《中国心血管健康与疾病报告2021》要点解读

doi:10.12114/j.issn.1007-9572.2022.0506

摘要/Abstract

摘要： 随着社会经济的发展，国民生活方式的变化，尤其是人口老龄化及城镇化进程的加速，居民不健康生活方式问题日益突出，心血管疾病（CVD）危险因素对居民健康的影响更加显著，CVD患病率和发病率仍在持续增高。2019年农村和城市CVD死亡人数分别占总死亡人数的46.74%和44.26%，每5例死亡者中就有2例死于CVD。推算中国CVD现患人数为3.3亿，其中脑卒中1 300万，冠心病1 139万，心力衰竭890万，肺源性心脏病500万，心房颤动487万，风湿性心脏病250万，先天性心脏病200万，下肢动脉疾病4 530万，高血压2.45亿。2019年中国心脑血管疾病的住院总费用为3 133.66亿元。CVD负担持续加重，特别是农村地区。由于医疗资源配置的不平衡、对疾病的认识较低及治疗的顺从性较差等原因，近几年农村地区冠心病和脑血管病的死亡率持续超过城市地区。同时也应看到，中国在CVD的防控方面也在不断进步，吸烟率下降，高血压控制率不断上升，临床诊疗水平和基础研究也有大幅进步，社区防治工作取得了一定成果，疾病后的康复工作愈发受到重视，医疗器械研发处于高速发展阶段。

关键词: 心血管疾病, 流行病学, 健康影响因素, 危险因素, 患病率, 死亡率, 社区防治, 康复, 基础研究, 器械研发, 费用, 医疗

Abstract:

The prevalence and incidence of cardiovascular diseases (CVD) are increasing in Chinese residents due to ever-deepening influence of associated risks caused by socioeconomic factors (such as the acceleration of population aging and urbanization) and lifestyle changes (such as recently emerged unhealthy lifestyle factors) . In 2019, CVD-related death accounted for 46.74% and 44.26% of all deaths occurring in China's rural and urban areas, respectively. Two out of every five deaths were due to CVD. It is estimated that about 330 million individuals suffer from CVD in China, among whom the number of those suffering from stroke, coronary heart disease, heart failure, pulmonary heart disease, atrial fibrillation, rheumatic heart disease, congenital heart disease, lower extremity artery disease and hypertension is 13 million, 11.39 million, 8.9 million, 5 million, 4.87 million, 2.5 million, 2 million, 45.3 million and 245 million, respectively. In 2019, the total hospitalization costs were 313.366 billion yuan for cardiovascular and cerebrovascular diseases. The burden of CVD is continually increasing, especially in rural areas. The mortality of coronary heart disease and cerebrovascular disease consistently exceeded the urban level in recent years due to unequal allocation of healthcare resources, low awareness of such diseases and poor compliance to the treatment. In the meantime, great progresses have been made in CVD prevention and control, such as decreased smoking prevalence, improved hypertension control rate, significantly improved clinical diagnosis, treatment and basic research, and enhanced community-based containment of CVD. Moreover, relevant rehabilitation has been increasingly valued, and the research and development of medical devices are in a rapid stage of progress.

Key words: Cardiovascular disease, Epidemiology, Health influencing factors, Risk factors, Prevalence, Mortality, Community-based prevention and control, Rehabilitation, Basic research, Medical device development, Fees, medical

马丽媛,王增武,樊静,等. 《中国心血管健康与疾病报告2021》要点解读[J]. 中国全科医学, 2022, 25(27): 3331-3346. DOI: 10.12114/j.issn.1007-9572.2022.0506.
Liyuan MA,Zengwu WANG,Jing FAN, et al. An Essential Introduction to the Annual Report on Cardiovascular Health and Diseases in China (2021)[J]. Chinese General Practice, 2022, 25(27): 3331-3346. DOI: 10.12114/j.issn.1007-9572.2022.0506.

图/表 14

图1 1982—2012年中国居民碳水化合物、蛋白质和脂肪供能比变化趋势

Figure 1 Trend of ratio of carbohydrates，proteins and fats for providing energy in Chinese residents from 1982 to 2012

图2 中国≥15岁居民高血压患病率

Figure 2 Prevalence of hypertension in Chinese residents aged ≥15 years，1958—2002

图3 1991—2015年高血压知晓率、治疗率和控制率

Figure 3 Awareness，treatment and control rates of hypertension in Chinese adults aged ≥18 years from 1991 to 2015

图4 2002年与2015年中国≥18岁成人血脂水平比较注：TC=总胆固醇，LDL-C=低密度脂蛋白胆固醇，HDL-C=高密度脂蛋白胆固醇，TG=三酰甘油

Figure 4 Levels of blood lipids in Chinese adults aged ≥18 years in 2002 and 2015

图5 中国糖尿病患病率调查注：2002年为城市人群糖尿病患病率

Figure 5 Surveys of diabetes prevalence in China

图6 2000—2019年中国城乡居民心血管病死亡率变化

Figure 6 Changes in cardiovascular mortalities in urban and rural Chinese residents from 2000 to 2019

图7 2019年中国农村和城市居民主要疾病死因构成比

Figure 7 Proportion of major causes of death among rural and urban Chinese residents in 2019

图8 2002—2019年中国城乡地区冠心病死亡率变化趋势

Figure 8 Trends of coronary heart disease mortalities in urban and rural Chinese residents from 2002 to 2019

图9 2002—2019年中国城乡地区急性心肌梗死死亡率变化趋势

Figure 9 Trends of acute myocardial infarction mortalities in urban and rural Chinese residents from 2002 to 2019

图10 2003—2019年中国城乡居民脑血管病粗死亡率变化趋势

Figure 10 Trends of crude mortalities of cerebrovascular disease in urban and rural Chinese residents from 2003 to 2019

图11 2020年中国714家医院心脏和大血管手术占比

Figure 11 Proportion of cardiac and macrovascular surgeries in 714 hospitals of China in 2020

图12 1980—2019年中国CVD患者出院人次数变化趋势注：心血管病包括缺血性心脏病（心绞痛、急性心肌梗死及其他缺血性心脏病）、慢性风湿性心脏病、急性风湿热、肺栓塞、心律失常、心力衰竭、高血压（包括高血压性心脏病、高血压性肾脏病），其中2002年以前，缺血性心脏病在卫生统计年报中的名称是冠心病

Figure 12 Trend in the number of discharged cardiovascular disease patients in China from 1980 to 2019

图13 2004—2019年3种心血管病住院总费用变化趋势（当年价格）

Figure 13 Trend of the annual total hospitalization costs of three CVDs from 2004 to 2019（current year price）

图14 2004—2019年3种心血管病次均住院费用变化趋势（当年价格）

Figure 14 Trend of the average cost per hospitalization for three CVDs from 2004 to 2019（calculated at current year prices）

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