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血压、肥胖和血脂指数与缺血性心脏病死亡率的关系:HUNT-II 研究。

Informativeness of indices of blood pressure, obesity and serum lipids in relation to ischaemic heart disease mortality: the HUNT-II study.

机构信息

Department of Public Health, Norwegian University of Science and Technology, Trondheim, Norway.

出版信息

Eur J Epidemiol. 2011 Jun;26(6):457-61. doi: 10.1007/s10654-011-9572-7. Epub 2011 Apr 3.

Abstract

The informativeness of blood pressure, obesity and serum lipids associated with cardiovascular events may depend on how the indices are expressed, and mid blood pressure, waist-to-hip ratio adjusted for body-mass index (BMI) and the ratio of total to HDL cholesterol may be more informative than other expressions. Our aim was to study the informativeness of indices of blood pressure, obesity and serum lipids associated with ischaemic heart disease mortality in a large, homogeneous population. Blood pressure, weight, height, waist and hip circumference, total and HDL cholesterol, and triglycerides were measured at baseline (1995-1997) in 28,158 men and 32,573 women. Information on deaths from ischaemic heart disease (IHD) was obtained from the Causes of Death Registry in Norway from baseline until the end of 2007. Informativeness was analysed using the difference in twice the log-likelihood of a Cox model with and without each index. During 11 years of follow-up, 597 men and 418 women had died from IHD. Systolic blood pressure in men and pulse pressure in women were the most informative predictors of blood pressure, and waist-to-hip ratio adjusted for BMI was the most informative expression of obesity in both men and women. Among serum lipids, the most informative predictor was the ratio of total cholesterol to HDL cholesterol. Using more informative expressions of conventional risk factors for ischemic heart disease may improve both the validity and precision of estimates of risk, and may be useful both clinically and for preventive purposes.

摘要

血压、肥胖和血清脂质与心血管事件相关的信息量可能取决于这些指标的表达方式,而中间血压、体重指数(BMI)校正的腰围与臀围比值以及总胆固醇与高密度脂蛋白胆固醇的比值可能比其他表达方式更具信息量。我们的目的是在一个大型同质人群中研究与缺血性心脏病死亡率相关的血压、肥胖和血清脂质指标的信息量。在基线(1995-1997 年)时,对 28158 名男性和 32573 名女性进行了血压、体重、身高、腰围和臀围、总胆固醇和高密度脂蛋白胆固醇、以及甘油三酯的测量。从挪威死因登记处获得了基线至 2007 年底因缺血性心脏病(IHD)导致的死亡信息。信息量通过使用 Cox 模型中包含和不包含每个指标的两倍对数似然差进行分析。在 11 年的随访期间,597 名男性和 418 名女性死于 IHD。男性的收缩压和女性的脉压是血压最具信息量的预测指标,而 BMI 校正的腰围与臀围比值是男性和女性肥胖最具信息量的表达。在血清脂质中,最具信息量的预测指标是总胆固醇与高密度脂蛋白胆固醇的比值。使用更具信息量的缺血性心脏病传统危险因素表达方式可能会提高风险估计的有效性和精确性,并且在临床和预防方面可能都有用。

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