Kannel W B, Neaton J D, Wentworth D, Thomas H E, Stamler J, Hulley S B, Kjelsberg M O
Am Heart J. 1986 Oct;112(4):825-36. doi: 10.1016/0002-8703(86)90481-3.
The influence of risk factors on CHD and all-cause mortality rates in 35- to 57-year-old men is examined by means of data on 325,348 white men who were screened for the MRFIT. This large data set permits an unusually detailed analysis of factors associated with the 6968 deaths, including 2426 ascribed to CHD, that were detected in the Social Security Administration data set during 6 years of follow-up. Simple cross classification of the data confirms the independent effect of serum cholesterol concentration, diastolic blood pressure, and cigarette smoking as risk factors for CHD and all-cause mortality rates. A distinct escalation of risk is noted for combinations of these risk factors. The strength of the association of each of the risk factors with CHD and all-cause mortality rates diminished with increasing age, although the number of excess deaths attributable to the risk factors increased because of the higher death rates in older men. Comparison of these findings with those observed in the five populations studied in the Pooling Project revealed an overall similarity in the risk relationships. It is estimated that elimination of these risk factors has the potential for reducing the CHD mortality rate by two thirds in 35- to 45-year old men, and by one half in 46- to 57-year-old men.
通过对325348名接受多重危险因素干预试验(MRFIT)筛查的白人男性的数据研究,考察了危险因素对35至57岁男性冠心病(CHD)及全因死亡率的影响。这个庞大的数据集使得对与6968例死亡相关因素的分析异常详尽,其中包括在社会保障管理数据集6年随访期间检测出的2426例归因于冠心病的死亡。对数据进行简单的交叉分类,证实了血清胆固醇浓度、舒张压和吸烟作为冠心病及全因死亡率危险因素的独立作用。注意到这些危险因素组合会使风险明显上升。尽管由于老年男性死亡率较高,归因于这些危险因素的额外死亡人数增加,但每个危险因素与冠心病及全因死亡率的关联强度随年龄增长而减弱。将这些结果与汇集项目中研究的五个人群的观察结果进行比较,发现风险关系总体相似。据估计,消除这些危险因素有可能使35至45岁男性的冠心病死亡率降低三分之二,使46至57岁男性的冠心病死亡率降低二分之一。