Huangfu Xinfeng, Zhu Zhengbao, Zhong Chongke, Bu Xiaoqing, Zhou Yipeng, Tian Yunfan, Batu Buren, Xu Tian, Wang Aili, Li Hongmei, Zhang Mingzhi, Zhang Yonghong
Department of Epidemiology, School of Public Health and Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Medical College of Soochow University, Suzhou, China.
Department of Epidemiology, Tongliao Center for Disease Prevention and Control, Tongliao, China.
J Stroke Cerebrovasc Dis. 2017 Dec;26(12):2749-2754. doi: 10.1016/j.jstrokecerebrovasdis.2017.06.048. Epub 2017 Aug 7.
We intended to investigate the combined effect of smoking and hypertension on ischemic stroke incidence based on a 10-year prospective study among Inner Mongolians in China.
A prospective cohort study from June 2003 to July 2012 was conducted among 2589 participants aged 20 years and older from Inner Mongolia, China. We categorized the participants into 4 subgroups according to the status of smoking and hypertension. The cumulative incidence rates of ischemic stroke among the 4 subgroups were estimated using Kaplan-Meier curves and compared by log-rank test. Cox proportional hazard model was used to compute hazard ratios of ischemic stroke across the 4 subgroups after adjusting for important confounding factors.
The cumulative incidence rates of ischemic stroke were .85%, 2.05%, 3.19%, and 8.14% among non-hypertension/non-smokers, non-hypertension/smokers, hypertension/non-smokers, and hypertension/smokers, respectively. The multivariable-adjusted hazard ratios [95% confidence intervals] of ischemic stroke for hypertension and smoking were 1.84 [1.05-3.23] and 1.89 [1.11-3.22], respectively. The hazard ratios [95% confidence intervals] of ischemic stroke for non-hypertension/smokers, hypertension/non-smokers, and hypertension/smokers were 1.37 [.56-3.33], 1.34 [.54-3.29], and 2.93 [1.26-6.83], respectively, compared with the non-hypertension/non-smokers. Significant interaction was detected between smoking and hypertension on the risk of ischemic stroke.
Our study indicated that participants with coexistence of smoking and hypertension were at the highest risk for ischemic stroke. There was a significant interaction between smoking and hypertension on the risk of ischemic stroke.
基于对中国内蒙古人群的一项为期10年的前瞻性研究，我们旨在调查吸烟与高血压对缺血性卒中发病率的联合影响。
2003年6月至2012年7月，对来自中国内蒙古的2589名20岁及以上参与者进行了一项前瞻性队列研究。我们根据吸烟和高血压状况将参与者分为4个亚组。使用Kaplan-Meier曲线估计4个亚组中缺血性卒中的累积发病率，并通过对数秩检验进行比较。在调整重要混杂因素后，使用Cox比例风险模型计算4个亚组中缺血性卒中的风险比。
非高血压/非吸烟者、非高血压/吸烟者、高血压/非吸烟者和高血压/吸烟者中缺血性卒中的累积发病率分别为0.85%、2.05%、3.19%和8.14%。高血压和吸烟导致缺血性卒中的多变量调整风险比[95%置信区间]分别为1.84[1.05 - 3.23]和1.89[1.11 - 3.22]。与非高血压/非吸烟者相比，非高血压/吸烟者、高血压/非吸烟者和高血压/吸烟者发生缺血性卒中的风险比[95%置信区间]分别为1.37[0.56 - 3.33]、1.34[0.54 - 3.29]和2.93[1.26 - 6.83]。在缺血性卒中风险方面，吸烟与高血压之间存在显著交互作用。
我们的研究表明，吸烟与高血压并存的参与者发生缺血性卒中的风险最高。吸烟与高血压在缺血性卒中风险方面存在显著交互作用。
