在一项基于横断面人群的队列研究中，心血管疾病的数量和负担与健康相关生活质量的关系。
Number and burden of cardiovascular diseases in relation to health-related quality of life in a cross-sectional population-based cohort study.
机构信息
Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden.
出版信息
BMJ Open. 2012 Oct 25;2(5). doi: 10.1136/bmjopen-2012-001554. Print 2012.
OBJECTIVES
To clarify whether a greater number of cardiovascular diseases or a larger burden of disease are associated with poorer health-related quality of life (HRQoL) in an unselected general population.
DESIGN
A population-based cross-sectional postal survey.
SETTINGS
A random sample of the Swedish general population aged 40-79 years matched for national distributions of age, gender and region.
PARTICIPANTS
Out of 6969 eligible individuals, 4910 (70.5%) participated. PRIMARY AND SECONDARY MEASURES: To create a reference database for HRQoL outcomes in the general population. To assess certain diseases and their relation to HRQoL.
METHODS
Predefined cardiovascular diseases and HRQoL were assessed from validated questionnaires (EORTC QLQ-C30). Aspects of HRQoL included in the analyses were global quality of life, physical function, role function, emotional function, fatigue and dyspnoea. Individuals were categorised into: 'good function' versus 'poor function' and 'no or minor symptoms' versus 'symptomatic'. Multivariable logistic regression calculated OR with 95% CI for poor HRQoL. The exposures were the number of cardiovascular diseases and the subjective disease burden.
RESULTS
Out of the 4910 participants, 1358 (28%) reported having a cardiovascular disease and hypertension was most common. Reporting a greater number of cardiovascular diseases was associated with an increased risk of poor HRQoL, especially regarding dyspnoea. The OR for symptomatic dyspnoea was 1.37 (95% CI 1.08 to 1.74) for participants with one cardiovascular disease, 4.81 (95% CI 3.24 to 7.13) for two diseases and 4.18 (95% CI 2.24 to 7.80) for those with three or more cardiovascular diseases. Among the 271 participants who assessed their cardiovascular disease burden as major, the highest risk for poor HRQoL was found for physical function (OR 6.18, 95% CI 3.72 to 10.30).
CONCLUSIONS
Increased number of cardiovascular diseases and a greater burden of disease are generally associated with poorer HRQoL in people with cardiovascular disease from an unselected population.
目的
明确在未选择的一般人群中，是否有更多的心血管疾病或更大的疾病负担与较差的健康相关生活质量（HRQoL）相关。
设计
基于人群的横断面邮寄调查。
设置
按年龄、性别和地区的全国分布匹配的瑞典 40-79 岁一般人群的随机样本。
参与者
在符合条件的 6969 人中，有 4910 人（70.5%）参与。
主要和次要措施
为一般人群的 HRQoL 结果创建参考数据库。评估某些疾病及其与 HRQoL 的关系。
方法
使用经过验证的问卷（EORTC QLQ-C30）评估预先定义的心血管疾病和 HRQoL。分析中包含的 HRQoL 方面包括整体生活质量、身体功能、角色功能、情绪功能、疲劳和呼吸困难。个体被分为：“功能良好”与“功能不良”和“无或轻微症状”与“有症状”。多变量逻辑回归计算了不良 HRQoL 的优势比（OR）及其 95%置信区间（CI）。暴露因素是心血管疾病的数量和主观疾病负担。
结果
在 4910 名参与者中，有 1358 人（28%）报告患有心血管疾病，其中高血压最常见。报告有更多的心血管疾病与较差的 HRQoL 风险增加相关，尤其是呼吸困难。对于有一个心血管疾病的患者，症状性呼吸困难的 OR 为 1.37（95%CI 1.08 至 1.74），有两个疾病的 OR 为 4.81（95%CI 3.24 至 7.13），有三个或更多心血管疾病的 OR 为 4.18（95%CI 2.24 至 7.80）。在 271 名评估其心血管疾病负担为主要的参与者中，身体功能的 HRQoL 最差（OR 6.18，95%CI 3.72 至 10.30）。
结论
在未选择的人群中，心血管疾病数量的增加和疾病负担的增加通常与心血管疾病患者的较差 HRQoL 相关。
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