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中华老年病研究电子杂志

中华老年病研究电子杂志 ›› 2024, Vol. 11 ›› Issue (01) : 24 -29. doi: 10.3877/cma.j.issn.2095-8757.2024.01.005

临床研究

1990—2019年我国75岁及以上居民高收缩压所致脑卒中疾病负担及趋势分析
罗峥1, 张蔚1, 徐晓云1, 史楠1, 张燕1, 赵梅珍1, 刘康永1, 李小攀2,†()   
  1. 1. 201318　上海健康医学院附属周浦医院神经内科
    2. 200032　上海，复旦大学附属中山医院健康管理中心
  • 收稿日期:2023-11-09 出版日期:2024-02-28
  • 通信作者: 李小攀
  • 基金资助:
    上海市浦东新区卫生健康委员会特色专病项目(PWZzb2022-20); 上海健康医学院院级教学课题(ZPJXKT-21-11); 上海市卫生健康委员会面上项目(202150015); 上海市浦东新区卫生健康委员会特色学科建设项目(PWYts2021-02)

Changes in disease burden of stroke due to high systolic blood pressure in residents aged 75 years and above in China, 1990-2019

Zheng Luo1, Wei Zhang1, Xiaoyun Xu1, Nan Shi1, Yan Zhang1, Meizhen Zhao1, Kangyong Liu1, Xiaopan Li2,†()   

  1. 1. Neurology Department, Zhoupu Hospital Affiliated to Shanghai Medical College, Pudong District, Shanghai 201318, China
    2. Department of Health Management Center, Zhongshan Hospital of Fudan University, Shanghai 200032, China
  • Received:2023-11-09 Published:2024-02-28
  • Corresponding author: Xiaopan Li
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罗峥, 张蔚, 徐晓云, 史楠, 张燕, 赵梅珍, 刘康永, 李小攀. 1990—2019年我国75岁及以上居民高收缩压所致脑卒中疾病负担及趋势分析[J]. 中华老年病研究电子杂志, 2024, 11(01): 24-29.

Zheng Luo, Wei Zhang, Xiaoyun Xu, Nan Shi, Yan Zhang, Meizhen Zhao, Kangyong Liu, Xiaopan Li. Changes in disease burden of stroke due to high systolic blood pressure in residents aged 75 years and above in China, 1990-2019[J]. Chinese Journal of Geriatrics Research(Electronic Edition), 2024, 11(01): 24-29.

目的

分析我国75岁及以上老年人高收缩压所致脑卒中疾病负担及其趋势。

方法

整理2019年全球疾病负担研究（GBD 2019）数据，采用Joinpoint回归模型对1990—2019年我国75岁及以上老年人高收缩压所致脑卒中死亡率和伤残调整生命年（DALY）进行分析。

结果

1990—2019年，我国75岁及以上居民因高收缩压导致的脑卒中死亡数自221 019人上升至552 179人，但粗死亡率和DALY率分别从806.84/105和10 694.21/105下降至611.01/105和7 967.83/105。趋势分析发现，我国75岁及以上居民因高收缩压导致的脑卒中粗死亡率逐年下降0.86%，男性逐年下降0.36%，女性逐年下降1.38%（Z=-6.72、-3.08、-9.43，P<0.01）；DALY率逐年下降0.88%，男性DALY率逐年下降0.45%，女性DALY率逐年下降1.33%（Z=-7.16、-3.88、-9.91，P<0.01）；75岁以上老年人因高血压所致脑卒中粗死亡率和DALY率均高于65～75（不包含75）岁老年人，且DALY率降速较低（分别为-0.88%和-1.24%）。我国75岁及以上居民因高收缩压导致的脑卒中DALY率高于高、中、低社会人口指数（SDI）国家或地区，逐年下降百分比低于高SDI国家或地区，但高于中、低SDI国家或地区（中国：-0.88%，高SDI国家或地区：-3.57%，中等SDI国家或地区：-0.69%，低SDI国家或地区：-0.67%）。

结论

我国75岁以上老年人因高收缩压导致的脑卒中疾病负担重且降速慢，应深入开展高龄险人群精准健康管理研究，以实现健康老龄化目标。

关键词: 脑卒中, 高收缩压, 疾病负担, 伤残调整生命年, 粗死亡率, 健康管理
Objective

To analyze the disease burden of stroke due to high systolic blood pressure and its trend in residents aged 75 years and above in China.

Methods

Data from the Global Burden of Disease Study 2019 (GBD 2019) were collected and Joinpoint regression model was used to analyze the mortality rate and disability-adjusted life year (DALY) of stroke due to high systolic blood pressure in elderly people aged 75 years and above in China from 1990 to 2019.

Results

From 1990 to 2019, the number of stroke deaths due to high systolic blood pressure in residents aged 75 years and above increased from 221 019 to 552 179, but the crude death rate and DALY rate declined from 806.84/105 and 10 694.21/105 to 611.01/105 and 7 967.83/105, respectively. Trend analysis found that the crude stroke mortality rate due to high systolic blood pressure among residents aged 75 years and above in China decreased by 0.86% per year, with 0.36% per year in men and 1.38% per year in women (Z=-6.72, -3.08, -9.43; P < 0.01); and the DALY rate decreased by 0.88% per year, with 0.45% per year in men and 1.33% per year in women (Z=-7.16, -3.88, -9.91; P < 0.01). Crude mortality and DALY rates for stroke due to hypertension were higher in residents aged 75 years and above compared with those between 65-<75 years old, and the DALY rate in residents aged 75 years and above decline at a lower rate (-0.88% and -1.24%, respectively). The DALY rate of stroke due to high systolic blood pressure among residents aged 75 years and above in China was higher than that of high, medium, and low social demographic index (SDI) countries or regions, and the percentage of year-on-year decline was lower than that of high SDI countries or regions, but higher than that of medium and low SDI countries or regions (China: -0.88%, high SDI countries or regions: -3.57%, medium SDI countries or regions: -0.69%, low SDI countries or regions: -0.67%).

Conclusion

The disease burden of stroke due to high systolic blood pressure in China's elderly is high and slow to decline, and research on precise health management of the elderly risk group should be carried out in depth to achieve the goal of healthy aging.

Key words: Stroke, High systolic blood pressure, Disease burden, Disability adjusted life years, Crude death rate, Health management
图1 1990—2019年中国高收缩压所致脑卒中的粗死亡率和DALY率变化趋势。1A：总人群、65～75（不含75）岁和≥75岁人群粗死亡率；1B：总人群、65～75（不含75）岁和≥75岁人群DALY率注：DALY指伤残调整生命年
图2 1990—2019年中国75岁及以上居民高收缩压所致脑卒中的疾病负担变化趋势Joinpoint回归分析结果
图3 1990—2019年中国与不同社会人口指数地区75岁及以上居民高收缩压所致脑卒中疾病负担的变化趋势。3A：粗死亡率变化趋势图；3B：DALY率变化趋势图注：SDI指社会人口指数；DALY指伤残调整生命年
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