1990—2019年中国归因高收缩压的死亡负担趋势分析  

Trend analysis of mortality burden attributed to high systolic blood pressure in China,1990-2019

作　　者：张译匀 吴霞 赵湘铃 姚承志 熊文婧 让蔚清[1] ZHANG Yiyun;WU Xia;ZHAO Xiangling;YAO Chengzhi;XIONG Wenjing;RANG Weiqing(School of Public Health,University of South China,Hengyang,Hunan 421001,China;Department of Traditional Chinese Medicine,First Affiliated Hospital of University of South China,Hengyang,Hunan 421000,China)

机构地区：[1]南华大学公共卫生学院,湖南衡阳421001 [2]南华大学附属第一医院中医科,湖南衡阳421000

出　　处：《实用预防医学》2025年第3期257-262,共6页Practical Preventive Medicine

基　　金：2019年度湖南省芙蓉教学名师专项基金(201RFS001)。

摘　　要：目的分析1990—2019年中国归因高收缩压死亡负担的长期变化趋势,为多种慢性病防控提供科学依据。方法提取全球疾病负担数据库中1990—2019年中国、全球、不同社会人口学指数(socio-demographic index,SDI)地区归因高收缩压的死亡数据,用Joinpoint回归模型和年龄-时期-队列模型分析死亡负担变化。结果1990—2019年中国归因高收缩压的粗死亡率呈上升趋势,年龄标化死亡率呈下降趋势,平均年度变化百分比(average annual percent change,AAPC)值分别为1.96%(95%CI:1.94%~1.99%)、-0.78%(95%CI:-0.81%~-0.76%)。全球、高SDI及中高SDI地区年龄标化死亡率的降幅大于中国,其AAPC值分别是中国的1.54、3.67和2.01倍。年龄-时期-队列模型的结果表明中国归因高收缩压的死亡率在同一出生队列中呈现指数型上升趋势,从25~29岁的7.38/10万(95%CI:6.29/10万~8.66/10万)上升至90~94岁的5561.57/10万(95%CI:5281.82/10万~5856.14/10万);越近时期、越晚的出生队列死亡风险越低。结论1990—2019年中国归因高收缩压的死亡负担仍处于较高水平,年龄效应对归因高收缩压的死亡率影响较大,应进一步完善初级卫生保健,加强高风险人群管理,切实有效地控制高收缩压的死亡。Objective To analyze the long-term changing trends in mortality burden due to high systolic blood pressure(SBP)in China from 1990 to 2019,and to provide a scientific basis for prevention and control of various chronic diseases.Methods Data about deaths attributable to high SBP in China,the global and regions with different socio-demographic index(SDI)from 1990 to 2019 were sourced from the database about Global Burden of Disease study.Joinpoint regression model and age-period-cohort model were employed to analyze changes in the burden of mortality.Results The crude mortality rate attributable to high SBP in China from 1990 to 2019 showed an increasing trend,but the age-standardized mortality rate showed a decreasing trend,with the average annual percent change(AAPC)values being 1.96%(95%CI:1.94%-1.99%)and-0.78%(95%CI:-0.81%--0.76%)respectively.The reduction in the age-standardized mortality rates of the global,high SDI and medium-high SDI regions was greater than that in China,and the AAPC values of the global,high SDI and medium-high SDI regions were 1.54,3.67 and 2.01 times that of China respectively.The results of the age-period-cohort model showed an exponential increase in the mortality rate attributable to high SBP in China in the same birth cohort,increasing from 7.38/100,000(95%CI:6.29/100,000-8.66/100,000)at ages 25-29 to 5,561.57/100,000(95%CI:5,281.82/100,000-5,856.14/100,000)at ages 90-94.The closer the period and the later the birth cohort,the lower the risk of death.Conclusion The burden of mortality attributable to high SBP in China from 1990 to 2019 still remained at a relatively high level,and the age effect had a significant impact on the mortality rate attributable to high SBP.It is necessary to further improve primary health care and strengthen the management of high-risk groups so as to effectively control deaths attributable to high SBP.

关 键 词：高收缩压 死亡负担 Joinpoint回归模型 年龄-时期-队列模型 

分 类 号：R544.1[医药卫生—心血管疾病]