Zhang M, Gao X J, Yang J G, Su S S, Yang Y J, Xu H Y, Feng Y Y, Song L, Wu Y, Zhang J, Hu F H, Qiao S B, Li W, Fu R, Sun H, Dong Q T, Yan X X, Zhang X, Ye Y Q, Jin C
Department of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medial Sciences and Peking Union Medical College, Beijing 100037, China.
State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medial Sciences and Peking Union Medical College, Beijing 100037, China.
Zhonghua Yi Xue Za Zhi. 2021 Nov 30;101(44):3643-3649. doi: 10.3760/cma.j.cn112137-20210413-00876.
To understand gender differences of cardiovascular risk factors in patients with acute myocardial infarction (AMI) in China. A total of 26 592 patients with AMI from 107 hospitals in 31 provinces in China from January 1, 2013 to September 30, 2014 were included. Self-designed questionnaire was used to collect patients' age, gender, height, weight, type of AMI, medical history of cardiovascular and cerebrovascular diseases, medication history, lifestyle and AMI risk factors, including high blood pressure, diabetes, dyslipidemia, overweight and/or obesity, smoking history and family history of early onset coronary artery disease. A total of 24 394 patients with complete clinical data were included in the analysis, and gender differences in cardiovascular risk factors were analyzed in all and subgroups with different characteristics. The patients were (62.2±13.8) years old, including 18 162 (74.5%) males and 18 209 (74.6%) ST-segment elevation myocardial infarction (STEMI). The age of male patients was (60.2±13.7) years, which was younger than that of female patients [(68.2±12.3) years]. The body mass index of male patients was (24.2±3.0) kg/m, which was higher than that of female patients [(23.8±3.4) kg/m]. The proportions of patients with overweight and/or obesity, smoking history, dyslipidemia, family history of early onset coronary heart disease, fatty diet and history of AMI were 51.8%, 55.2%, 7.2%, 3.8%, 80.4% and 7.7%, which were higher than those of females (45.9%, 9.9%, 5.8%, 2.3%, 65.0% and 5.9%, respectively]. The proportions of hypertension, diabetes, physical inactivity and stroke history were 46.5%, 17.2%, 77.8% and 8.5%, respectively, which were lower than those in female patients [61.4% (3 829 cases), 24.8%, 81.7% and 11.1%, respectively] (all values<0.05).The proportions of peripheral vascular diseases history in male and female patients were 0.6% and 0.7%, respectively, with no statistical significance in difference (>0.05). Subgroup analysis showed inconsistent results comparing to analysis of all patients: there were no statistical significance in gender differences as for the proportion of dyslipidemia in the non-ST-segment elevation MI group, the proportion of family history of early onset coronary heart disease in the young and middle aged groups, the proportion of overweight and/or obesity, and the proportion of physical inactivity in the elderly group (all values>0.05). There are gender differences in cardiovascular risk factors among Chinese patients with acute myocardial infarction. Hypertension and diabetes are more common in women, and overweight and/or obesity, fatty diet and smoking are more common in men.
了解中国急性心肌梗死(AMI)患者心血管危险因素的性别差异。纳入了2013年1月1日至2014年9月30日期间来自中国31个省份107家医院的26592例AMI患者。采用自行设计的问卷收集患者的年龄、性别、身高、体重、AMI类型、心脑血管疾病病史、用药史、生活方式及AMI危险因素,包括高血压、糖尿病、血脂异常、超重和/或肥胖、吸烟史以及早发冠心病家族史。共24394例具有完整临床资料的患者纳入分析,对所有患者及不同特征亚组的心血管危险因素的性别差异进行分析。患者年龄为(62.2±13.8)岁,其中男性18162例(74.5%),ST段抬高型心肌梗死(STEMI)18209例(74.6%)。男性患者年龄为(60.2±13.7)岁,低于女性患者[(68.2±12.3)岁]。男性患者体重指数为(24.2±3.0)kg/m²,高于女性患者[(23.8±3.4)kg/m²]。超重和/或肥胖、吸烟史、血脂异常、早发冠心病家族史、高脂饮食及AMI病史患者的比例分别为51.8%、55.2%、7.2%、3.8%、80.4%和7.7%,均高于女性患者(分别为45.9%、9.9%、5.8%、2.3%、65.0%和5.9%)。高血压、糖尿病、缺乏体力活动及卒中病史患者的比例分别为46.5%、17.2%、77.8%和8.5%,均低于女性患者[分别为61.4%(3829例)、24.8%、81.7%和11.1%](均P值<0.05)。男性和女性患者外周血管疾病病史的比例分别为0.6%和0.7%,差异无统计学意义(P>0.05)。亚组分析结果与所有患者的分析结果不一致:非ST段抬高型心肌梗死组血脂异常比例、中青年组早发冠心病家族史比例、老年组超重和/或肥胖比例及缺乏体力活动比例的性别差异无统计学意义(均P值>0.05)。中国急性心肌梗死患者的心血管危险因素存在性别差异。高血压和糖尿病在女性中更常见,超重和/或肥胖、高脂饮食及吸烟在男性中更常见。