Menotti A, Giampaoli S, Seccareccia F
Division of Epidemiology, School of Public Health, University of Minnesota, 1300 South Second Street, Minneapolis, MN 55454-1015, USA.
Arch Gerontol Geriatr. 1998 Mar-Apr;26(2):99-111. doi: 10.1016/s0167-4943(97)00035-6.
The objective was to study the relationship of cardiovascular risk factors measured at different ages to all-cause mortality in a population-based sample of middle-aged Italian men over a 30-year period. Two rural populations of men aged 40-59 were examined in 1960 (n=1712, participation rate 98.8%). Cardiovascular disease risk factors measured at year 0, 10 and 20 were used for the multivariate prediction of all-cause mortality during 30, 20 and 10 years, respectively. In men aged 40-59 with follow-up of 30 years, age, systolic blood pressure, serum cholesterol, cigarette smoking, body mass index, arm circumference (inverse), vital status of father and mother, forced expiratory volume (inverse), arcus senilis and xanthelasma were strong, significant predictors of mortality. In men aged 50-69 followed for 20 years, age, systolic blood pressure, cigarette smoking, vital capacity (inverse), body mass index and arcus senilis were strong, significant predictors of mortality. In men aged 60-79 followed 10 years only age, arm circumference (inverse) and arcus senilis were significant predictors of mortality (respiratory measurements were not available). On two occasions body mass index and serum cholesterol showed curvilinear relationships with mortality (U-shaped). It is concluded that cardiovascular disease risk factors are strong predictors of all-cause mortality. Their predictive power (relative risk) declines with age. Some factors, such as body mass index and serum cholesterol level, show curvilinear relationship to mortality with greater age.
目的是在一个基于人群的意大利中年男性样本中，研究不同年龄测量的心血管危险因素与全因死亡率在30年期间的关系。1960年对两个年龄在40 - 59岁的农村男性人群进行了检查（n = 1712，参与率98.8%）。在第0年、第10年和第20年测量的心血管疾病危险因素分别用于对30年、20年和10年期间的全因死亡率进行多变量预测。在随访30年的40 - 59岁男性中，年龄、收缩压、血清胆固醇、吸烟、体重指数、臂围（反向）、父母的生命状态、用力呼气量（反向）、角膜弓和睑黄瘤是死亡率的强有力的显著预测因素。在随访20年的50 - 69岁男性中，年龄、收缩压、吸烟、肺活量（反向）、体重指数和角膜弓是死亡率的强有力的显著预测因素。在仅随访10年的60 - 79岁男性中，只有年龄、臂围（反向）和角膜弓是死亡率的显著预测因素（无法获得呼吸测量值）。体重指数和血清胆固醇在两个时间点与死亡率呈现曲线关系（U形）。结论是心血管疾病危险因素是全因死亡率的强有力预测因素。它们的预测能力（相对风险）随年龄下降。一些因素，如体重指数和血清胆固醇水平，与年龄较大时的死亡率呈现曲线关系。
