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女性健康倡议中的腹主动脉瘤事件:队列研究

Abdominal aortic aneurysm events in the women's health initiative: cohort study.

作者信息

Lederle Frank A, Larson Joseph C, Margolis Karen L, Allison Matthew A, Freiberg Matthew S, Cochrane Barbara B, Graettinger William F, Curb J David

机构信息

VA Medical Center, Minneapolis, MN 55417, USA.

出版信息

BMJ. 2008 Oct 14;337:a1724. doi: 10.1136/bmj.a1724.

Abstract

OBJECTIVE

To assess the association between potential risk factors and subsequent clinically important abdominal aortic aneurysm events (repairs and ruptures) in women.

DESIGN

Large prospective observational cohort study with mean follow-up of 7.8 years.

SETTING

40 clinical centres across the United States.

PARTICIPANTS

161 808 postmenopausal women aged 50-79 enrolled in the women's health initiative.

MAIN OUTCOME MEASURES

Association of self reported or measured baseline variables with confirmed abdominal aortic aneurysm events assessed with multiple logistic regression.

RESULTS

Events occurred in 184 women and were strongly associated with age and smoking. Ever smoking, current smoking, and amount smoked all contributed independent risk. Diabetes showed a negative association (odds ratio 0.29, 95% confidence interval 0.13, 0.68), as did postmenopausal hormone therapy. Positive associations were also seen for height, hypertension, cholesterol lowering treatment, and coronary and peripheral artery disease.

CONCLUSIONS

Our findings confirm the strong positive associations of clinically important abdominal aortic aneurysm with age and smoking in women and the negative association with diabetes previously reported in men.

摘要

目的

评估女性潜在风险因素与随后发生的具有临床重要意义的腹主动脉瘤事件(修复和破裂)之间的关联。

设计

大型前瞻性观察性队列研究,平均随访7.8年。

地点

美国40个临床中心。

参与者

161808名年龄在50 - 79岁的绝经后女性参与了女性健康倡议研究。

主要观察指标

通过多因素逻辑回归评估自我报告或测量的基线变量与确诊的腹主动脉瘤事件之间的关联。

结果

184名女性发生了相关事件,且这些事件与年龄和吸烟密切相关。曾经吸烟、当前吸烟及吸烟量均构成独立风险因素。糖尿病呈负相关(比值比0.29,95%置信区间0.13,0.68),绝经后激素治疗也是如此。身高、高血压、降胆固醇治疗以及冠状动脉和外周动脉疾病也呈正相关。

结论

我们的研究结果证实,具有临床重要意义的腹主动脉瘤在女性中与年龄和吸烟呈强正相关,与先前在男性中报道的糖尿病呈负相关。

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