中国高血压调查结果:心血管病医疗费用增速赶超GDP,移动医疗是契机?

2018-08-08 郑聪毅 中国循环杂志

在中国心脏大会2018(CHC2018)心血管社区防治论坛上,国家心血管病中心、阜外医院王增武教授把脉了我国最新的心血管病流行趋势,并介绍了我国当前的防治不完善之处和应对策略。


在中国心脏大会2018(CHC2018)血管社区防治论坛上,国家血管病中心、阜外医院王增武教授把脉了我国最新的心血管病流行趋势,并介绍了我国当前的防治不完善之处和应对策略。

心血管病危险因素居高不下

在《循环》在线刊出的我国“十二五”高血压抽样调查最新结果显示,我国18岁及以上成人高血压患病率为23.2%,患病人数达2.45亿;正常高值血压患病率为41.3%,患病人数4.35 亿。

应用2017美国心脏学院/美国心脏协会(ACC/AHA )的高血压标准,高血压患病率则升高一倍,达到了46.4%;成人高血压知晓率、治疗率和控制率分别为46.9%、40.7%和15.3%,与2002年的调查结果相比有显著提高,但控制率仍处于较低的状态,与美国等发达国家相比仍存在一定差距。

“十二五”调查关于其他常见危险因素初步结果提示:与2002年相比,2015年我国≥18岁人群吸烟状况有所改善,吸烟率由35.8%下降到20.0%;≥35岁人群血脂异常的患病率为31.82%;我国≥35岁人群糖尿病的患病率为10.1%,结合2002年(2.6%)、2007年(9.7%)、2010年(11.6%)、2013年(10.9%)的调查来看,仍呈增长态势。

关于重要心血管病事件的初步结果提示:外周动脉疾病患病率0.35%,冠心病患病率482/10万,慢性心力衰竭1.31%。

近日发表在《美国心脏病学杂志》的研究表明,我国≥35岁居民房颤患病率为0.71%,估计房颤患者约487万,房颤伤残调整寿命年为每10万人97.0;脑卒中患病率1243/10万,与之前天坛医院王文志教授发表的1114.8/10万相近。

心脑血管病住院费用年增长速度大于GDP增速

据2017年《中国心血管病报告》,2004年至今,心脑血管病住院费用年均增速远高于国内生产总值(GDP)增速,心血管病负担日渐加重,

其中2015年心血管疾病出院总人数为1887.72万人次,占出院总人次数的12.87%,其中心血管病占比6.61%,脑血管病占6.25%。住院费用中扣除物价因素的影响,自2004年以来,急性心梗、颅内出血、脑梗死,年均增长速度分别为30.1%、18.1% 和23.5%。

基层防治工作有“裂痕”

基层是防治心血管病的主要战场,我国心血管病基层防治工作也持续了40多年的探索与实践,但目前还存在以下“裂痕”:政策裂痕、传统防治模式与现代防治模式裂痕、教育裂痕、学科间不融合导致的裂痕和功能裂痕。

王增武教授指出,弥合“防”与“治”裂痕需要的是观念转变、学科整合、弥合裂痕、防治站前前移和证据向政策转化。

互联网+、移动医疗带来了新的契机,以指南为基准,利用先进技术、理念提升管理水平无疑是解决问题的出路。

目前国家心血管病中心构建了国家心血管病防治技术服务平台,采用互联网与智能相结合的方式,构建全国社区心血管疾病管理服务中心,定期通过远程实时视频咨询指导,医生可以随时和专家沟通交流,高效提升基层医疗机构的服务水平,有效实现高血压规范化管理。众志成城,构建心血管病基层防治医联体,相信中国心血管事件的“拐点”将不久矣。

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    2018-08-26 freve
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    2018-08-10 yahu
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