38 个低收入和中等收入国家心血管疾病二级预防指南建议目标的实现情况。

IF 3.8 4区 医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH
Zhiguang Liu, Minghai Yan, Lap Ah Tse, Yingxuan Zhu, Xinyue Lang, Xin Liu, Yang Lin, Bo Hu
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引用次数: 0

摘要

背景:本研究旨在估算38个中低收入国家(LMICs)实现世界卫生组织(WHO)心血管疾病(CVD)指南建议的二级预防目标的普及率:我们汇集了 2013 年至 2020 年期间 38 个中低收入国家具有全国代表性的横断面调查。根据世卫组织的建议,对自述有心血管疾病史的个人的治疗、代谢和生活方式目标进行了评估。采用多变量泊松回归模型评估了指南遵守率与社会人口特征之间的关系:汇总样本包括 126 106 名参与者,其中 9821 人(6.8% [95% CI 6.4-7.2])报告有心血管疾病史。总体而言,在心血管疾病患者中,降压药达到治疗目标的比例为 22.7%(95% CI,21.0-24.5%),阿司匹林为 19.6%(17.9-21.4%),他汀类药物为 13.6%(12.0-15.44%)。达到代谢目标的比例为:体重指数 54.9%(52.5%-57.3%)、血压 39.9%(37.7%-42.2%)、总胆固醇 46.1%(43.6%-48.6%)、空腹血糖 84.9%(83.1%-86.5%)。达到生活方式目标的比例为:不吸烟 83.2%(81.5%-84.7%),不饮酒 83.1%(81.2%-84.9%),充足的体育锻炼 65.5%(63.1%-67.7%),健康饮食 16.2%(14.5%-18.0%)。只有 6.1%(5.1%-7.4%)的国家实现了三项治疗目标,16.0%(14.3%-17.9%)的国家实现了四项代谢目标,6.9%(5.8%-8.0%)的国家实现了四项生活方式目标。在实现治疗、不饮酒和饮食目标方面,中上收入国家优于低收入国家。结论:在低收入和中等收入国家,实现新陈代谢目标的情况较差:结论:在低收入和中等收入国家,心血管疾病患者在治疗、新陈代谢和健康生活方式方面实现指南建议目标的程度明显较低。这突出表明,迫切需要有效、系统的二级预防策略来改善心血管疾病的管理。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Achievement of Guideline-Recommended Targets for Secondary Prevention of Cardiovascular Disease in 38 Low-Income and Middle-Income Countries.

Background: This study aimed to estimate the prevalence of achieving the secondary prevention targets recommended in the World Health Organization (WHO) guidelines for cardiovascular disease (CVD) in 38 low-income and middle-income countries (LMICs).

Methods: We pooled nationally representative cross-sectional surveys from 38 LMICs between 2013 and 2020. Treatment, metabolic and lifestyle targets were assessed for individuals with a self-reported history of CVD according to WHO's recommendations. Associations between the prevalence of guideline adherence and sociodemographic characteristics were assessed using multivariate Poisson regression models.

Results: The pooled sample included 126 106 participants, of whom 9821 (6.8% [95% CI 6.4-7.2]) reported a history of CVD. Overall, the prevalence of achieving treatment targets in patients with CVD was 22.7% (95% CI, 21.0-24.5%) for antihypertensive drugs, 19.6% (17.9-21.4%) for aspirin, and 13.6% (12.0-15.44%) for statins. The prevalence of achieving metabolic targets was 54.9% (52.5-57.3%) for BMI, 39.9% (37.7-42.2%) for blood pressure, 46.1% (43.6-48.6%) for total cholesterol, and 84.9% (83.1-86.5%) for fasting blood glucose. The prevalence of achieving lifestyle targets was 83.2% (81.5-84.7%) for not smoking, 83.1% (81.2-84.9%) for not drinking, 65.5% (63.1-67.7%) for sufficient physical activity and 16.2% (14.5-18.0%) for healthy diet. Only 6.1% (5.1-7.4%) achieved three treatment targets, 16.0% (14.3-17.9%) achieved four metabolic targets, and 6.9% (5.8-8.0%) achieved four lifestyle targets. Upper-middle income countries were better than low-income countries at achieving the treatment, non-drinking and dietary targets. Being younger and female were associated with poorer achievement of metabolic targets.

Conclusion: In LMICs, achieving the targets recommended in the guideline for treatment, metabolism and healthy lifestyles for patients with CVD is notably low. This highlights an urgent need for effective, systematic secondary prevention strategies to improve CVD management.

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来源期刊
CiteScore
10.70
自引率
1.40%
发文量
57
审稿时长
19 weeks
期刊介绍: The Journal of Epidemiology and Global Health is an esteemed international publication, offering a platform for peer-reviewed articles that drive advancements in global epidemiology and international health. Our mission is to shape global health policy by showcasing cutting-edge scholarship and innovative strategies.
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