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按传统风险因素分层的心血管疾病终生风险:德黑兰血脂与血糖研究队列的结果

Lifetime risk of cardiovascular disease stratified by traditional risk factors: Findings from the cohort of Tehran lipid and glucose study.

作者信息

Ramezankhani Azra, Azizi Fereidoun, Hadaegh Farzad

机构信息

Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

出版信息

Hellenic J Cardiol. 2023 Sep-Oct;73:36-46. doi: 10.1016/j.hjc.2023.03.003. Epub 2023 Mar 11.

Abstract

BACKGROUND

We aimed to estimate the lifetime risk (LTR) of cardiovascular disease (CVD) in the Iranian population, stratified by sex and traditional risk factors including high body mass index (BMI), hypertension, diabetes, smoking, and hypercholesterolemia.

METHODS

We included 10222 (4430 men) participants aged ≥20 years without CVD at baseline. LTRs at index ages 20 and 40 years and number of years lived without CVD was estimated. We further assessed the effect of traditional risk factors on the LTR of CVD and the number of years lived without CVD, stratified by sex and index ages.

RESULTS

During a median follow-up of 18 years, 1326 participants (774 men) developed CVD and 430 (238 men) died from non-cardiovascular causes. At age 20, the remaining LTR for CVD was 66.7% (95% CI 62.9-70.4) in men and 52.0% (47.6-56.8) in women, with similar LTRs at age 40 for both men and women. The LTRs at both index ages for those with ≥3 risk factors were about 30% and 55% higher in men and women, respectively, than those without any of the five risk factors. At the age of 20, men with ≥3 risk factors lived 24.1 fewer years without CVD compared with men with no risk factors; the corresponding value was 8 years in their female counterparts.

CONCLUSIONS

Our findings suggest that both sexes may benefit from effective prevention strategies early in the life course, despite the observed differences between men and women in LTR for CVD and number of years lived without CVD.

摘要

背景

我们旨在评估伊朗人群中心血管疾病(CVD)的终生风险(LTR),并按性别以及包括高体重指数(BMI)、高血压、糖尿病、吸烟和高胆固醇血症在内的传统风险因素进行分层。

方法

我们纳入了10222名(4430名男性)基线时年龄≥20岁且无CVD的参与者。估计了20岁和40岁索引年龄时的LTR以及无CVD生存的年数。我们进一步评估了传统风险因素对CVD的LTR和无CVD生存年数的影响,并按性别和索引年龄进行分层。

结果

在中位随访18年期间,1326名参与者(774名男性)发生了CVD,430名(238名男性)死于非心血管原因。在20岁时,男性CVD的剩余LTR为66.7%(95%CI 62.9 - 70.4),女性为52.0%(47.6 - 56.8),男性和女性在40岁时的LTR相似。在两个索引年龄,有≥3个风险因素的男性和女性的LTR分别比无任何五个风险因素的人高约30%和55%。在20岁时,有≥3个风险因素的男性无CVD生存年数比无风险因素的男性少24.1年;女性相应的值为8年。

结论

我们的研究结果表明,尽管观察到男性和女性在CVD的LTR和无CVD生存年数方面存在差异,但两性在生命早期都可能从有效的预防策略中获益。

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