Menotti Alessandro, Puddu Paolo Emilio, Adachi Hisashi, Kafatos Anthony, Tolonen Hanna, Kromhout Daan
a Association for Cardiac Research , Rome , Italy.
b Department of Cardiovascular, Respiratory, Nephrological, Anesthesiological and Geriatric Sciences , Sapienza University of Rome , Rome , Italy.
Acta Cardiol. 2018 Apr;73(2):148-154. doi: 10.1080/00015385.2017.1351249. Epub 2017 Aug 8.
To compare the magnitude of multivariable coefficients and hazard ratios of four cardiovascular risk factors across five worldwide regions of the Seven Countries Study in predicting 50-year coronary deaths.
A total of 13 cohorts of middle-aged men at entry (40-59 years old) were enrolled in the mid-1900s from five relatively homogeneous groups of cohorts (areas): USA, Finland and Zutphen - the Netherlands, Italy and Greece, Serbia, Japan for a total of 10,368 middle-aged men. The major risk factors measured at baseline were age, number of cigarettes smoked, systolic blood pressure and serum cholesterol. Cox proportional hazards models were solved for 50-year (45 years for Serbia) deaths from coronary heart disease (CHD), and the multivariable coefficients were compared for heterogeneity.
The highest levels of risk factors and CHD death rates were found in Finland and Zutphen - the Netherlands and the lowest in Japan. All four risk factors were predictive for long-term CHD mortality in all regions, except serum cholesterol in Japan where the mean levels and CHD events were lowest. Tests of heterogeneity of coefficients for single risk factors in predicting CHD mortality were non-significant across the five areas. The same analyses for the first 25 years of follow-up produced similar findings.
The strength of the multivariable associations of four major traditional CHD risk factors with long-term CHD mortality appears to be relatively homogeneous across areas, pending needed further evidence.
比较七国研究中五个全球区域的四个心血管危险因素在预测50年冠心病死亡方面的多变量系数和风险比的大小。
20世纪中叶，从五个相对同质的队列组（地区）中招募了总共13个中年男性队列（40 - 59岁）：美国、芬兰和荷兰的祖特芬、意大利和希腊、塞尔维亚、日本，共有10368名中年男性。在基线时测量的主要危险因素为年龄、吸烟量、收缩压和血清胆固醇。针对冠心病（CHD）50年（塞尔维亚为45年）死亡情况求解Cox比例风险模型，并比较多变量系数的异质性。
在芬兰和荷兰的祖特芬发现危险因素和冠心病死亡率最高，在日本最低。所有四个危险因素在所有地区都可预测长期冠心病死亡率，但日本的血清胆固醇除外，其平均水平和冠心病事件最低。五个地区中单一危险因素预测冠心病死亡率的系数异质性检验无显著性。对随访的前25年进行的相同分析得出了类似的结果。
在有进一步证据之前，四个主要传统冠心病危险因素与长期冠心病死亡率的多变量关联强度在各地区似乎相对同质。
