Miall W E, Del Campo E, Fodor J, Nava Rhode J R, Ruiz L, Standard K L, Swan A V
Bull World Health Organ. 1972;46(6):685-94.
The relationship between cardiovascular characteristics and mortality was investigated in an epidemiological study of heart disease in a representative adult rural community in Jamaica. Of 449 men and 469 women followed up for 5 years, 36 men and 28 women died and the data concerning their status as regards arterial pressure, electrocardiographic abnormalities, and histories of effort pain at the intial survey have been analysed. Cardiovascular disease, and heart disease in particular, was the major cause of death in this population. Blood pressure levels exceeding 160/95 mm Hg had been recorded in about one third of the men and half the women who died and a clear trend was found between overall mortality and arterial pressure. Symptoms of effort pain and ECG abnormalities compatible with myocardial ischaemia, both of which were unexpectedly common, appeared to have independent prognostic significance. The prognosis of each was worse when associated with hypertension; hypertension unaccompanied by either effort pain or ECG "ischaemic" abnormality, on the other hand, caused no excess mortality in either sex within the period of follow-up. Although classical myocardial infarction was confirmed to be relatively infrequent, myocardial disorders with many of the features of ischaemic heart disease are an important cause of death in rural Jamaicans.
在牙买加一个具有代表性的成年农村社区开展的心脏病流行病学研究中，对心血管特征与死亡率之间的关系进行了调查。在449名男性和469名女性长达5年的随访中，36名男性和28名女性死亡，并且对他们在初次调查时的动脉压、心电图异常及劳力性疼痛病史等相关数据进行了分析。心血管疾病，尤其是心脏病，是该人群的主要死因。在死亡的男性中约三分之一以及女性中约一半的人曾记录到血压水平超过160/95 mmHg，并且在总死亡率与动脉压之间发现了明显的趋势。劳力性疼痛症状和与心肌缺血相符的心电图异常，这两者都出乎意料地常见，似乎具有独立的预后意义。当与高血压相关时，二者的预后都更差；另一方面，在随访期间，未伴有劳力性疼痛或心电图“缺血性”异常的高血压在两性中均未导致额外的死亡率增加。尽管经证实典型心肌梗死相对少见，但具有许多缺血性心脏病特征的心肌疾病是牙买加农村地区重要的死亡原因。
