世界卫生组织MONICA项目人群中的当前吸烟情况与非致死性心肌梗死风险
Current smoking and the risk of non-fatal myocardial infarction in the WHO MONICA Project populations.
作者信息
Mähönen M S, McElduff P, Dobson A J, Kuulasmaa K A, Evans A E
机构信息
Department of Epidemiology and Health Promotion, KTL-National Public Health Institute, Mannerheimintie 166, FIN-00300 Helsinki, Finland; markku.mahonen.ktl.fi.
出版信息
Tob Control. 2004 Sep;13(3):244-50. doi: 10.1136/tc.2003.003269.
BACKGROUND
Cohort studies have shown that smoking has a substantial influence on coronary heart disease mortality in young people. Population based data on non-fatal events have been sparse, however.
OBJECTIVE
To study the impact of smoking on the risk of non-fatal acute myocardial infarction (MI) in young middle age people.
METHODS
From 1985 to 1994 all non-fatal MI events in the age group 35-64 were registered in men and women in the WHO MONICA (multinational monitoring of trends and determinants in cardiovascular disease) project populations (18,762 events in men and 4047 in women from 32 populations from 21 countries). In the same populations and age groups 65,741 men and 66,717 women participated in the surveys of risk factors (overall response rate 72%). The relative risk of non-fatal MI for current smokers was compared with non-smokers, by sex and five year age group.
RESULTS
The prevalence of smoking in people aged 35-39 years who experienced non-fatal MI events was 81% in men and 77% in women. It declined with increasing age to 45% in men aged 60-64 years and 36% in women, respectively. In the 35-39 years age group the relative risk of non-fatal MI for smokers was 4.9 (95% confidence interval (CI) 3.9 to 6.1) in men and 5.3 (95% CI 3.2 to 8.7) in women, and the population attributable fractions were 65% and 55%, respectively.
CONCLUSIONS
During the study period more than half of the non-fatal MIs occurring in young middle age people can be attributed to smoking.
背景
队列研究表明，吸烟对年轻人的冠心病死亡率有重大影响。然而，基于人群的非致命性事件的数据却很稀少。
目的
研究吸烟对中青年非致命性急性心肌梗死（MI）风险的影响。
方法
1985年至1994年期间，世界卫生组织MONICA（心血管疾病趋势和决定因素多国监测）项目人群中35至64岁年龄组的所有非致命性MI事件均进行了登记（来自21个国家32个人群的18762例男性事件和4047例女性事件）。在相同人群和年龄组中，65741名男性和66717名女性参与了危险因素调查（总体应答率72%）。按性别和五年年龄组比较当前吸烟者与非吸烟者发生非致命性MI的相对风险。
结果
发生非致命性MI事件的35至39岁人群中，男性吸烟率为81%，女性为77%。随着年龄增长，男性吸烟率降至60至64岁时的45%，女性降至36%。在35至39岁年龄组中，吸烟者发生非致命性MI的相对风险男性为4.9（95%置信区间（CI）3.9至6.1），女性为5.3（95%CI 3.2至8.7），人群归因分数分别为65%和55%。
结论
在研究期间，中青年发生的非致命性MI中，超过一半可归因于吸烟。
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