公共卫生干预措施可挽救近1亿人的生命

创作：迟卉审核：aluba 2019年07月10日

①通过各国人口健康调查汇总，分析三种干预措施（高血压治疗，减少钠摄入量，消除人工反式脂肪酸的摄入）的影响；
②三种干预措施的综合效应可以在25年间延迟9430万人的死亡；
③单独将抗高血压治疗率提高到70％可以使3940万人延迟死亡，减少30％的钠摄入量可以延迟另外4,000万人死亡，消除反式脂肪酸摄入将延迟额外1480万人死亡；
④在南亚，消除反式脂肪酸的影响最大；
⑤在非洲撒哈拉以南，早期延迟死亡数（70岁以前的死亡）所占的比例最大。

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政策措施 cardiovascular mortality Global health population health salt reduction trans-fat 公共卫生 Vasilis Kontis Goodarz Danaei

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Circulation [IF:37.8]

Three Public Health Interventions Could Save 94 Million Lives in 25 Years Global Impact Assessment Analysis

在25年的全球影响评估分析中，三项公共卫生干预措施可挽救9400万人的生命

10.1161/CIRCULATIONAHA.118.038160

2019-06-10, Article

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BACKGROUND:: Preventable noncommunicable diseases, mostly cardiovascular diseases, are responsible for 38 million deaths annually. A few well-documented interventions have the potential to prevent many of these deaths, but a large proportion of the population in need does not have access to these interventions. We quantified the global mortality impact of 3 high-impact and feasible interventions: scaling up treatment of high blood pressure to 70%, reducing sodium intake by 30%, and eliminating the intake of artificial trans fatty acids.
METHODS: We used global data on mean blood pressure levels and sodium and trans fat intake by country, age, and sex from a pooled analysis of population health surveys, and regional estimates of current coverage of antihypertensive medications, and cause-specific mortality rates in each country, as well, with projections from 2015 to 2040. We used the most recent meta-analyses of epidemiological studies to derive relative risk reductions for each intervention. We estimated the proportional effect of each intervention on reducing mortality from related causes by using a generalized version of the populationattributable fraction. The effect of antihypertensive medications and lowering sodium intake were modeled through their impact on blood pressure and as immediate increase/reduction to the proposed targets.
RESULTS: The combined effect of the 3 interventions delayed 94.3 million (95% uncertainty interval, 85.7–102.7) deaths during 25 years. Increasing coverage of antihypertensive medications to 70% alone would delay 39.4 million deaths (35.9–43.0), whereas reducing sodium intake by 30% would delay another 40.0 million deaths (35.1–44.6) and eliminating trans fat would delay an additional 14.8 million (14.7–15.0). The estimated impact of trans fat elimination was largest in South Asia. SubSaharan Africa had the largest proportion of premature delayed deaths out of all delayed deaths.
CONCLUSIONS:: Three effective interventions can save almost 100 million lives globally within 25 years. National and international efforts to scale up these interventions should be a focus of cardiovascular disease prevention programs.

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