Wang Wei, Zhao Dong, Liu Jing, Zeng Zhe-chun, Sun Jia-yi, Liu Jun, Qin Lan-ping, Wu Zhao-su
Department of Epidemiology, Institute of Beijing Heart, Lung and Blood Vessel Diseases, Beijing 100029, China.
Zhonghua Xin Xue Guan Bing Za Zhi. 2006 Feb;34(2):169-73.
To evaluate the association between serum total cholesterol (TC) and the risk of cardiovascular diseases (CVD) in subjects aged 35-64 years.
This prospective study was performed from 1992 to 2002 in 11 provinces of China and the association between baseline TC level and the development of cardiovascular diseases was analyzed in 30 384 subjects aged 35-64 years using Cox multivariate proportional hazards regression.
(1) Compared with the group of TC < 3.64 mmol/L (140 mg/dl), multivariate-adjusted relative risk of ischemic cardiovascular disease (ICVD, including CHD and ischemic stroke) increased continuously with increasing TC level. (2) TC level was positively related to the occurrence of ischemic stroke, but not to hemorrhagic stroke. The risk of CHD increased by 74% (RR = 1.743) and the risk of ischemic stroke increased by 12% (RR = 1.119) in the group with TC > or = 5.72 mmol/L compared with the group with TC < 5.72 mmol/L (220 mg/dl). (3) High serum cholesterol was responsible to 5.9% of ICVD, 11.7% of the acute CHD and 2.9% of the acute stroke. (4) At each TC level, the 10-year risk of ICVD increased in the presence of other risk factors.
Starting from TC of 3.64 mmol/L, the risk of ICVD increases continuously with increasing TC level. Multiple risk factor intervention should be strengthened to reduce the overall risk of CVD.
评估35 - 64岁人群血清总胆固醇（TC）与心血管疾病（CVD）风险之间的关联。
这项前瞻性研究于1992年至2002年在中国11个省份开展，采用Cox多变量比例风险回归分析了30384名35 - 64岁受试者的基线TC水平与心血管疾病发生之间的关联。
（1）与TC < 3.64 mmol/L（140 mg/dl）组相比，缺血性心血管疾病（ICVD，包括冠心病和缺血性中风）的多变量调整相对风险随TC水平升高而持续增加。（2）TC水平与缺血性中风的发生呈正相关，但与出血性中风无关。与TC < 5.72 mmol/L（220 mg/dl）组相比，TC≥5.72 mmol/L组的冠心病风险增加74%（RR = 1.743），缺血性中风风险增加12%（RR = 1.119）。（3）高血清胆固醇导致5.9%的ICVD、11.7%的急性冠心病和2.9%的急性中风。（4）在每个TC水平，存在其他危险因素时ICVD的10年风险都会增加。
从TC 3.64 mmol/L开始，ICVD风险随TC水平升高而持续增加。应加强多危险因素干预以降低CVD的总体风险。
