Jensen G, Nyboe J, Appleyard M, Schnohr P
Copenhagen City Heart Study, Medical Department B, Rigshospitalet, Denmark.
Eur Heart J. 1991 Mar;12(3):298-308. doi: 10.1093/oxfordjournals.eurheartj.a059894.
The Copenhagen City Heart Study is a prospective cardiovascular population study designed to evaluate incidence of, and risk factors for, cardiovascular disease. A random sample, comprising approximately 20,000 people, were invited to participate. Initial information about potential risk factors was collected during 1976-78 (attendance rate 74%); data about 389 new cases of first acute myocardial infarction (AMI) was obtained from a second survey in 1981-83, as well as from hospital and death registers up to 31 December 1983. The average observation period was 6.5 years. Cox's regression model was used for data analysis. Some 'basic' factors, namely age, sex, family history of AMI, early parental death, height, earlobe crease, length of school education, income and living alone or with a partner were dealt with in a previous paper and are among the potential risk factors for AMI included in the Copenhagen City Heart Study. In this analysis we also include life-style characteristics, some biological traits and disease conditions. An increased risk for first AMI among smokers was graded: the estimated relative risk (ERR) for heavy smokers consuming more than 29g tobacco per day was 2.8 relative to non-smokers. Alcohol intake of five or more drinks per day was associated with a decreased risk, an ERR of 0.6 relative to those who did not drink alcohol daily. Physical inactivity during work but not at leisure was associated with increased risk (ERR 1.4) as was body mass index where the risk was mediated mainly through blood pressure and plasma triglycerides. Oral contraception was not associated with an increased risk, whereas with diabetes the risk increased (the ERR for diabetes being 1.8). Plasma cholesterol above the level of approximately 7 mmol l-1 proportionally increased risk; the ERR in the 1.5% with the highest level was 3.7. A low triglyceride level was associated with low risk; the ERR in the fifth of the study population with the lowest level was 0.6. Elevated blood pressure also proportionally increased risk. Subjects on antihypertensive drug treatment had higher risk than non-treated subjects with similar blood pressure. The effect of socioeconomic factors described in the previous paper was not mediated through their influence on the risk factors included in the present analysis.
哥本哈根城市心脏研究是一项前瞻性心血管人群研究，旨在评估心血管疾病的发病率及其危险因素。研究邀请了一个约20000人的随机样本参与。1976 - 1978年期间收集了有关潜在危险因素的初始信息（参与率74%）；1981 - 1983年的第二次调查以及截至1983年12月31日的医院和死亡登记数据获取了389例首次急性心肌梗死（AMI）新病例。平均观察期为6.5年。采用Cox回归模型进行数据分析。一些“基本”因素，即年龄、性别、AMI家族史、父母早亡、身高、耳垂折痕、受教育年限、收入以及独居或与伴侣同住等，已在先前的一篇论文中论述过，它们是哥本哈根城市心脏研究中所包含的AMI潜在危险因素。在本分析中，我们还纳入了生活方式特征、一些生物学特征和疾病状况。吸烟者首次发生AMI的风险增加程度分为不同等级：每天吸烟超过29克的重度吸烟者相对于不吸烟者的估计相对风险（ERR）为2.8。每天饮酒五杯或更多与风险降低相关，相对于不每天饮酒者，ERR为0.6。工作时而非休闲时身体活动不足与风险增加相关（ERR 1.4），体重指数也是如此，其风险主要通过血压和血浆甘油三酯介导。口服避孕药与风险增加无关，而糖尿病则使风险增加（糖尿病的ERR为1.8）。血浆胆固醇高于约7 mmol/l水平会按比例增加风险；处于最高水平的1.5%人群的ERR为3.7。低甘油三酯水平与低风险相关；研究人群中甘油三酯水平最低的五分之一人群的ERR为0.6。血压升高也会按比例增加风险。接受抗高血压药物治疗的受试者比血压相似但未接受治疗的受试者风险更高。先前论文中描述的社会经济因素的影响并非通过其对本分析中所包含的危险因素的影响来介导。
