Hatmi Zinat Nadia, Mahdavi-Mazdeh Mitra, Hashemi-Nazari Seyed Saeid, Hajighasemi Ebrahim, Nozari Behnaz, Mahdavi Azita
Department of Community Medicine, Tehran University of Medical Sciences, Tehran, Iran.
Acta Med Iran. 2011;49(6):368-74.
More than eighty percent of patients with coronary heart diseases (CHD) have conventional risk factors. Prevalence of well known risk factors seems to show a different pattern in younger patients and individual above 55 years. To evaluate the pattern of conventional CHD risk factors in healthy individuals in two different age groups. A large scale population based survey of 31999 individuals from ten medical centers was designed. Screening of risk factors was performed upon these protocols: taking medical history, physical examination and blood tests of complete blood cell counts, fasting blood sugar, lipid profile, urinalysis and creatinine. Prevalence of the risk factors in healthy people aged above 55 years were: 8.1% for systolic blood pressure (SBP)>140 mmHg, 3.8% for diastolic blood pressure (DBP)>90 mmHg, 13.9% for fasting blood glucose (FBS)≥126 Mg/dl, 36.9% for total cholesterol>200 Mg/dl, 19.2% for triglyceride (TG)>200 Mg/dl, 67.8% for HDL-c<40 Mg/dl, 27.2% for LDL-c>130 Mg/dl, 4.72 for TC/HDL-c ratio, 2.88 for LDL-c/HDL/c ratio and 4.24 for TG/HDL-c ratio. Prevalence of risk factors in individuals younger than 55 years were: 1.7% for SBP>140 mmHg, 1.2% for DBP>90 mmHg, 5.2% for FBS≥126 Mg/dl, 31.3% for TC>200 Mg/dl, 21.5% for TG>200 Mg/dl, 69.4% for HDL-c<40 Mg/dl, 23.2% for LDL-c>130 Mg/dl, 4.7 for TC/HDL-c ratio, 2.83 for LDL-c/HDL-c ratio and 4.43 for TG/HDL-c ratio. In univariate model of analysis: prevalence of the risk factors were significantly higher in age above 55 years than in people younger than 55 years except for hypertriglyceridemia and HDL-c<40 Mg/dl. In a multivariate model of logistic regression, pattern of following CHD risk factors remained to demonstrate a statistically significance difference between two age groups: FBS≥126 Mg/dl P=0.006, TG>200 Mg/dl P= 0.002, HDL-c<40 Mg/dl P= 0.019, education status P=0.001, sex P=0.012, and SBP>140 mmHg P=0.001. Pattern of such a CHD risk factors of FBS≥126 Mg/dl, TG>200 Mg/dl, HDL-c<40 Mg/dl, education status, sex and SBP>140 mmHg demonstrated a statistically significant difference in the age above 55 years to the healthy people younger than 55 years. These results cab be implicated to set up prediction models for stratifying individuals at higher risk of CHD.
超过80%的冠心病(CHD)患者具有传统危险因素。在年轻患者和55岁以上个体中,已知危险因素的患病率似乎呈现出不同的模式。为评估两个不同年龄组健康个体中传统冠心病危险因素的模式。设计了一项基于大规模人群的调查,对来自十个医疗中心的31999名个体进行研究。按照以下方案对危险因素进行筛查:采集病史、进行体格检查以及进行全血细胞计数、空腹血糖、血脂谱、尿液分析和肌酐的血液检测。55岁以上健康人群中危险因素的患病率分别为:收缩压(SBP)>140 mmHg为8.1%,舒张压(DBP)>90 mmHg为3.8%,空腹血糖(FBS)≥126 Mg/dl为13.9%,总胆固醇>200 Mg/dl为36.9%,甘油三酯(TG)>200 Mg/dl为19.2%,高密度脂蛋白胆固醇(HDL-c)<40 Mg/dl为67.8%,低密度脂蛋白胆固醇(LDL-c)>130 Mg/dl为27.2%,总胆固醇/高密度脂蛋白胆固醇(TC/HDL-c)比值为4.72,低密度脂蛋白胆固醇/高密度脂蛋白胆固醇(LDL-c/HDL/c)比值为2.88,甘油三酯/高密度脂蛋白胆固醇(TG/HDL-c)比值为4.24。55岁以下个体中危险因素的患病率分别为:SBP>140 mmHg为1.7%,DBP>90 mmHg为1.2%,FBS≥126 Mg/dl为5.2%,总胆固醇(TC)>200 Mg/dl为31.3%,TG>200 Mg/dl为21.5%,HDL-c<40 Mg/dl为69.4%,LDL-c>130 Mg/dl为23.2%,TC/HDL-c比值为4.7,LDL-c/HDL-c比值为2.83,TG/HDL-c比值为4.43。在单变量分析模型中:除高甘油三酯血症和HDL-c<40 Mg/dl外,55岁以上人群中危险因素的患病率显著高于55岁以下人群。在逻辑回归多变量模型中,以下冠心病危险因素模式在两个年龄组之间仍显示出统计学显著差异:FBS≥126 Mg/dl,P = 0.006;TG>200 Mg/dl,P = 0.002;HDL-c<40 Mg/dl,P = 0.019;教育状况,P = 0.001;性别,P = 0.012;SBP>140 mmHg,P = 0.001。FBS≥126 Mg/dl、TG>200 Mg/dl、HDL-c<40 Mg/dl、教育状况、性别和SBP>140 mmHg等冠心病危险因素模式在年龄55岁以上的健康人群与55岁以下的健康人群之间显示出统计学显著差异。这些结果可用于建立预测模型,以对冠心病高危个体进行分层。