我國(guó)心血管疾病流行和負(fù)擔(dān)第1頁(yè)/共55頁(yè)我國(guó)心血管疾?。?/p>

流行和負(fù)擔(dān)第2頁(yè)/共55頁(yè)背景我國(guó)目前面臨低出生率、低死亡率和較高期望壽命（73歲）,和人口老齡化，在2007年底，8.0%的人口年齡≥65歲,達(dá)1億。重要心腦肺血管疾病患病率和危險(xiǎn)因素水平在發(fā)達(dá)國(guó)家已經(jīng)降低，如高血壓和吸煙患病率但我國(guó)還在繼續(xù)上升。我國(guó)目前正處于人口、社會(huì)和經(jīng)濟(jì)高速發(fā)展變化的階段，這將進(jìn)一步加重心血管病負(fù)擔(dān)。第3頁(yè)/共55頁(yè)中國(guó)高血壓患病率－全國(guó)性調(diào)查

1959-2002

第4頁(yè)/共55頁(yè)

中國(guó)高血壓知曉率、治療和控制率1991–2002

NationalBPSurveyCooperativeGroupChineseJHypertensionGuDHypertension20021995,3(suppl):9-1340:920-927

(%)2000-200130246(%)1991VS2002Age15-74Age35-74第5頁(yè)/共55頁(yè)MenWomen在過(guò)去20年，年齡調(diào)整的高膽固醇血癥患病率變化趨勢(shì)*

>=200mg/dl.BJ:Beijingworker BJF:Beijingfarmer SYF:Shanxifarmer SZF:Shaanxifarmer JJF:Jiangsufarmer GWF:Guangxifarmer GZW:Guangzhouworker GZF:GuangzhoufarmerZZFs:Zhejiangfishermen

WuYF.ChineseJournalofCardiology2001,29(2):74-79.男性女性第6頁(yè)/共55頁(yè)中國(guó)35-74歲成年人中血清膽固醇發(fā)布

百分比,2000-2001240HeJ,GuD.Circulation2004;110:405-11

第7頁(yè)/共55頁(yè)HazardratioMeanusualtotalcholesterol(mmol/l)血清膽固醇和心血管病關(guān)系4.55.05.56.06.5+1mmol/L:1.32(1.20-1.46)0.71.01.42.0TC和CHD4.55.05.56.06.5+1mmol/L:0.81(0.72-0.92)0.250.501.002.004.00TC和出血性中風(fēng)

+1mmol/L:1.23(1.12-1.35)4.55.05.56.06.50.501.002.004.00TC和缺血性中風(fēng)TC上升+1mmol/L

冠心病危險(xiǎn)32％上升缺血性中風(fēng)危險(xiǎn)上升23％出血性中風(fēng)下降19％第8頁(yè)/共55頁(yè)中國(guó)≥18成年人的年齡調(diào)整的超重肥胖患病率

全國(guó)營(yíng)養(yǎng)和健康調(diào)查,2002第9頁(yè)/共55頁(yè)中國(guó)成年人吸煙率男女NumberofParticipants

%

%1984258,42261.0261,178

4.21996

65,00063.0

57,000

3.8a:WengX,etal:Datafrom1984NationalSmokingSurvey.b:YangG.SmokingandHealthinChina:1996NationalPrevalenceSurveyofSmokingPattern.Beijing,ChinaScienceandTechnologyPress,1997.C:WangL,ed.Seriesreport#1,ChineseNutritionandHealthStatusReport,p49,2005NumberofParticipants200273,19353.9

87,360

3.1第10頁(yè)/共55頁(yè)中美人群CVD危險(xiǎn)因素年齡標(biāo)化患病率***p<0.001Standardizedonthebasisoftheyear2000agedistributionoftheChinesepopulation.第11頁(yè)/共55頁(yè)中國(guó)心血管疾病發(fā)病率和死亡率，和發(fā)展趨勢(shì)第12頁(yè)/共55頁(yè)1957－2000年中國(guó)前10位死因死亡構(gòu)成比心腦血管疾病、腫瘤是中國(guó)成人主要死因

NEnglJMed.2005第13頁(yè)/共55頁(yè)我國(guó)成人前五位死因的年齡標(biāo)化死亡率1991－2000男性女性NEnglJMed.2005第14頁(yè)/共55頁(yè)中國(guó)五種主要心血管死亡原因的年齡標(biāo)化死亡率第15頁(yè)/共55頁(yè)我國(guó)成年人(35-74歲)的心血管病患者數(shù)(百萬(wàn)）第16頁(yè)/共55頁(yè)********不同國(guó)家中，25-45%的死亡是由心血管疾病所致。心血管疾病死亡率（每10萬(wàn)人）：中國(guó)位列第12，分別為400人。美國(guó)位列第15，分別為360人。第17頁(yè)/共55頁(yè)中國(guó)高血壓和糖尿病病人出院人數(shù)1980-2006DiabeticsHypertension中國(guó)衛(wèi)生統(tǒng)計(jì)年報(bào)(1980-2007).中國(guó)衛(wèi)生部第18頁(yè)/共55頁(yè)中國(guó)5種主要心臟病病人出院人數(shù),1980-2006第19頁(yè)/共55頁(yè)中國(guó)心血管病和腦血管病人出院人數(shù),1980-2006HemorrhagicIschemic第20頁(yè)/共55頁(yè)HemorrhagicIschemic中國(guó)主要心血病出院人數(shù)排序變化,1980-2006第21頁(yè)/共55頁(yè)冠心病發(fā)病率和死亡率與總死亡率趨勢(shì):1991-1999

總死亡冠心病死亡率冠心病發(fā)病率第22頁(yè)/共55頁(yè)心腦肺血管?。薮蠊残l(wèi)生問(wèn)題

2600萬(wàn) 糖尿病20000萬(wàn) 血脂異常20000萬(wàn) 高血壓26000萬(wàn) 超重/肥胖30000萬(wàn) 吸煙 2002全國(guó)營(yíng)養(yǎng)與健康調(diào)查資料；中國(guó)心血管健康多中心合作研究；

7700萬(wàn) 代謝綜合征

300萬(wàn) 心肌梗死

700萬(wàn) 腦卒中

400萬(wàn) 心力衰竭

320萬(wàn)心腦肺血管疾病死亡/年第23頁(yè)/共55頁(yè)中國(guó)和世界其他地區(qū)成人高血壓病例數(shù),2025年Lancet2005;365:217-223；JHypertens.200422:11-92025年我國(guó)成人高血壓患病率27.4%；高血壓患者近3億；第24頁(yè)/共55頁(yè)中國(guó)35-64歲和65-84歲男性

冠心病年度死亡人數(shù)預(yù)測(cè)2000-2029年MoranA,ZhaoD,GuD,etal.BMCPublicHealth.2008;8(1):394第25頁(yè)/共55頁(yè)結(jié)論中國(guó)心血管病長(zhǎng)期變化趨勢(shì)在過(guò)去20年間，心血管病危險(xiǎn)因素水平不斷上升.這些危險(xiǎn)因素的趨勢(shì)表明21世紀(jì)中國(guó)冠心病和中風(fēng)的發(fā)病率將會(huì)進(jìn)一步顯著增加.第26頁(yè)/共55頁(yè)結(jié)論中國(guó)高血壓和高膽固醇血癥的知曉、治療和控制率異常之低.加強(qiáng)針對(duì)血脂異常、高血壓、糖尿病、吸煙和超重等危險(xiǎn)因素的預(yù)防、檢測(cè)和治療，可以大大降低將來(lái)中國(guó)成年人心血管疾病的負(fù)擔(dān)。第27頁(yè)/共55頁(yè)謝謝第28頁(yè)/共55頁(yè)CardiovascularDiseases:

BurdenandEpidemiologyinCHINADongfengGuM.DFuWaiHospital&CardiovascularInstitute,ChineseAcademyofMedicalSciencesNationalCenterofCVD,China

第29頁(yè)/共55頁(yè)BackgroundFacingalowdeathrate,alonglifeexpectancy,73years,andanagingpopulationwith8.0%oftotalpopulation,over100millionpeopleaged≥65yearattheendof2007.AlthoughtheprevalenceofsomeCVDriskfactorshasdecreasedindevelopedcountries,thecorrespondingprevalencehasincreasedinChina.Chinaiscurrentlyundergoingrapiddemographic,social,andeconomicchangesthatmayfurtherincreasetheburdenofCVD.第30頁(yè)/共55頁(yè)P(yáng)revalenceofHypertensioninChina

1959-2002from4nationalsurveys第31頁(yè)/共55頁(yè)

TheAwareness,TreatmentandControlRateofHypertensioninChina1991–2002

NationalBPSurveyCooperativeGroupChineseJHypertensionGuDHypertension20021995,3(suppl):9-1340:920-927

(%)2000-200130246(%)1991VS2002Age15-74Age35-74第32頁(yè)/共55頁(yè)MenWomenTrendsinage-adjustedprevalenceofhypercholesterolemia*inpast2decades*

>=200mg/dl.BJ:Beijingworker BJF:Beijingfarmer SYF:Shanxifarmer SZF:Shaanxifarmer JJF:Jiangsufarmer GWF:Guangxifarmer GZW:Guangzhouworker GZF:GuangzhoufarmerZZFs:Zhejiangfishermen

WuYF.ChineseJournalofCardiology2001,29(2):74-79.第33頁(yè)/共55頁(yè)P(yáng)ercentageDistributionofSerumTotalCholesterolinAdultPopulationAged35-74YearsinChina,2000-2001240HeJ,GuD.Circulation2004;110:405-11

第34頁(yè)/共55頁(yè)TCandfatalCHD,fatalandnonfatalischemicandhaemorrhagicstrokeinAsiaHazardratioMeanusualtotalcholesterol(mmol/l)4.55.05.56.06.5+1mmol/L:1.32(1.20-1.46)0.71.01.42.0TCandCHD4.55.05.56.06.5+1mmol/L:0.81(0.72-0.92)0.250.501.002.004.00TCandhaemorrhagicstroke

+1mmol/L:1.23(1.12-1.35)4.55.05.56.06.50.501.002.004.00TCandischemicstrokeTCincresing+1mmol/L

CHDrisk32％ischemicstrokerisk23％haemorrhagicstroke19％Circulation.2004;110:2678-86AnnEpidemiol2005;15:504-13

第35頁(yè)/共55頁(yè)Age-standardizedPrevalenceofOverweight/ObesityamongAdultsAged≥18,China

NationalNutritionandHealthSurvey,2002第36頁(yè)/共55頁(yè)P(yáng)revalenceofSmokinginChina

MenWomenNumberofParticipants

%

%1984258,42261.0261,178

4.21996

65,00063.0

57,000

3.8a:WengX,etal:Datafrom1984NationalSmokingSurvey.b:YangG.SmokingandHealthinChina:1996NationalPrevalenceSurveyofSmokingPattern.Beijing,ChinaScienceandTechnologyPress,1997.C:WangL,ed.Seriesreport#1,ChineseNutritionandHealthStatusReport,p49,2005NumberofParticipants200273,19353.9

87,360

3.1第37頁(yè)/共55頁(yè)Age-StandardizedPrevalenceofMajorCVDRiskFactorsinChinaandtheUnitedStates***p<0.001Standardizedonthebasisoftheyear2000agedistributionoftheChinesepopulation.第38頁(yè)/共55頁(yè)CVDIncidenceandMortalityandTheirTrendsinChina第39頁(yè)/共55頁(yè)P(yáng)roportionateMortalityfortheTenLeadingCausesofDeathinChina,1957-2000HeJ&GuD,etal,NEnglJMed2005;353;11:1124-113419572000Heartdiseasestroke第40頁(yè)/共55頁(yè)Age-standardizedMortalityfortheFiveLeadingCausesofDeathinAdultsHeJ&GuD,etal,NEnglJMed2005;353;11:1124-1134WomenMen第41頁(yè)/共55頁(yè)CPHD-chronicpulmonaryheartdisease;CHD-coronaryheartdisease;HF-heartfailure;RHD-rheumaticheartdiseaseAge-standardizedMortalityfortheFiveLeadingCausesofVascularDeath第42頁(yè)/共55頁(yè)NumberofPatientswithcardiovasculardiseasesinAdultPopulationAged35-74YearsinChina,2000-2001第43頁(yè)/共55頁(yè)*****30%causesofdeathbyCVDWorld-wideCVDmortalityrate/100,000：

China12th，400/100,000;USA15th，360/100,000;第44頁(yè)/共55頁(yè)NumberofPatientswithDiabeticsandHypertension

DischargedfromHospitals,1980-2006DiabeticsHypertensionChinaHealthStatisticsYearbook(1980-2007).MinistryofHealth,P.R.China第45頁(yè)/共55頁(yè)NumberofPatientswithFiveMajorHeartDiseasesDischargedfromHospitals,1980-2006第46頁(yè)/共55頁(yè)NumberofPatientswithCVDandCBVDDischargedfromHospitals,1980-2006HemorrhagicIschemic第47頁(yè)/共55頁(yè)HemorrhagicIschemic第48頁(yè)/共55頁(yè)1991-1999TrendsinCHDIncidenceandMortality,inComparisontoTotalMortality:ChinaMUCAStudy

AlldeathCHDdeathCHDincidence第49頁(yè)/共55頁(yè)

BurdenandChallenges:

MajorPublicHealthIssuesinAdults,China

26m. DM200m. Dyslipidemia200m. Hypertension260m. Overweight/OB300m. Smoking2002NationalNutritionandHealthSurvey2002InterAsiaStudy2000-2001

77m. MS

3m. MI(0.6%)7m. Stroke

(1.4%)4m. HeartFailure3.2m.dieofCVDperyear第50頁(yè)/共55頁(yè)P(yáng)rojectedGlobalBurdenofHypertensionin2025Thenumberofadultswithhypertensionin2025waspredictedtoincreasebyabout60%toa