School of Public Health and Administration, Universidad Peruana Cayetano Heredia, Lima, Peru.
CRONICAS Center of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Av. Armendáriz 445, Miraflores, Lima 18, Peru.
BMC Cardiovasc Disord. 2021 Dec 7;21(1):582. doi: 10.1186/s12872-021-02405-8.
To estimate the association between the aggregation and pair-wise combination of selected cardiovascular risk factors (CVRF) and 10-year all-cause mortality.
Secondary data analysis of the PERU MIGRANT study, a prospective population-based cohort. Ten-year all-cause mortality was determined for participants originally enrolled in the PERU MIGRANT Study (baseline in 2007) through the National Registry of Identification and Civil Status. The CVRF included hypertension, type 2 diabetes mellitus, hypercholesterolemia, and overweight/obesity. Exposures were composed of both the aggregation of the selected CVRF (one, two, and three or more CVRF) and pair-wise combinations of CVRF. Cox regression models were used to calculate hazard ratios (HR) and 95% confidence intervals (95% CI).
Of the 989 participants evaluated at baseline, 976 (98.8%) had information about vital status at 10 years of follow-up (9992.63 person-years), and 63 deaths were recorded. In the multivariable model, adjusting for sociodemographic and lifestyle variables, participants with two CVRF (HR: 2.48, 95% CI: 1.03-5.99), and those with three or more CVRF (HR: 3.93, 95% CI: 1.21-12.74) had higher all-cause mortality risk, compared to those without any CVRF. The pair-wise combinations associated with the highest risk of all-cause mortality, compared to those without such comorbidities, were hypertension with type 2 diabetes (HR: 11.67, 95% CI: 3.67-37.10), and hypertension with overweight/obesity (HR: 2.76, 95% CI: 1.18-6.71).
The aggregation of two or more CVRF and the combination of hypertension with type 2 diabetes or overweight/obesity were associated with an increased risk of 10-year all-cause mortality. These risk profiles will inform primary and secondary prevention strategies to delay mortality from cardiovascular risk factors.
评估选定心血管危险因素（CVRF）的聚集和两两组合与 10 年全因死亡率之间的关联。
这是对 PERU MIGRANT 研究的二次数据分析，该研究是一项前瞻性基于人群的队列研究。通过国家身份和公民身份登记处，确定最初参加 PERU MIGRANT 研究（基线为 2007 年）的参与者的 10 年全因死亡率。CVRF 包括高血压、2 型糖尿病、高胆固醇血症和超重/肥胖。暴露由选定 CVRF 的聚集（一个、两个和三个或更多 CVRF）和 CVRF 的两两组合组成。使用 Cox 回归模型计算风险比（HR）和 95%置信区间（95%CI）。
在基线评估的 989 名参与者中，有 976 名（98.8%）在 10 年随访时有生命状态信息（9992.63 人年），记录了 63 例死亡。在多变量模型中，调整了社会人口统计学和生活方式变量后，患有两种 CVRF（HR：2.48，95%CI：1.03-5.99）和三种或更多 CVRF（HR：3.93，95%CI：1.21-12.74）的参与者全因死亡率风险更高，与没有任何 CVRF 的参与者相比。与没有这些合并症的患者相比，与全因死亡率风险最高相关的两两组合是高血压合并 2 型糖尿病（HR：11.67，95%CI：3.67-37.10）和高血压合并超重/肥胖（HR：2.76，95%CI：1.18-6.71）。
两种或多种 CVRF 的聚集以及高血压与 2 型糖尿病或超重/肥胖的组合与 10 年全因死亡率增加相关。这些风险概况将为初级和二级预防策略提供信息，以延缓心血管危险因素导致的死亡率。
