Association for Cardiac Research, Rome, Italy.
EA 4650, Signalisation, Électrophysiologie et Imagerie des Lésions d'ischémie Reperfusion Myocardique, UNICAEN, Caen, France.
Acta Cardiol. 2023 Jul;78(5):578-585. doi: 10.1080/00015385.2022.2101876. Epub 2022 Jul 29.
To study lifetime relationships of three major lifestyle behaviours with cardiovascular mortality in a cohort of middle-aged men that reached practical extinction. In the Italian Areas of the Seven Countries Study of Cardiovascular Diseases (SCS), 1712 men were enrolled and examined in 1960, and behavioural habits were measured: smoking habits, physical activity and diet each divided into three classes. Follow-up for mortality was extended for 61 years. Three groups of major cardiovascular diseases (CVD) were used for analysis, coronary heart disease (CHD), STROKE and other Heart Diseases of Uncertain Aetiology (HDUE). Kaplan-Meier curves, death rates in classes of behaviours and Cox proportional hazard models were computed, the last ones adjusted for other major risk factors.In 61 years of follow-up, 1708 men died and 727 were cases of CVD as defined above. Clear separation of classes in Kaplan-Meier survival curves were seen only for physical activity and diet in CHD, and physical activity for STROKE. Cox proportional hazard ratios (HR, adjusted for age, blood pressure and serum cholesterol) showed the significant protective effect on CHD of Mediterranean diet (HR = 0.72), vigorous physical activity (0.55), never smoking (0.73); on STROKE of vigorous physical activity (0.67); on HDUE of never smoking (0.57). Combination of three healthy versus three unhealthy behaviours was associated for CHD to a lower mortality of 39%. This comparison was not coherent for STROKE and HDUE.Lifetime healthy behaviours are clearly beneficial versus CHD mortality but not necessarily for mortality from HDUE and STROKE that probably represent different morbid conditions.
研究在达到实际灭绝的中年男性队列中，三种主要生活方式行为与心血管死亡率的终生关系。在心血管疾病七国研究（SCS）的意大利地区，共纳入 1712 名男性进行 1960 年的检查，并测量了行为习惯：吸烟习惯、体力活动和饮食，每种习惯均分为三个等级。对死亡率的随访时间延长了 61 年。分析使用了三组主要心血管疾病（CVD），即冠心病（CHD）、中风和其他病因不明的心脏病（HDUE）。计算了 Kaplan-Meier 曲线、各行为等级的死亡率和 Cox 比例风险模型，后者根据其他主要危险因素进行了调整。在 61 年的随访中，1708 名男性死亡，727 名男性患有上述 CVD。仅在 CHD 中可以看到体力活动和饮食的 Kaplan-Meier 生存曲线的等级明显分离，而在中风中则是体力活动。Cox 比例风险比（HR，根据年龄、血压和血清胆固醇进行调整）显示，地中海饮食（HR=0.72）、剧烈体力活动（0.55）、从不吸烟（0.73）对 CHD 有显著的保护作用；剧烈体力活动（0.67）对中风有保护作用；从不吸烟（0.57）对 HDUE 有保护作用。三种健康行为与三种不健康行为的组合与 CHD 死亡率降低 39%相关。这种比较对于中风和 HDUE 并不一致。终生健康行为显然对 CHD 死亡率有益，但对 HDUE 和中风死亡率不一定有益，因为这两种疾病可能代表不同的病态。
