Lancet Glob Health:到2030年,慢病过早死亡率降低1/3,则全球30~70岁人群的预期寿命可延长0.80岁

2018-11-13 xujing 中国循环杂志

《柳叶刀全球健康》杂志上的一项研究分析指出,如果实现这一目标,全球30~70岁人群的预期寿命预计延长0.80岁。

联合国可持续发展目标(SDG)3.4旨在到2030年,将慢性非传染性疾病所致的过早死亡率降低三分之一。

《柳叶刀全球健康》杂志上的一项研究分析指出,如果实现这一目标,全球30~70岁人群的预期寿命预计延长0.80岁。

同时,如果实现四种主要慢性非传染性疾病——血管疾病、癌症、慢性呼吸道、糖尿病降低三分之一就是预期寿命延长0.64岁。

这些增长可能看起来很小,但在2015年,全球30-70岁人口的预期寿命是36.7岁,最长的寿命也不过是40.0岁,因此这一增长是巨大的。

该研究结果提示,实现这一目标的最大受益者在低收入和中低收入国家,在这些国家,慢性非传染性疾病特别是血管疾病的过早死亡率最高。

研究者通过分析2000-2015年的趋势,不看好低收入和中低收入国家能实现慢性非传染性疾病过早死亡降低三分之一的目标。

同期述评指出,来自高收入国家流行病学转变的证据表明,长期慢性非传染性疾病变化很少是线性的。过去几十年中,高收入国家非传染性疾病死亡率的下降通常伴随着长期的缓慢下降甚至上升,低收入和中等收入国家正经历这样的状况。

对于低收入和中等收入国家而言,如果像高收入国家发生的那样,成功实施危险因素的干预措施,将在未来几年中将会出现比2000-2015年更快的下降,并且实现慢性非传染性疾病过早死亡率降低三分之一的可能性更大。

而高收入国家目前CVD死亡率下降的放缓,因为风险因素流行率下降到已经较低的水平之后再降低则变得更具挑战性,在这些国家,到2030年实现减少三分之一的目标可能比过去更难以实现。

研究者没有分析男性和女性NCD死亡率变化趋势。

述评指出,尽管SDG 3.4没有包括性别特异性目标,但是由于男、女各自不同的危险因素,非传染性疾病过早死亡率的变化通常不同。

高收入国家的经验表明,男性的非传染性疾病死亡率高峰显着高于女性,这主要是因为吸烟率更高。

在低收入和中等收入国家中,目前男性的慢性非传染性疾病过早死亡率显着高于女性,因此SDG 3.4的实现将主要来源于男性死亡率的下降和男性危险因素流行控制。

该研究使用世卫组织的全球卫生估计,该估计从一系列来源获得死亡率数据,包括民事登记和生命统计(CRVS)系统,并对质量不佳的全因死亡率数据和特定原因死亡率数据进行各种调整。

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    2019-01-05 howi
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    2019-03-15 shizhenshan
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