 4.3.1.were used for data cleaning and statistical analysis.The weighted Cox proportional risk regression model was used to analyze the association of CVH level with the risk of all-cause death and death from cardiovascular disease.Association of CVH scores with risk of all-cause and CVD mortality was estimated using a restrictive cubic spline model.Results The study included 64987 subjects.The subjects with higher,moderate and lower baseline CVH leves were 17980(27.7%),44368(68.3%)and 2639(4.0%),respectively.The weighted Cox proportional risk regression models showed that as compared to the subjects with low CVH level,the risk of all-cause death and CVD death in the subjects with high CVH level was lower(HR=0.30,95%CI:0.21-0.42;HR=0.19,95%CI:0.10-0.36).For every 10-point increase in CVH score,the risk of all-cause and CVD mortality decreased by 24%(HR=0.76,95%CI:0.70-0.82)and 33%(HR=0.67,95%CI:0.58-0.77),respectively.The risk of all-cause mortality and CVD mortality in subjects decreased with increasing CVH score(Pnon-linear>0.05).Conclusion Promoting a healthy lifestyle,improving the management and control of chronic disease risk factors,and obtaining a high level of CVH can significantly reduce the risk of mortality from all-cause and CVD among adults in C

关 键 词：心血管健康 生命八要素 全因死亡 心血管疾病死亡 

分 类 号：R54[医药卫生—心血管疾病]