Menotti Alessandro, Lanti Mariapaola, Kromhout Daan, Blackburn Henry, Nissinen Aulikki, Dontas Anastasios, Kafatos Antony, Nedeljkovic Srecko, Adachi Hisashi
Association for Cardiac Research - Associazione per Ricerca Cardiologica, Via Latina 49, Rome 00179, Italy.
Eur J Epidemiol. 2007;22(11):747-54. doi: 10.1007/s10654-007-9176-4. Epub 2007 Sep 7.
Time trends in coronary heart disease (CHD) mortality during a 40-year follow-up were studied in the Seven Countries Study. Thirteen cohorts of men aged 40-59 at entry were enrolled in seven countries (USA, Finland, the Netherlands, Italy, Serbia, Greece and Japan) for a total of 10,628 subjects. Cardiovascular risk factors were measured at entry and at the 10-year follow-up examination and coronary heart disease mortality data collected during 40 years. During the 40-year follow-up, the hazard rate of the Weibull parametric distribution (annual conditional risk of death) for CHD mortality tended to slightly decline in the US, Finnish, Dutch and Japanese cohorts, moderately increased in Italy and exponentially increased in cohorts of Serbia and Greece. A strong positive association was found between the shape of the hazard curve, describing the acceleration of the hazard, and a score of population mean risk factor changes (serum cholesterol, systolic blood pressure and smoking prevalence) observed during the first 10 years of follow-up, with a correlation coefficient of 0.91 between the two indicators. The countries with a relative decline in the annual hazard function were the same where, during the same historical period, large decreases in official death rate from CHD were recorded, and viceversa. The acceleration in mortality risk for CHD mortality in different countries, described by the shape of the Weibull distribution, is related to changes in mean levels of major coronary risk factors.
在七国研究中，对冠心病（CHD）死亡率在40年随访期间的时间趋势进行了研究。七个国家（美国、芬兰、荷兰、意大利、塞尔维亚、希腊和日本）招募了13组初始年龄为40 - 59岁的男性，共计10628名受试者。在入组时和10年随访检查时测量心血管危险因素，并收集40年期间的冠心病死亡率数据。在40年随访期间，美国、芬兰、荷兰和日本队列中冠心病死亡率的威布尔参数分布的危险率（年度条件死亡风险）趋于略有下降，意大利队列中适度增加，塞尔维亚和希腊队列中呈指数增加。在描述危险加速的危险曲线形状与随访前10年观察到的人群平均危险因素变化评分（血清胆固醇、收缩压和吸烟率）之间发现了强烈的正相关，两个指标之间的相关系数为0.91。年度危险函数相对下降的国家与在同一历史时期冠心病官方死亡率大幅下降的国家相同，反之亦然。由威布尔分布形状描述的不同国家冠心病死亡率的死亡风险加速与主要冠心病危险因素平均水平的变化有关。
