Terry Dellara F, Pencina Michael J, Vasan Ramachandran S, Murabito Joanne M, Wolf Philip A, Hayes Margaret Kelly, Levy Daniel, D'Agostino Ralph B, Benjamin Emelia J
Department of Geriatrics, Boston Medical Center, School of Medicine, Boston University, Boston, Massachusetts 02118, USA.
J Am Geriatr Soc. 2005 Nov;53(11):1944-50. doi: 10.1111/j.1532-5415.2005.00465.x.
To examine whether midlife cardiovascular risk factors predict survival and survival free of major comorbidities to the age of 85.
Prospective community-based cohort study.
Framingham Heart Study, Massachusetts.
Two thousand five hundred thirty-one individuals (1,422 women) who attended at least two examinations between the ages of 40 and 50.
Risk factors were classified at routine examinations performed between the ages of 40 and 50. Stepwise sex-adjusted logistic regression models predicting the outcomes of survival and survival free of morbidity to age 85 were selected from the following risk factors: systolic and diastolic blood pressure, total serum cholesterol, glucose intolerance, cigarette smoking, education, body mass index, physical activity index, pulse pressure, antihypertensive medication, and electrocardiographic left ventricular hypertrophy.
More than one-third of the study sample survived to age 85, and 22% of the original study sample survived free of morbidity. Lower midlife blood pressure and total cholesterol levels, absence of glucose intolerance, nonsmoking status, higher educational attainment, and female sex predicted overall and morbidity-free survival. The predicted probability of survival to age 85 fell in the presence of accumulating risk factors: 37% for men with no risk factors to 2% with all five risk factors and 65% for women with no risk factors to 14% with all five risk factors.
Lower levels of key cardiovascular risk factors in middle age predicted overall survival and major morbidity-free survival to age 85. Recognizing and modifying these factors may delay, if not prevent, age-related morbidity and mortality.
研究中年心血管危险因素是否能预测至85岁时的生存率及无主要合并症的生存率。
基于社区的前瞻性队列研究。
马萨诸塞州弗雷明汉心脏研究。
2531名个体（1422名女性），她们在40至50岁之间至少参加了两次检查。
在40至50岁时进行的常规检查中对危险因素进行分类。从以下危险因素中选择逐步进行性别调整的逻辑回归模型，以预测至85岁时的生存结果和无发病生存结果：收缩压和舒张压、总血清胆固醇、葡萄糖耐量异常、吸烟、教育程度、体重指数、身体活动指数、脉压、抗高血压药物治疗以及心电图左心室肥厚。
超过三分之一的研究样本存活至85岁，原始研究样本中有22%无发病存活。中年时较低的血压和总胆固醇水平、无葡萄糖耐量异常、不吸烟状态、较高的教育程度以及女性性别可预测总体生存和无发病生存。随着危险因素的累积，预测的85岁生存率下降：无危险因素的男性为37%，有所有五项危险因素的男性为2%；无危险因素的女性为65%，有所有五项危险因素的女性为14%。
中年时关键心血管危险因素水平较低可预测至85岁时的总体生存和无主要发病生存。认识并改变这些因素可能延缓（即使不能预防）与年龄相关的发病和死亡。
