关节炎及活动受限对加拿大普通人群首次发生心脏病事件影响中的性别差异：全国纵向人口健康调查结果

Sex Variations in the Effects of Arthritis and Activity Limitation on First Heart Disease Event Occurrence in the Canadian General Population: Results From the Longitudinal National Population Health Survey.

作者信息

Schieir Orit, Hogg-Johnson Sheilah, Glazier Richard H, Badley Elizabeth M

机构信息

University of Toronto Dalla Lana School of Public Health, Toronto, Ontario, Canada.

University of Toronto Dalla Lana School of Public Health and Institute for Work and Health, Toronto, Ontario, Canada.

出版信息

Arthritis Care Res (Hoboken). 2016 Jun;68(6):811-8. doi: 10.1002/acr.22764.

DOI:10.1002/acr.22764

PMID:26473753

Abstract

OBJECTIVE

To estimate sex-specific effects of arthritis and activity limitation on incident heart disease in a nationally representative, Canadian longitudinal population-based survey.

METHODS

Information on sociodemographic variables, self-reported physician-diagnosed chronic conditions (including arthritis and heart disease), activity limitations, and traditional risk factors was collected every 2 years from 1994-1995 through 2010-2011 as part of the longitudinal Canadian National Population Health Survey. Deaths due to ischemic heart disease (International Classification of Diseases, Tenth Revision [ICD-10] codes I20-I25) and heart failure (ICD-10 codes I50.0-I50.9) were confirmed against the Canadian Vital Statistics Database. Discrete-time survival analysis stratified by sex was used to estimate effects of arthritis and activity limitation on first heart disease event occurrence.

RESULTS

The study included 12,591 participants with no prior history of heart disease and 1,783 incident heart disease events. After adjusting for common risk factors, arthritis was associated with a significant increased risk of incident heart disease in women (adjusted odds ratio [OR] 1.58, 95% confidence interval [95% CI] 1.23-2.02). Even higher risks were reported in women with arthritis and activity limitation (OR 2.19, 95% CI 1.61-2.97). Arthritis was not associated with incident heart disease in men, except for when also reported with activity limitation (OR 1.60, 95% CI 1.14-2.26).

CONCLUSION

Women with arthritis, and men with arthritis and activity limitation, have significant excess risks for developing heart disease in the general population. These findings point to the need for improved access to arthritis care, cardiovascular prevention strategies, particularly in women with arthritis, and directed interventions toward prevention of activity limitation.

摘要

目的

在一项具有全国代表性的加拿大纵向人群调查中，评估关节炎和活动受限对心脏病发病的性别特异性影响。

方法

作为加拿大全国人口健康纵向调查的一部分，从1994年至1995年到2010年至2011年，每两年收集一次社会人口统计学变量、自我报告的医生诊断慢性病（包括关节炎和心脏病）、活动受限以及传统风险因素的信息。通过加拿大生命统计数据库确认因缺血性心脏病（国际疾病分类第十版[ICD-10]编码I20-I25）和心力衰竭（ICD-10编码I50.0-I50.9）导致的死亡。采用按性别分层的离散时间生存分析来评估关节炎和活动受限对首次心脏病事件发生的影响。

结果

该研究纳入了12,591名无心脏病病史的参与者以及1,783例心脏病发病事件。在调整常见风险因素后，关节炎与女性心脏病发病风险显著增加相关（调整后的优势比[OR]为1.58，95%置信区间[95%CI]为1.23 - 2.02）。关节炎且有活动受限的女性报告的风险更高（OR为2.19，95%CI为1.61 - 2.97）。除了同时报告有活动受限时，关节炎与男性心脏病发病无关（OR为1.60，95%CI为1.14 - 2.26）。