芬兰中年男性理想心血管健康与心源性猝死和全因死亡率风险的关联。
Association between ideal cardiovascular health and risk of sudden cardiac death and all-cause mortality among middle-aged men in Finland.
机构信息
Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Finland.
National Institute for Health Research, Bristol Biomedical Research Centre, University Hospitals Bristol NHS Foundation Trust and University of Bristol, UK.
出版信息
Eur J Prev Cardiol. 2021 Apr 23;28(3):294-300. doi: 10.1177/2047487320915338.
BACKGROUND
Strong associations have been demonstrated between the American Heart Association's cardiovascular health (CVH) metrics and various cardiovascular outcomes, but the association with sudden cardiac death (SCD) is uncertain. We examined the associations between these CVH metrics and the risks of SCD and all-cause mortality among men in Finland.
METHODS AND RESULTS
We used the prospective population-based Kuopio Ischaemic Heart Disease cohort study, which consists of men between 42 and 60 years of age at baseline. CVH metrics were computed for 2577 men with CVH scores at baseline ranging from 0 to 7, categorized into CVH scores of 0-2 (poor), 3-4 (intermediate) and 5-7 (ideal). Multivariate Cox regression models were used to estimate the hazards ratios (HRs) and 95% confidence intervals (CIs) of ideal CVH metrics for SCD and all-cause mortality. During a median follow-up period of 25.8 years, 280 SCDs and 1289 all-cause mortality events were recorded. The risks of SCD and all-cause mortality decreased continuously with increasing number of CVH metrics across the range 2-7 (p value for non-linearity for all <0.05). In multivariable analyses, men with an ideal CVH score had an 85% reduced risk of SCD compared with men with a poor CVH score (HR 0.15; 95% CI 0.05-0.48; p = 0.001). For all-cause mortality, there was a 67% lower risk among men with an ideal CVH score compared with those with a poor CVH score (HR 0.33; 95% CI 0.23-0.49; p <0.001).
CONCLUSIONS
Ideal CVH metrics were strongly and linearly associated with decreased risks of SCD and all-cause mortality among middle-aged men in Finland.
背景
美国心脏协会的心血管健康（CVH）指标与各种心血管结局之间存在很强的关联，但与心源性猝死（SCD）的关联尚不确定。我们研究了这些 CVH 指标与芬兰男性 SCD 和全因死亡率风险之间的关系。
方法和结果
我们使用前瞻性基于人群的库奥皮奥缺血性心脏病队列研究，该研究包括基线时年龄在 42 至 60 岁之间的男性。根据 CVH 评分将 2577 名男性分为 CVH 评分 0-2（差）、3-4（中等）和 5-7（理想），计算了 CVH 指标。使用多变量 Cox 回归模型估计理想 CVH 指标与 SCD 和全因死亡率的危险比（HR）和 95%置信区间（CI）。在中位随访 25.8 年期间，记录了 280 例 SCD 和 1289 例全因死亡事件。随着 CVH 指标在 2-7 范围内的增加，SCD 和全因死亡率的风险呈连续下降趋势（所有 p 值<0.05）。在多变量分析中，与 CVH 评分差的男性相比，CVH 评分理想的男性 SCD 风险降低 85%（HR 0.15；95%CI 0.05-0.48；p=0.001）。对于全因死亡率，CVH 评分理想的男性风险比 CVH 评分差的男性低 67%（HR 0.33；95%CI 0.23-0.49；p<0.001）。
结论
在芬兰中年男性中，理想的 CVH 指标与 SCD 和全因死亡率风险降低呈强烈和线性相关。
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