Strachan D P
Department of Epidemiology and Population Sciences, London School of Hygiene and Tropical Medicine, UK.
Br J Surg. 1991 Apr;78(4):401-4. doi: 10.1002/bjs.1800780407.
Among 18,403 male civil servants examined at age 40-64 years there were 99 deaths attributed to aortic aneurysm during 18 years of follow-up. Each case was matched by age to ten controls who survived longer than the case. The risk of all types of fatal aneurysm was substantially increased for current smokers of manufactured cigarettes (rate ratio compared with lifelong non-smokers = 6.5; 95 per cent confidence interval 2.3-18.7), pipe or cigars (6.7; 1.7-26.5) and hand-rolled cigarettes (25.0; 7.5-83.3). Diastolic blood pressure was strongly associated with dissecting aneurysm (rate ratio per 10 mmHg increase = 2.4; 95 per cent confidence interval 1.7-3.2) and abdominal aneurysm (1.5; 1.2-1.9) but not other aneurysms (1.0; 0.7-1.5). The independent effects of height, adiposity, plasma cholesterol, glucose intolerance, reported angina and intermittent claudication were not significant. Hypertension and smoking, particularly of hand-rolled cigarettes, are confirmed as major and potentially remediable risk factors for fatal aortic aneurysm.
在18403名年龄在40 - 64岁的男性公务员中，有99人在18年的随访期间死于主动脉瘤。每例病例按年龄与10名存活时间长于该病例的对照进行匹配。对于吸机制卷烟的现吸烟者（与终生不吸烟者相比的率比=6.5；95%置信区间2.3 - 18.7）、吸烟斗或雪茄者（6.7；1.7 - 26.5）以及吸手卷烟者（25.0；7.5 - 83.3），所有类型致命性动脉瘤的风险均大幅增加。舒张压与夹层动脉瘤（每升高10 mmHg的率比=2.4；95%置信区间1.7 - 3.2）和腹主动脉瘤（1.5；1.2 - 1.9）密切相关，但与其他动脉瘤无关（1.0；0.7 - 1.5）。身高、肥胖、血浆胆固醇、葡萄糖耐量异常、报告的心绞痛和间歇性跛行的独立影响不显著。高血压和吸烟，尤其是吸手卷烟，被确认为致命性主动脉瘤的主要且可能可纠正的危险因素。
