Department of Evidence Based Medicine, Cardiovascular Institute and Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China.
Biomed Environ Sci. 2010 Feb;23(1):37-41. doi: 10.1016/S0895-3988(10)60029-3.
Total cholesterol (TC) is an important risk factor for myocardial infarction (MI), but the effect of TC on MI in Chinese male hypertension population has not been well documented. We conducted a prospective cohort study to determine the incidence and relative risk for MI across a wide range of TC levels in Chinese male hypertension population.
A cohort of 5298 male employees aged 18-74 years recruited from Capital Steel and Iron Company in Beijing of China in 1974-1980 was followed up for an average of 20.84 years. A total of 122 incident MI cases were identified during the period of follow-up.
The incidence of MI among participants with elevated TC and those with desirable TC in male non-hypertension population was 137.20 and 63.81 per 100,000 person-years, respectively; and the corresponding incidence in male hypertension population was 279.80 and 130.96 per 100,000 person-years, respectively. After adjustment for important covariables, 10.38%, 16.71%, and 23.80% of MI cases were attributable to hypertension, elevated TC, and hypertension plus elevated TC, respectively. In male hypertension population, the multivariate adjusted hazard ratios of MI were 1.21, 2.39, 3.38, and 3.95 for participants with TC level of 5.17-5.68, 5.69-6.20, 6.21-6.71, and > or = 6.72 mmol/L, compared with those with TC < 5.17 mmol/L. The corresponding population attributable risks were 2.92%, 9.20%, 8.87%, and 9.84%, respectively.
Elevated TC is an important independent risk factor of MI both in male non-hypertension and hypertension populations. There is a linear association between TC level and MI incidence in Chinese male hypertension population.
总胆固醇（TC）是心肌梗死（MI）的一个重要危险因素，但 TC 对中国男性高血压人群中 MI 的影响尚未得到很好的证实。我们进行了一项前瞻性队列研究，以确定在中国男性高血压人群中，TC 水平广泛范围内 MI 的发生率和相对风险。
1974-1980 年，我们从中国北京首都钢铁公司招募了 5298 名年龄在 18-74 岁的男性员工，对他们进行了平均 20.84 年的随访。在随访期间共发现 122 例 MI 事件。
在男性非高血压人群中，TC 升高组和 TC 理想组的 MI 发生率分别为每 10 万人年 137.20 和 63.81 例；而在男性高血压人群中，这一发生率分别为每 10 万人年 279.80 和 130.96 例。在调整了重要的协变量后，高血压、TC 升高和高血压合并 TC 升高分别导致 10.38%、16.71%和 23.80%的 MI 病例。在男性高血压人群中，TC 水平为 5.17-5.68、5.69-6.20、6.21-6.71 和≥6.72mmol/L 的参与者发生 MI 的多变量调整后的危险比分别为 1.21、2.39、3.38 和 3.95，与 TC<5.17mmol/L 的参与者相比。相应的人群归因风险分别为 2.92%、9.20%、8.87%和 9.84%。
TC 升高是男性非高血压和高血压人群中 MI 的一个重要独立危险因素。在中国男性高血压人群中，TC 水平与 MI 发生率之间存在线性关联。
