Fraser G E, Strahan T M, Sabaté J, Beeson W L, Kissinger D
Center for Health Research, Loma Linda University School of Public Health, CA 92350.
Circulation. 1992 Aug;86(2):406-13. doi: 10.1161/01.cir.86.2.406.
California Seventh-Day Adventists have lower mortality rates from coronary heart disease (CHD) than other Californians. Associations between traditional risk factor and CHD events have not been reported previously for Adventists.
A cohort study allowed 6 years of follow-up of 27,658 male and female California Seventh-Day Adventists. Data collected included age, sex, physician-diagnosed hypertension and diabetes mellitus, body height, weight, previous and current cigarette smoking habits, and current exercise habits. Incident cases of definite myocardial infarction (MI) and definite fatal CHD were diagnosed according to recognized criteria. Both stratified and proportional hazards analyses demonstrated that in this low-risk population, the above traditional coronary risk factors exhibit their usual associations with risk of CHD events. It was noted that exercise had a strong negative association with fatal CHD events (relative risks [RR], 1.0, 0.66, and 0.50 with increasing exercise) but no association with risk of MI (either nonfatal or all cases). Conversely, obesity was much more clearly associated with MI (RR, 1.0, 1.18, and 1.83 with increasing tertiles of obesity) than with fatal events. The importance of the risk factors was similar in both sexes, except that the effect of cigarette smoking seemed more pronounced in women.
The epidemiology of coronary heart disease in this low-risk California population appears to be at least qualitatively similar to that seen in other groups. There was evidence that the effects of exercise and obesity may differ depending on whether fatal CHD and MI (either all MI or nonfatal alone) is the end point.
加利福尼亚州的基督复临安息日会信徒患冠心病（CHD）的死亡率低于其他加利福尼亚人。此前尚未有关于基督复临安息日会信徒传统风险因素与冠心病事件之间关联的报道。
一项队列研究对27658名加利福尼亚州的基督复临安息日会男女信徒进行了6年的随访。收集的数据包括年龄、性别、医生诊断的高血压和糖尿病、身高、体重、既往和当前的吸烟习惯以及当前的运动习惯。根据公认标准诊断明确的心肌梗死（MI）和明确的致命性冠心病事件。分层分析和比例风险分析均表明，在这个低风险人群中，上述传统的冠心病风险因素与冠心病事件风险呈现出常见的关联。值得注意的是，运动与致命性冠心病事件呈强烈负相关（相对风险[RR]分别为1.0、0.66和0.50，运动增加时），但与MI风险（非致命性或所有病例）无关。相反，肥胖与MI的关联（RR分别为1.0、1.18和1.83，肥胖三分位数增加时）比与致命事件的关联更为明显。除吸烟对女性的影响似乎更显著外，风险因素在两性中的重要性相似。
在这个低风险的加利福尼亚人群中，冠心病的流行病学至少在质量上与其他群体相似。有证据表明，根据终点是致命性冠心病还是MI（所有MI或仅非致命性MI），运动和肥胖的影响可能有所不同。
