Zhao Liancheng, Zhou Beifan, Li Ying, Yang Jun, Wu Yangfeng
Department of Epidemiology, Cardiovascular Institute and Fuwai Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing 100037, China.
Zhonghua Nei Ke Za Zhi. 2002 May;41(5):291-4.
To assess the relationship between low cardiovascular disease (CVD) risk and the mortalities of coronary heart disease (CHD), stroke, cancer and all causes as well as life expectancy in Chinese population.
CVD risk factors were surveyed in 1982 approximately 1985 for 30 thousand male and female participants aged 35 approximately 59 from 10 Chinese population groups including 3 groups of factory workers, 6 groups of farmers and 1 group of fishermen according a uniform protocol with standardized methods. Follow-up was carried out up to 1999 approximately 2000 and the causes of death were all documented. Low cardiovascular risk was defined as: SBP/DBP < 120/80 mm Hg without anti-hypertensive medication 2 weeks before the baseline survey, serum total cholesterol < 5.17 mmol/L, BMI > 18.5 but < 24 kg/m(2) and no smoking at baseline survey. Mortality rates of CHD and stroke, cancer and all causes the participants with low CVD risk were compared with the rest of the cohort and difference in life expectancy was estimated.
Out of the whole cohort of 30 560 participants, 24 900 with complete data were available for the present analysis. Among these, 4 542 participants (18.2%) were defined as low CVD risk group, including 959 (7.7%) men and 3 583 (28.9%) women. During a follow-up of 15.2 years on average, 243 deaths including 6 CHD, 15 stroke and 117 cancer deaths took place in low risk group, while 2 383 deaths including 182 CHD, 333 stroke, and 934 cancer deaths occurred in rest of the cohort. Cox proportional hazards model adjusted for age showed that the relative risks of death of CHD, stroke, cancer and all causes in low risk group were 0.51 (95% CI: 0.19 approximately 1.37), 0.30 (95% CI: 0.11 approximately 0.81), 0.86 (95% CI: 0.62 approximately 1.19) and 0.77 (95% CI: 0.62 approximately 0.96) for men and 0.11 (95% CI: 0.03 approximately 0.45), 0.31 (95% CI: 0.17 approximately 0.58), 0.84 (95% CI: 0.66 approximately 1.10) and 0.67 (95% CI: 0.56 approximately 0.79) for women, respectively. Life expectancy was 2.6 years longer for men and 4.0 years longer for women in the low risk group.
The mortality rates of CVD and all causes were lower and life expectancy was longer in the participants with low CVD risk. Keeping low risk profile may not only prevent from having CVD but also extend life expectancy.
评估中国人群中心血管疾病(CVD)低风险与冠心病(CHD)、中风、癌症及全因死亡率以及预期寿命之间的关系。
1982年至1985年期间,按照统一方案和标准化方法,对来自10个中国人群组(包括3组工厂工人、6组农民和1组渔民)的约3万名年龄在35至59岁之间的男性和女性参与者进行了CVD危险因素调查。随访至1999年至2000年,并记录所有死亡原因。低心血管风险定义为:在基线调查前2周未服用抗高血压药物时收缩压/舒张压<120/80 mmHg,血清总胆固醇<5.17 mmol/L,体重指数>18.5但<24 kg/m²,且在基线调查时不吸烟。将CVD低风险参与者的冠心病、中风、癌症及全因死亡率与队列中的其他参与者进行比较,并估计预期寿命的差异。
在整个30560名参与者队列中,有24900名具有完整数据可用于本分析。其中,4542名参与者(18.2%)被定义为CVD低风险组,包括959名(7.7%)男性和3583名(28.9%)女性。在平均15.2年的随访期间,低风险组发生了243例死亡,包括6例冠心病死亡、15例中风死亡和117例癌症死亡,而队列中的其他参与者发生了2383例死亡,包括182例冠心病死亡、333例中风死亡和934例癌症死亡。经年龄调整的Cox比例风险模型显示,低风险组男性冠心病、中风、癌症及全因死亡的相对风险分别为0.51(95%置信区间:0.19至1.37)、0.30(95%置信区间:0.11至0.81)、0.86(95%置信区间:0.62至1.19)和0.77(95%置信区间:0.62至0.96),女性分别为0.11(95%置信区间:0.03至0.45)、0.31(95%置信区间:0.17至0.58)、0.84(95%置信区间:0.66至1.10)和0.67(95%置信区间:0.56至0.79)。低风险组男性的预期寿命长2.6岁,女性长4.0岁。
CVD低风险参与者的CVD和全因死亡率较低,预期寿命较长。保持低风险状态不仅可以预防CVD,还可以延长预期寿命。