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在两项基于人群的横断面研究中,萨米人和非萨米人群中传统心血管危险因素的变化及急性心肌梗死或脑卒中等 10 年发病风险的预估:SAMINOR 研究。

Changes in conventional cardiovascular risk factors and the estimated 10-year risk of acute myocardial infarction or cerebral stroke in Sami and non-Sami populations in two population-based cross-sectional surveys: the SAMINOR Study.

机构信息

Department of Community Medicine, Centre for Sami Health Research, UiT The Arctic University of Norway, Tromsø, 9037, Norway.

Faculty of Nursing and Health Sciences, Nord University, Bodø, Norway.

出版信息

BMJ Open. 2019 Jul 19;9(7):e028939. doi: 10.1136/bmjopen-2019-028939.

Abstract

OBJECTIVE

To describe changes in cardiovascular risk factors and in the estimated 10-year risk of acute myocardial infarction (AMI) or cerebral stroke (CS) between SAMINOR 1 (2003-2004) and SAMINOR 2 (2012-2014), and explore if these changes differed between Sami and non-Sami.

DESIGN

Two cross-sectional surveys.

SETTING

Inhabitants of rural Northern Norway.

PARTICIPANTS

Participants were aged 40-79 years and participated in SAMINOR 1 (n=6417) and/or SAMINOR 2 (n=5956).

PRIMARY OUTCOME MEASURES

Generalised estimating equation regressions with an interaction term were used to estimate and compare changes in cardiovascular risk factors and 10-year risk of AMI or CS between the two surveys and by ethnicity.

RESULTS

Mean cholesterol declined by 0.50, 0.43 and 0.60 mmol/L in women, Sami men and non-Sami men, respectively (all p<0.001). Sami men had a small decline in mean high-density lipoprotein (HDL) cholesterol and an increase in mean triglycerides (both p<0.001), whereas non-Sami showed no change in these variables. Non-Sami women had an increase in mean HDL cholesterol (p<0.001) whereas Sami women had no change. Triglycerides did not change in non-Sami and Sami women. Systolic and diastolic blood pressure declined by 3.6 and 1.0 mm Hg in women, and 3.1 and 0.7 in men, respectively (all p<0.01). Mean waist circumference increased by 6.7 and 5.9 cm in women and men, respectively (both p<0.001). The odds of being a smoker declined by 35% in women and 46% in men (both p<0.001). Estimated 10-year risk of AMI or CS decreased in all strata of sex and ethnicity (p<0.001), however, Sami women had a smaller decline than non-Sami did.

CONCLUSIONS

Independent of ethnicity, there was a decline in mean cholesterol, blood pressure, smoking, hypertension (women only) and 10-year risk of AMI or CS, but waist circumference increased. Relatively minor ethnic differences were found in changes of cardiovascular risk factors.

摘要

目的

描述心血管危险因素和急性心肌梗死(AMI)或脑卒(CS)的 10 年估计风险在 SAMINOR 1(2003-2004 年)和 SAMINOR 2(2012-2014 年)之间的变化,并探讨这些变化在萨米人和非萨米人之间是否存在差异。

设计

两项横断面调查。

地点

挪威北部农村地区。

参与者

年龄在 40-79 岁的参与者,参加了 SAMINOR 1(n=6417)和/或 SAMINOR 2(n=5956)。

主要观察指标

使用广义估计方程回归分析,并加入交互项,以估计和比较两次调查之间以及按种族划分的心血管危险因素和 AMI 或 CS 10 年风险的变化。

结果

女性、萨米男性和非萨米男性的平均胆固醇分别下降 0.50、0.43 和 0.60mmol/L(均<0.001)。萨米男性的高密度脂蛋白(HDL)胆固醇平均值略有下降,甘油三酯平均值升高(均<0.001),而非萨米男性则没有这些变化。非萨米女性的平均 HDL 胆固醇升高(<0.001),而萨米女性则没有变化。非萨米女性和萨米女性的甘油三酯均无变化。女性的收缩压和舒张压分别下降 3.6 和 1.0mmHg,男性分别下降 3.1 和 0.7mmHg(均<0.01)。女性和男性的平均腰围分别增加 6.7 和 5.9cm(均<0.001)。女性和男性的吸烟率分别下降 35%和 46%(均<0.001)。所有性别和种族亚组的 AMI 或 CS 10 年风险预计均有所下降(<0.001),但萨米女性的下降幅度小于非萨米女性。

结论

无论种族如何,平均胆固醇、血压、吸烟、高血压(仅女性)和 AMI 或 CS 的 10 年风险均有所下降,但腰围增加。在心血管危险因素变化方面,发现了相对较小的种族差异。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/710d/6661668/4e0e35a94588/bmjopen-2019-028939f01.jpg

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