a Groningen Research Institute of Pharmacy, PharmacoTherapy, Epidemiology & Economics , University of Groningen , Groningen , the Netherlands.
b Center for Medicines Information and Pharmaceutical Care, Faculty of Pharmacy , Universitas Surabaya , Surabaya , Indonesia.
Curr Med Res Opin. 2019 Feb;35(2):291-299. doi: 10.1080/03007995.2018.1491149. Epub 2018 Jul 30.
Scientific studies on cardiovascular disease (CVD) burden and risk factors are predominantly based on short-term risk in Westerner populations, and such information may not be applicable to Asian populations, especially over the longer term. This review aims to estimate the long-term (>10 years) CVD burden, including coronary heart disease (CHD) and stroke, as well as associated risk factors in Asian populations.
PubMed, Embase and Web of Science were systematically searched, and hits screened on: Asian adults, free of CVD at baseline; cohort study design (follow-up >10 years). Primary outcomes were fatal and non-fatal CVD events. Pooled estimates and between-study heterogeneity were calculated using random effects models, Q and I statistics.
Overall, 32 studies were eligible for inclusion (follow-up: 11-29 years). The average long-term rate of fatal CVD is 3.68 per 1000 person-years (95% CI 2.84-4.53), the long-term cumulative risk 6.35% (95% CI 4.69%-8.01%, mean 20.13 years) and the cumulative fatal stroke/CHD risk ratio 1.5:1. Important risk factors for long-term fatal CVD (RR, 95% CI) were male gender (1.49, 1.36-1.64), age over 60/65 years (7.55, 5.59-10.19) and current smoking (1.68, 1.26-2.24). High non-HDL-c, and β- and γ-tocopherol serum were associated only with CHD (HR 2.46 [95% CI 1.29-4.71] and 2.47 [1.10-5.61] respectively), while stage 1 and 2 hypertensions were associated only with fatal stroke (2.02 [1.19-3.44] and 2.89 [1.68-4.96] respectively).
Over a 10 year + follow-up period Asian subjects had a higher risk of stroke than CHD. Contrary to CVD prevention in Western countries, strategies should also consider stroke instead of CHD only.
心血管疾病（CVD）负担和危险因素的科学研究主要基于西方人群的短期风险，而此类信息可能不适用于亚洲人群，尤其是在较长时间内。本综述旨在评估亚洲人群的长期（>10 年）CVD 负担，包括冠心病（CHD）和中风，以及相关的危险因素。
系统检索了 PubMed、Embase 和 Web of Science，并根据以下标准筛选了命中记录：亚洲成年人，基线时无 CVD；队列研究设计（随访>10 年）。主要结局是致命和非致命 CVD 事件。使用随机效应模型、Q 和 I 统计量计算汇总估计值和研究间异质性。
共有 32 项研究符合纳入标准（随访时间：11-29 年）。致命 CVD 的长期平均发生率为每 1000 人年 3.68 例（95%CI：2.84-4.53），长期累积风险为 6.35%（95%CI：4.69%-8.01%，平均 20.13 年），致命性中风/CHD 累积风险比为 1.5:1。长期致命 CVD 的重要危险因素（RR，95%CI）为男性（1.49，1.36-1.64）、60/65 岁以上年龄（7.55，5.59-10.19）和当前吸烟（1.68，1.26-2.24）。高非高密度脂蛋白胆固醇和β-和γ-生育酚血清仅与 CHD 相关（HR 分别为 2.46[95%CI：1.29-4.71]和 2.47[1.10-5.61]），而 1 期和 2 期高血压仅与致命性中风相关（2.02[1.19-3.44]和 2.89[1.68-4.96]）。
在 10 年以上的随访期间，亚洲受试者中风的风险高于 CHD。与西方国家的 CVD 预防不同，策略还应考虑中风而不仅仅是 CHD。
