Rodin Miriam B, Daviglus Martha L, Wong Gordon C, Liu Kiang, Garside Daniel B, Greenland Philip, Stamler Jeremiah
Division of Geriatrics, Department of Medicine, University of Chicago Pritzker School of Medicine, Chicago, USA.
Hypertension. 2003 Jul;42(1):61-8. doi: 10.1161/01.HYP.0000078829.02288.98. Epub 2003 Jun 9.
Few prospective studies have examined associations between major cardiovascular risk factors and occurrence of abdominal aortic aneurysm; findings from cross-sectional studies are inconsistent. This long-term population-based study assessed relationships of major risk factors in middle-age to clinical nonfatal plus fatal abdominal aortic aneurysm in older-age in the Chicago Heart Association Detection Project in Industry cohort--10 574 men and 8700 women baseline ages 40 to 64 years screened for risk factors in 1967-1973 at workplaces. With average follow-up of 30 years and clinical cases identified from Medicare records and death certificates, risk factor relationships to abdominal aortic aneurysm occurrence were assessed by Cox regression. There were among men 309 cases and among women, 109--most from Medicare records. Most findings were qualitatively similar for men and women. In multivariate analyses (5 models), hazard ratios for abdominal aortic aneurysm were significantly greater for men than women (> or =1.97), with older age (> or =1.63/5 years), higher serum cholesterol (> or =1.30/40.0 mg/dL), cigarettes/d (> or =2.43/20 cigarettes), past smoking (> or =1.41), height (> or =1.17/7 cm), evidence of adverse blood pressure (hazard ratio 1.10/20 mm Hg higher systolic pressure, 1.12 to 1.14/12 mm Hg higher diastolic pressure, 1.87 with history of treated hypertension). It is concluded that major cardiovascular risk factors--serum cholesterol, smoking, and blood pressure--in middle age relate significantly to risk of abdominal aortic aneurysm in persons surviving into older age.
很少有前瞻性研究探讨主要心血管危险因素与腹主动脉瘤发生之间的关联；横断面研究的结果并不一致。这项基于人群的长期研究评估了芝加哥心脏协会工业队列检测项目中中年主要危险因素与老年临床非致命性加致命性腹主动脉瘤之间的关系——1967年至1973年在工作场所对10574名男性和8700名女性进行了基线年龄40至64岁的危险因素筛查。平均随访30年，从医疗保险记录和死亡证明中确定临床病例，通过Cox回归评估危险因素与腹主动脉瘤发生的关系。男性中有309例，女性中有109例——大多数来自医疗保险记录。男性和女性的大多数研究结果在定性上相似。在多变量分析（5个模型）中，男性腹主动脉瘤的风险比显著高于女性（≥1.97），年龄较大（≥1.63/5岁）、血清胆固醇较高（≥1.30/40.0mg/dL）、每天吸烟量（≥2.43/20支香烟）、既往吸烟史（≥1.41）、身高较高（≥1.17/7cm）、有不良血压证据（收缩压每升高20mmHg风险比为1.10，舒张压每升高12mmHg风险比为1.12至1.14，有高血压治疗史风险比为1.87）。结论是，中年时主要的心血管危险因素——血清胆固醇、吸烟和血压——与活到老年的人群腹主动脉瘤风险显著相关。
