Ragland D R, Brand R J
School of Public Health, University of California, Berkeley 94720.
Am J Epidemiol. 1988 Mar;127(3):462-75. doi: 10.1093/oxfordjournals.aje.a114823.
In 1960-1961, 3,154 healthy, middle-aged men were entered into the Western Collaborative Group Study, a long-term study of coronary heart disease. A 22-year mortality follow-up of this cohort in 1982-1983 accounted for almost 99% of the cohort, and determined that 214 of the men had died of coronary heart disease. The risk of coronary heart disease mortality was studied for several variables measured at baseline, i.e., Type A/B behavior, systolic blood pressure, serum cholesterol level, cigarette smoking status, and age. Using a proportional hazards regression model, systolic blood pressure, serum cholesterol level, cigarette smoking status, and age were highly significant predictors (p less than 0.001) of 22-year coronary heart disease mortality. Type A/B behavior showed no association with 22-year coronary heart disease mortality (standardized relative hazard (SRH) = 0.98, 95% confidence interval (CI) = 0.85-1.12). Systolic blood pressure, serum cholesterol, and age showed relatively consistent positive associations with coronary heart disease mortality over four successive time intervals after the baseline examination. Cigarette smoking showed a significant positive association in the first and second intervals and a nonsignificant positive association in the third and fourth intervals. Type A/B behavior was positively but not significantly associated with coronary heart disease in the first and third intervals, significantly negatively associated (SRH = 0.70, 95% CI = 0.53-0.93) in the second interval and not associated in the fourth interval. The results confirm the importance of the traditional coronary heart disease risk factors, and raise a substantial question about the importance of Type A/B behavior as a risk factor for coronary heart disease mortality.
1960年至1961年，3154名健康的中年男性参与了西方协作组研究，这是一项关于冠心病的长期研究。1982年至1983年对该队列进行了22年的死亡率随访，随访对象几乎涵盖了整个队列的99%，并确定其中214名男性死于冠心病。研究了在基线时测量的几个变量与冠心病死亡风险的关系，即A型/ B型行为、收缩压、血清胆固醇水平、吸烟状况和年龄。使用比例风险回归模型，收缩压、血清胆固醇水平、吸烟状况和年龄是22年冠心病死亡率的高度显著预测因素（p小于0.001）。A型/ B型行为与22年冠心病死亡率无关联（标准化相对风险（SRH）= 0.98，95%置信区间（CI）= 0.85 - 1.12）。在基线检查后的四个连续时间间隔内，收缩压、血清胆固醇和年龄与冠心病死亡率呈现相对一致的正相关。吸烟在第一和第二个时间间隔内呈现显著正相关，在第三和第四个时间间隔内呈现不显著的正相关。A型/ B型行为在第一和第三个时间间隔内与冠心病呈正相关但不显著，在第二个时间间隔内呈显著负相关（SRH = 0.70，95% CI = 0.53 - 0.93），在第四个时间间隔内无关联。这些结果证实了传统冠心病危险因素的重要性，并对A型/ B型行为作为冠心病死亡风险因素的重要性提出了重大质疑。
