Kagansky Nadya, Knobler Hilla, Stein-Babich Marina, Voet Hillary, Shalit Adi, Lindert Jutta, Knobler Haim Y
Sherutei Briut Clalit (Clalit Health Services), Central region, Israel.
Institute of Diabetes, Endocrinology, and Metabolism, Kaplan Medical Center, Rehovot, Israel.
Isr Med Assoc J. 2019 Apr;21(4):241-245.
Reports of longevity in Holocaust survivors (HS) conflict with excess prevalence of chronic diseases described among them. However, data on their long-term risk of cardiovascular diseases (CVD) are limited. Clinical data on large representative groups of HS who were exposed to severe persecution are also limited.
To determine the prevalence of CVD and the risk factors in a large cohort of elderly HS compared to elderly individuals who were not exposed to the Holocaust (NHS).
CVD prevalence rates and risk factors data from the computerized system of the central district of Clalit Health Services, the largest Israeli health maintenance organization (HMO) in Israel were evaluated in a retrospective observational study. The study was comprised of 4004 elderly HS who underwent direct severe persecution. They were randomly matched by identification numbers to 4004 elderly NHS.
HS were older than NHS and 51% of them were older than 85 years. The prevalence rate of ischemic heart disease (IHD) was significantly higher among HS. HS underwent significantly more cardiac interventions (20% vs. 15.7%, P < 0.05). HS status was an independent risk factor for increased IHD and for more coronary interventions.
Despite having a higher prevalence of CVD, a substantial number of HS live long lives. This finding may imply both unique resilience and ability to cope with chronic illness of the survivors as well as adjusted medical services for this population. These findings may help in planning the treatment of other mass trauma survivors.
大屠杀幸存者（HS）的长寿报告与他们中描述的慢性疾病高患病率相矛盾。然而，关于他们心血管疾病（CVD）长期风险的数据有限。关于遭受严重迫害的大量有代表性的HS群体的临床数据也很有限。
与未经历大屠杀的老年人（NHS）相比，确定一大群老年HS中CVD的患病率及其危险因素。
在一项回顾性观察研究中，对以色列最大的健康维护组织（HMO）——Clalit健康服务中心地区计算机系统中的CVD患病率和危险因素数据进行了评估。该研究包括4004名遭受直接严重迫害的老年HS。通过身份证号码将他们与4004名老年NHS进行随机匹配。
HS比NHS年龄更大，其中51%的人年龄超过85岁。HS中缺血性心脏病（IHD）的患病率显著更高。HS接受心脏干预的比例显著更高（20%对15.7%，P<0.05）。HS状态是IHD增加和更多冠状动脉干预的独立危险因素。
尽管CVD患病率较高，但大量HS寿命较长。这一发现可能意味着幸存者具有独特的恢复力和应对慢性病的能力，以及针对该人群的调整后的医疗服务。这些发现可能有助于规划其他大规模创伤幸存者的治疗。
