Empana Jean-Philippe, Perier Marie-Cecile, Warming Peder Emile, Marijon Eloi, van Valkengoed Irene, Ågesen Frederik N, Prescott Eva, Jabbari Rezza, Climie Rachel E, Elders Petra, Blom Marieke T, Schwartz Peter J, Tan Hanno L, Tfelt-Hansen J, Jouven Xavier
Universite Paris Cité, Paris Cardiovascular Research Centre, Integrative Epidemiology of Cardiovascular Diseases, Paris, 56 rue Leblanc, 75015 Paris, France.
Paris Sudden Death Expertise Centre (SDEC), 56 rue Leblanc, 75015 Paris, France.
Europace. 2025 Mar 28;27(4). doi: 10.1093/europace/euaf046.
Adherence to an ideal cardiovascular health (CVH) might contribute to lower the burden of sudden cardiac death (SCD) in the community. We aimed to examine the association between the number of ideal CVH metrics at baseline and of its change over 10 years with the risk of SCD.
The Copenhagen City Heart Study is a community-based prospective cohort study. The number of ideal CVH metrics (range 0-6; non-smoking and ideal level of body mass index, physical activity, untreated glucose, untreated systolic blood pressure, and untreated total cholesterol levels) at baseline in 1991-94 and its 10-year change thereof between 1981-83 and 1991-94 were evaluated. Definite SCD was defined as a death occurring within 1 h (eye-witnessed case) or within 24 h (non-eye-witnessed) of symptoms onset, with the presence of confirmed ventricular tachycardia and the exclusion of non-cardiac cause at autopsy. Fine and Gray sub-distribution HRs (sHRs) were calculated to account for competing risk. The study population includes 8837 participants (57% women; mean age 57 years, ±15 years) in 1991-94. After a median follow-up of 22.6 years from 1 January 1993 up to 31 December 2016, 56 definite SCD occurred. The risk of definite SCD decreased gradually with the number of ideal metrics in 1991-94 [sHR = 0.58; 95% confidence interval (CI): 0.44-0.75 per additional ideal metric] and with the change (i.e. improvement) in the number of ideal metrics between 1981-83 and 1991-94 (sHR = 0.68; 0.50-0.93 per change in the number of ideal metrics). Effect size was lower for coronary death, all-cause mortality, and coronary heart disease events.
Adherence to a higher number of ideal cardiovascular health was related to a substantial lower risk of definite SCD.
坚持理想的心血管健康（CVH）可能有助于降低社区中心脏性猝死（SCD）的负担。我们旨在研究基线时理想CVH指标的数量及其10年间的变化与SCD风险之间的关联。
哥本哈根城市心脏研究是一项基于社区的前瞻性队列研究。评估了1991 - 1994年基线时理想CVH指标的数量（范围为0 - 6；包括不吸烟、理想的体重指数水平、身体活动、未治疗的血糖、未治疗的收缩压和未治疗的总胆固醇水平）及其在1981 - 1983年至1991 - 1994年期间的10年变化。明确的SCD定义为症状发作后1小时内（有目击者的病例）或24小时内（无目击者的病例）发生的死亡，伴有确诊的室性心动过速且尸检排除非心脏原因。计算精细和灰色子分布危险比（sHRs）以考虑竞争风险。1991 - 1994年的研究人群包括8837名参与者（57%为女性；平均年龄57岁，±15岁）。从1993年1月1日至2天6年12月31日，经过中位数22.6年的随访，发生了56例明确的SCD。1991 - 1994年明确SCD的风险随着理想指标的数量逐渐降低[sHR = 0.58；95%置信区间（CI）：每增加一个理想指标为0.44 - 0.75]，并且随着1981 - 1983年至1991 - 1994年期间理想指标数量的变化（即改善）而降低（sHR = 0.68；理想指标数量每变化一个为0.50 - 0.93）。对于冠状动脉死亡、全因死亡率和冠心病事件，效应量较低。
坚持更多理想的心血管健康与明确SCD的风险显著降低相关。
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