高血压英文PPT精品课件心血管疾病的流行病学
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- Migration: Ni-Hon-San Study: Japanese living in Japan had the lowest rates of CHD and cholesterol levels, those living in Hawaii had intermediate rates for both, those living in San Francisco had the highest rates for both
Developed countries: decreasing tendencies (e.g, USA: 30% between 1988-98, Sweden: 42%)
- improvement of lifestyle factors, for example, a decrease of smoking and a higher level of health consciousness in many developed countries
- Study of the natural history of CVD
- Formulation and testing of etiological hypotheses (risk factors)
- Contribution to the development of cardiovascular prevention programs and the measurement of their effectiveness
Question: What is the relative amount of CVD in death rates in different age groups?
- Early lesions of blood vessel, atherosclerotic plaques: around 20 years - adult lifestyle patterns usually start in childhood and youth (smoking, dietary habits, sporting behavior, etc.)
- Women: special case (WHO, 2004)
a., Higher risk in women than men (smoking, high triglyceride levels)
b., Higher prevalence of certain risk factors in women (diabetes mellitus, depression)
- Increase in CVD morbidity and mortality: in age-group of 30-44 years
- Premature death (<64 years of age, or 25-64 years): in the elderly population more difficult to interpret death rate due to multiple ill health causes
- Widespread idea: CVD is often thought to be a disease of middle-aged men.
- Cardiovascular mortality (fatal cases) are more common among men. However, CVD affect nearly as many women as men, albeit at an older age
In the world: CVD deaths account for one third of all deaths (25-50% depending on the level of economic development) among which 50%: coronary deaths
> stroke 6.0 million > 0.9 million hypertensive heart disease > 0.4 million inflammatory heart disease > 0.3 million rheumatic heart disease > 1.9 million other CVD
CVD made up 16.7 million of global deaths in 2002, among which 7 million due to coronary heart disease, 6 million due to stroke
Distribution of types of CVD in global deaths : Global cardiovascular deaths in 2002: 16.7 million among which: coronary heart disease 7.2 million
c., Gender-specific risk factors (risks for women only) (oral contraceptives, hormone replacement therapy, polycystic ovary syndrome)
Question: What is the relative amount of CVD in death rates in different ethnic groups?
- Congenital heart disease
- Cardiomyopathies
- Detection of the occurrence and distribution of CVD in populations, surveillance, monitoring, trends of changes
- better diagnostic and therapeutic procedures (e.g., bypass surgeries, hypertension screening, pharmacological treatment of hypertension and hypercholesterinaemia, access to health care)
- Morbidity: nearly 30% of all disability cases
- Contributes to deterioration of the quality of life
- Coronary heart disease (CHD, ischemic heart disease, heart attack, myocardial infarction, angina pectoris)
Question: What is the relative amount of CVD in different geographical places? What are the time trends? International and regional characteristics of distribution
PROPORTION OF MORTALITY IN DIFFERENT AGE-GROUPS (MEN)
100% 90% 80% 70% 60% 50% 40% 30% 20% 10% 0%
61,5%
22,5% 11,4% 4,6%
1-24 yrs
14,0% 26,0% 26,9% 32,7%
25-64 yrs
- A major impact on life expectancy
- Significantly contributes to morbidity and death rates in the middle aged population: potential life years lost, common cause of premature death, labor force (economic costs), family life
1., Descriptive epidemiology:
= Describing distribution of cardiovascular disease by means of certain characteristics such as : PERSON (i.e., age, gender, ethnicity) TIME and PLACE
3., Experimental epidemiology/Interventions
= Strategies of cardiovascular prevention (primordial, primary, secondary, tertiary; individual and community levels)
- In the US: increased cardiovascular disease deaths in African-American and South-Asian populations in comparison with Whites
- Increased stroke risk in African-American, some Hispanic American, Chinese, and Japanese populations
- Cerebrovascular disease (stroke, TIA, transient ischemic attack)
- Hypertensive heart disease
- Peripheral vascular disease
- Heart failure
- Rheumatic heart disease (streptococcal infection)
源自文库4,7% 14,9% 24,6%
55,8%
>65 yrs
external others cancer CVD
PROPORTION OF MORTALITY IN DIFFERENT AGE-GROUPS (WOMEN)
100% 90% 80% 70% 60% 50% 40% 30% 20% 10% 0%
SDR: Standardized Death Rate
Direct mode of standardization, using the age distribution of a hypothetical European standard population
Premature death rates for comparison purposes (<64 years of age)
2., Analytic epidemiology
= Analyzing relationships between CVD and risk factors (which elevate the probability of a disease at population level), risk model and multicausal developments
40,0%
35,0%
17,7% 7,3%
1-24 yrs
8,2% 24,0% 36,5%
31,3%
25-64 yrs
4,8% 18,3% 12,2%
64,7%
>65 yrs
external others cancer
CVD
Question: What is the relative amount of CVD in death rates in women and men?
Public Health BETTINA PIKO, M.D., Ph.D.
- Leading cause of mortality in developed countries and a rising tendency in developing countries (disease of civilization)
Developed countries: decreasing tendencies (e.g, USA: 30% between 1988-98, Sweden: 42%)
- improvement of lifestyle factors, for example, a decrease of smoking and a higher level of health consciousness in many developed countries
- Study of the natural history of CVD
- Formulation and testing of etiological hypotheses (risk factors)
- Contribution to the development of cardiovascular prevention programs and the measurement of their effectiveness
Question: What is the relative amount of CVD in death rates in different age groups?
- Early lesions of blood vessel, atherosclerotic plaques: around 20 years - adult lifestyle patterns usually start in childhood and youth (smoking, dietary habits, sporting behavior, etc.)
- Women: special case (WHO, 2004)
a., Higher risk in women than men (smoking, high triglyceride levels)
b., Higher prevalence of certain risk factors in women (diabetes mellitus, depression)
- Increase in CVD morbidity and mortality: in age-group of 30-44 years
- Premature death (<64 years of age, or 25-64 years): in the elderly population more difficult to interpret death rate due to multiple ill health causes
- Widespread idea: CVD is often thought to be a disease of middle-aged men.
- Cardiovascular mortality (fatal cases) are more common among men. However, CVD affect nearly as many women as men, albeit at an older age
In the world: CVD deaths account for one third of all deaths (25-50% depending on the level of economic development) among which 50%: coronary deaths
> stroke 6.0 million > 0.9 million hypertensive heart disease > 0.4 million inflammatory heart disease > 0.3 million rheumatic heart disease > 1.9 million other CVD
CVD made up 16.7 million of global deaths in 2002, among which 7 million due to coronary heart disease, 6 million due to stroke
Distribution of types of CVD in global deaths : Global cardiovascular deaths in 2002: 16.7 million among which: coronary heart disease 7.2 million
c., Gender-specific risk factors (risks for women only) (oral contraceptives, hormone replacement therapy, polycystic ovary syndrome)
Question: What is the relative amount of CVD in death rates in different ethnic groups?
- Congenital heart disease
- Cardiomyopathies
- Detection of the occurrence and distribution of CVD in populations, surveillance, monitoring, trends of changes
- better diagnostic and therapeutic procedures (e.g., bypass surgeries, hypertension screening, pharmacological treatment of hypertension and hypercholesterinaemia, access to health care)
- Morbidity: nearly 30% of all disability cases
- Contributes to deterioration of the quality of life
- Coronary heart disease (CHD, ischemic heart disease, heart attack, myocardial infarction, angina pectoris)
Question: What is the relative amount of CVD in different geographical places? What are the time trends? International and regional characteristics of distribution
PROPORTION OF MORTALITY IN DIFFERENT AGE-GROUPS (MEN)
100% 90% 80% 70% 60% 50% 40% 30% 20% 10% 0%
61,5%
22,5% 11,4% 4,6%
1-24 yrs
14,0% 26,0% 26,9% 32,7%
25-64 yrs
- A major impact on life expectancy
- Significantly contributes to morbidity and death rates in the middle aged population: potential life years lost, common cause of premature death, labor force (economic costs), family life
1., Descriptive epidemiology:
= Describing distribution of cardiovascular disease by means of certain characteristics such as : PERSON (i.e., age, gender, ethnicity) TIME and PLACE
3., Experimental epidemiology/Interventions
= Strategies of cardiovascular prevention (primordial, primary, secondary, tertiary; individual and community levels)
- In the US: increased cardiovascular disease deaths in African-American and South-Asian populations in comparison with Whites
- Increased stroke risk in African-American, some Hispanic American, Chinese, and Japanese populations
- Cerebrovascular disease (stroke, TIA, transient ischemic attack)
- Hypertensive heart disease
- Peripheral vascular disease
- Heart failure
- Rheumatic heart disease (streptococcal infection)
源自文库4,7% 14,9% 24,6%
55,8%
>65 yrs
external others cancer CVD
PROPORTION OF MORTALITY IN DIFFERENT AGE-GROUPS (WOMEN)
100% 90% 80% 70% 60% 50% 40% 30% 20% 10% 0%
SDR: Standardized Death Rate
Direct mode of standardization, using the age distribution of a hypothetical European standard population
Premature death rates for comparison purposes (<64 years of age)
2., Analytic epidemiology
= Analyzing relationships between CVD and risk factors (which elevate the probability of a disease at population level), risk model and multicausal developments
40,0%
35,0%
17,7% 7,3%
1-24 yrs
8,2% 24,0% 36,5%
31,3%
25-64 yrs
4,8% 18,3% 12,2%
64,7%
>65 yrs
external others cancer
CVD
Question: What is the relative amount of CVD in death rates in women and men?
Public Health BETTINA PIKO, M.D., Ph.D.
- Leading cause of mortality in developed countries and a rising tendency in developing countries (disease of civilization)