Prev Med. 1986 May;15(3):254-73. doi: 10.1016/0091-7435(86)90045-9.
The relationship between selected baseline risk factors and subsequent coronary heart disease (CHD) death and total mortality among participants in the Multiple Risk Factor Intervention Trial (MRFIT) was studied in order to determine whether the three risk factors used to identify high-risk men for the trial were associated with CHD death; whether other risk factors measured at baseline, especially lipoprotein cholesterol levels, were associated with CHD and total mortality; and whether there were any differences between special intervention (SI) and usual care (UC) participants in the relationship of the specific levels of risk factors to CHD or total mortality. The three main risk factors (blood cholesterol, cigarette smoking, and diastolic blood pressure) and age were significantly associated with CHD mortality; age, diastolic blood pressure, and cigarette smoking were associated with total mortality. The risk score based on the multiple logistic equation developed from the Framingham Study was also strongly associated with CHD mortality. When the joint associations of selected baseline risk factors with CHD and total mortality were considered, age, diastolic blood pressure, cigarette smoking, and low- and high-density lipoprotein cholesterol were significantly associated with CHD mortality; age, cigarette smoking, and low-density lipoprotein cholesterol were positively associated with total mortality. Systolic blood pressure significantly improved the prediction of CHD mortality for SI and UC men when it was added to a regression model that included age, diastolic blood pressure, cigarettes smoked per day, body mass index, and lipoprotein levels, but improved the prediction of total mortality only for SI men. In similar analyses, serum thiocyanate improved the prediction of both CHD and total mortality for UC men. Among SI men the improved prediction gained by considering serum thiocyanate was less pronounced and not significant for CHD death. This latter finding may be due in part to the changes made in smoking behavior by SI participants during the course of the study. The estimated regression coefficients for CHD and total mortality endpoints were not significantly different between the SI and UC groups.
为了确定用于该试验识别高危男性的三个风险因素是否与冠心病（CHD）死亡相关；基线时测量的其他风险因素，尤其是脂蛋白胆固醇水平，是否与冠心病和全因死亡率相关；以及在特定风险因素水平与冠心病或全因死亡率的关系方面，特殊干预（SI）组和常规护理（UC）组参与者之间是否存在差异，我们对多重危险因素干预试验（MRFIT）参与者中选定的基线风险因素与随后的冠心病死亡和全因死亡率之间的关系进行了研究。三个主要风险因素（血胆固醇、吸烟和舒张压）以及年龄与冠心病死亡率显著相关；年龄、舒张压和吸烟与全因死亡率相关。基于弗雷明汉研究得出的多元逻辑方程的风险评分也与冠心病死亡率密切相关。当考虑选定的基线风险因素与冠心病和全因死亡率的联合关联时，年龄、舒张压、吸烟以及低密度和高密度脂蛋白胆固醇与冠心病死亡率显著相关；年龄、吸烟和低密度脂蛋白胆固醇与全因死亡率呈正相关。当将收缩压添加到包含年龄、舒张压、每日吸烟量、体重指数和脂蛋白水平的回归模型中时，收缩压显著改善了SI组和UC组男性冠心病死亡率的预测，但仅改善了SI组男性全因死亡率的预测。在类似分析中，血清硫氰酸盐改善了UC组男性冠心病和全因死亡率的预测。在SI组男性中，考虑血清硫氰酸盐所获得的预测改善不太明显，且对冠心病死亡无显著意义。后一发现可能部分归因于SI组参与者在研究过程中吸烟行为的改变。SI组和UC组之间冠心病和全因死亡率终点的估计回归系数无显著差异。
