Department of Biostatistics, School of Public Health, University of Alabama at Birmingham, Birmingham, AL, USA.
Prev Med. 2009 Aug-Sep;49(2-3):129-32. doi: 10.1016/j.ypmed.2009.03.004. Epub 2009 Mar 11.
Geographic variation in risk factors may underlie geographic disparities in coronary heart disease (CHD) and stroke mortality.
Framingham CHD Risk Score (FCRS) and Stroke Risk Score (FSRS) were calculated for 25,770 stroke-free and 22,247 CHD-free participants from the REasons for Geographic And Racial Differences in Stroke cohort. Vital statistics provided age-adjusted CHD and stroke mortality rates. In an ecologic analysis, the age-adjusted, race-sex weighted, average state-level risk factor levels were compared to state-level mortality rates.
There was no relationship between CHD and stroke mortality rates (r=0.04; p=0.78), but there was between CHD and stroke risk scores at the individual (r=0.68; p<0.0001) and state (r=0.64, p<0.0001) level. There was a stronger (p<0.0001) association between state-level FCRS and state-level CHD mortality (r=0.28, p=0.18), than between FSRS and stroke mortality (r=0.12, p=0.56).
Weak associations between CHD and stroke mortality and strong associations between CHD and stroke risk scores suggest that geographic variation in risk factors may not underlie geographic variations in stroke and CHD mortality. The relationship between risk factor scores and mortality was stronger for CHD than stroke.
危险因素的地理差异可能是冠心病（CHD）和中风死亡率的地理差异的基础。
从弗雷明汉心脏病风险评分（FCRS）和中风风险评分（FSRS）计算了 25770 例无中风和 22247 例无 CHD 的参与者。生命统计数据提供了年龄调整后的 CHD 和中风死亡率。在生态分析中，将年龄调整后的、种族性别加权的、平均州级危险因素水平与州级死亡率进行了比较。
CHD 和中风死亡率之间没有关系（r=0.04；p=0.78），但个体（r=0.68；p<0.0001）和州（r=0.64，p<0.0001）水平的 CHD 和中风风险评分之间存在关系。州级 FCRS 与州级 CHD 死亡率（r=0.28，p=0.18）之间的相关性更强（p<0.0001），而 FSRS 与中风死亡率（r=0.12，p=0.56）之间的相关性较弱。
CHD 和中风死亡率之间的关联较弱，CHD 和中风风险评分之间的关联较强，这表明危险因素的地理差异可能不是中风和 CHD 死亡率的地理差异的基础。危险因素评分与死亡率之间的关系对于 CHD 比中风更强。
