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配偶的心血管疾病对中年人群心血管疾病的影响:一项配对队列研究。

Spouse's Cardiovascular Disease As a Risk Factor for Cardiovascular Disease in Middle-Aged Adults: A Matched-Pair Cohort Study.

机构信息

Department of Clinical Epidemiology and Health Economics, School of Public Health, The University of Tokyo, Japan.

出版信息

Circ Cardiovasc Qual Outcomes. 2021 Aug;14(8):e007649. doi: 10.1161/CIRCOUTCOMES.120.007649. Epub 2021 Jul 9.

Abstract

BACKGROUND

Little is known about the risk of subsequent cardiovascular events in individuals whose spouse has a history of cardiovascular diseases. We assessed whether the spouse's history of cardiovascular disease is associated with a greater risk of cardiovascular events.

METHODS

Using data on married couples from the Japan Medical Data Center database (April 2008-August 2018), we conducted a matched-pair cohort study by matching individuals who had no history of cardiovascular disease and whose spouse had a history of cardiovascular disease at their first health check-up (exposure group) with up to 4 individuals who had no history of cardiovascular disease and whose spouse had no history of cardiovascular disease at their first health check-up (nonexposure group) matched for birth year, sex, and first health check-up year. We compared severe cardiovascular events after the first health check-up between the 2 groups.

RESULTS

Among 236 527 eligible married couples (473 054 spouses), we identified 13 759 individuals in the exposure group who were matched with 55 027 individuals in the nonexposure group. During the mean 95-month observational period from the first health check-up, the percentage of individuals with severe cardiovascular events was higher in the exposure group than in the nonexposure group (0.6% [82/13 759] versus 0.4% [224/55 027], respectively), with a hazard ratio of 1.48 (95% CI, 1.15-1.90). Analyses stratified by sex showed that the hazard ratios of the exposure to the spouse's history of cardiovascular disease for severe cardiovascular events in women and men were 1.22 (95% CI, 0.82-1.83) and 1.68 (95% CI, 1.22-2.32), respectively.

CONCLUSIONS

This study suggests that a spouse's history of cardiovascular disease can be a risk factor for subsequent cardiovascular events in men but not in women. Further studies are needed to confirm our findings and to explore effective primary prevention strategies for these individuals.

摘要

背景

人们对于配偶曾患有心血管疾病的个体发生心血管事件的风险知之甚少。我们评估了配偶的心血管疾病史是否与心血管事件风险增加有关。

方法

利用日本医疗数据库(2008 年 4 月至 2018 年 8 月)中的已婚夫妇数据,我们通过匹配首次健康检查时无心血管疾病史且配偶有心血管疾病史的个体(暴露组)与首次健康检查时无心血管疾病史且配偶无心血管疾病史的个体(无暴露组)进行了一项配对队列研究,匹配因素包括出生年份、性别和首次健康检查年份。我们比较了两组在首次健康检查后发生严重心血管事件的情况。

结果

在 236527 对符合条件的已婚夫妇(473054 名配偶)中,我们在暴露组中确定了 13759 名个体,并与无暴露组中的 55027 名个体进行了匹配。在首次健康检查后的平均 95 个月观察期间,暴露组中发生严重心血管事件的个体比例高于无暴露组(0.6%[82/13759]与 0.4%[224/55027]),风险比为 1.48(95%CI,1.15-1.90)。按性别分层的分析显示,暴露于配偶心血管疾病史与女性和男性严重心血管事件的风险比分别为 1.22(95%CI,0.82-1.83)和 1.68(95%CI,1.22-2.32)。

结论

本研究表明,配偶的心血管疾病史可能是男性发生后续心血管事件的危险因素,但不是女性的危险因素。需要进一步研究来证实我们的发现,并探索针对这些个体的有效一级预防策略。

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