Simons Leon A, Simons Judith, Friedlander Yechiel, McCallum John
Lipid Research Department, University of NSW, St Vincent's Hospital, Sydney, Darlinghurst, NSW 2010, Australia.
Heart Lung Circ. 2009 Oct;18(5):330-3. doi: 10.1016/j.hlc.2009.05.001. Epub 2009 Aug 3.
Conventional risk factors for coronary heart disease (CHD) and ischaemic stroke (IS) have been well documented. This study examines whether there is a unique pattern of risk factors for each disease.
This is a prospective cohort study in Dubbo NSW which has followed 2805 men and women 60 years and older for 16 years since 1988-1989. CHD and IS events were identified by hospital record linkage. The independent contributions of risk factors to these events were evaluated in proportional hazards regression models.
CHD events (without stroke) occurred in 853 subjects (30.4/100). IS events (without CHD) occurred in 185 subjects (6.6/100). Some risk factors produced broadly similar prediction of CHD and IS events (male sex, current smoking, diabetes, LDL cholesterol, reduced peak expiratory flow, physical disability). Other factors potentially produced unique prediction of CHD (CHD at baseline, family history of CHD, HDL cholesterol, ApoB/ApoA1 ratio) or IS (stroke at baseline), or stronger prediction of IS compared with CHD (age, hypertension, atrial fibrillation).
CHD and IS may each have some unique predictors, but treatable risk factors have been demonstrated for both cardiovascular outcomes.
冠心病（CHD）和缺血性中风（IS）的传统危险因素已有充分记录。本研究旨在探讨这两种疾病的危险因素是否存在独特模式。
这是一项在新南威尔士州达博进行的前瞻性队列研究，自1988 - 1989年以来，对2805名60岁及以上的男性和女性进行了16年的随访。通过医院记录链接确定冠心病和缺血性中风事件。在比例风险回归模型中评估危险因素对这些事件的独立影响。
853名受试者发生冠心病事件（无中风，发病率为30.4/100）。185名受试者发生缺血性中风事件（无冠心病，发病率为6.6/100）。一些危险因素对冠心病和缺血性中风事件的预测大致相似（男性、当前吸烟、糖尿病、低密度脂蛋白胆固醇、呼气峰值流量降低、身体残疾）。其他因素可能对冠心病有独特的预测作用（基线时患冠心病、冠心病家族史、高密度脂蛋白胆固醇、载脂蛋白B/载脂蛋白A1比值）或对缺血性中风有独特的预测作用（基线时患中风），或者与冠心病相比，对缺血性中风的预测更强（年龄、高血压、心房颤动）。
冠心病和缺血性中风可能各有一些独特的预测因素，但已证明这两种心血管疾病结局都有可治疗的危险因素。
