Yang Xiaomeng, Wang Anxin, Liu Xiaoxue, An Shasha, Chen Shuohua, Wang Yilong, Wang Yongjun, Wu Shouling
Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China.
Sci Rep. 2016 Jan 21;6:19673. doi: 10.1038/srep19673.
The American Heart Association defined 7 ideal cardiovascular health (CVH) metrics and the benefits of them in reducing the incidence of stroke are well established, but it is unclear whether changes in them alter stroke risk. We calculated the changes of 7 ideal CVH metrics from 2006 to 2008 among 64,373 participants in the Kailuan study. We tested whether changes in the numbers and total scores for the CVH metrics were associated with the incidence of stroke in the 4.89 person-years follow-up. Cox regression modeling was used to estimate the risk of stroke. By year 2008, CVH metrics number of 32.54% participants improved (change ≥+1); 31.90% deteriorated (≤-1); 35.56% stayed the same; In the follow-up,we identified1,182 incident stroke events. Each increase in CVH metrics and every 1-point increase in total CVH score from 2006 to 2008 were associated with reduced odds of total stroke (hazard ratio = 0.87; 95% confidence interval; 0.83-0.92 and 0.89[0.86-0.92] respectively), after adjusting for age, gender, educational level, income and scores for the metrics of ideal CVH at baseline. Positive changes in ideal CVH metrics reduce the incidence of stroke. Our results support the concept that achieving ideal CVH helps to prevent stroke.
美国心脏协会定义了7项理想心血管健康(CVH)指标,且这些指标在降低中风发病率方面的益处已得到充分证实,但尚不清楚这些指标的变化是否会改变中风风险。我们计算了开滦研究中64373名参与者在2006年至2008年期间7项理想CVH指标的变化情况。我们测试了在4.89人年的随访中,CVH指标的数量和总分变化是否与中风发病率相关。采用Cox回归模型估计中风风险。到2008年,32.54%的参与者CVH指标有所改善(变化≥+1);31.90%的参与者指标恶化(≤-1);35.56%的参与者指标保持不变;在随访中,我们确定了1182例新发中风事件。在调整了年龄、性别、教育水平、收入以及基线时理想CVH指标的得分后,2006年至2008年期间CVH指标每增加一项以及CVH总得分每增加1分,均与总中风几率降低相关(风险比分别为0.87;95%置信区间为0.83 - 0.92和0.89[0.86 - 0.92])。理想CVH指标的积极变化可降低中风发病率。我们的结果支持这样一种观念,即实现理想的CVH有助于预防中风。