Objective To evaluate the 10-year risk of ischemic cardiovascular disease ICVD) in cormmunity residents aged 45-59 by using the National 10-year Risk Assessment for ICVD Scale and to investigate the community-based intervention effct.Methods From October 2013 to March 2014,by using cluster random sampling,we selected 5 from the 33 neighborhood committees in Shanghai Hudong Community,and in which the permanent residents aged 45-59 were recruited in this study.We obtained their baseline data [height,weight,level of total cholesterol (TC)] by questionnaire survey,physical examination and laboratory testing,and assessed their 10-year risk of ICVD by using the National 10-year Risk Assessment for ICVD Scale.Those who had 10-year moderate or high or extremely high risk of ICVD and needed intervention,were given 1-year intervention,including the clinical intervention,community health education and personalized health guidance based on their own conditions.Results Of the 690 participants,we obtained the complete data of 636 participants,including 439 with 10-year extremely low risk of ICVD,158 with 10-year low risk of ICVD,30 with 10-year moderate risk of ICVD,7 with 10 -year high risk of ICVD,and 2 with 10-year extremely high risk of ICVD.The 39 participants with 10-year moderate or high or extremely high risk of ICVD needed the 1-year intervention,but 34 finished it finally.After the intervention,in the 34 final participants,no significant changes in their BMI were observed (P ＞ 0.05);their systolic pressure and TC level significantly decreased (P ＜ 0.05);the proportion of smokers before and after intervention were 38.2％ (13/34),29.4％ (10/34) respectively,and 3 cases stopped smoking.After intervention,3 were found with 10-year extremely low risk of ICVD,and 10 with 10-year low risk of ICVD in male;in female,4 were found with 10-year extremely low risk of ICVD,10 with 10-year low risk of ICVD,6 with 10-year moderate risk of ICVD,and 1 with 10-year high risk of ICVD.Conclusion Middle-aged population are found to be with the risk of ICVD,and some of them need to be intervened immediately.Community-based early intervention given to the population who have the risk of ICVD but without syndromes can achieve good social and economic benefits.%目的 采用《国人缺血性心血管病(ICVD)十年发病危险度评估表》评估社区45 ～ 59岁居民10年ICVD的发病风险,并评价社区干预的效果.方法 2013年10月-2014年3月,按照随机整群抽样原则,随机选取上海市沪东社区33个居委会中的5个居委会,其中年龄为45 ～59岁的常住人口均纳入本研究.调查受试者基本情况,测量身高、体质量,检测总胆固醇水平,采用《国人缺血性心血管病(ICVD)十年发病危险度评估表》评估10年ICVD发病危险度.将发病危险度在中危及以上人群归为需进行社区干预者,进行为期1年的干预.干预方案采用临床干预和社区宣教相结合,并依据其自身情况进行个体化指导.结果 本研究共调查690例,获得完整资料者636例,其中10年ICVD发病危险度为极低危439例,低危158例,中危30例,高危7例,极高危2例.需进行社区干预39例,实际完成干预34例.中危及以上人群干预前后体质指数比较,差异无统计学意义(P＞0.05).中危及以上人群干预后收缩压、总胆固醇水平低于干预前(P＜0.05).中危及以上人群干预前吸烟率为38.2％ (13/34),经干预后有3例戒烟,干预后吸烟率为29.4％ (10/34).干预后,男性10年ICVD发病危险度为极低危3例,低危10例;女性10年ICVD发病危险度为极低危4例,低危10例,中危6例,高危1例.结论 ICVD的危险因素在中年人群中已经存在,部分已达到了亟待干预的状况,早期对无症状危险人群的社区干预具有较好的效果.
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