Yano K, Reed D M, McGee D L
Am J Epidemiol. 1984 May;119(5):653-66. doi: 10.1093/oxfordjournals.aje.a113787.
In 10 years of follow-up of 7705 Japanese men living in Hawaii, aged 45-68 years and judged free of coronary heart disease (CHD) at the initial examination during 1965-1968, a total of 511 new CHD cases were identified: fatal CHD, 139; nonfatal myocardial infarction (MI), 216; acute coronary insufficiency, 55; and uncomplicated angina pectoris (AP), 101. The incidence rate of fatal CHD and nonfatal MI for this cohort is less than half the rate for US whites and approximately twice the rate for Japanese men in Japan. The relationships of 14 biologic and lifestyle characteristics measured at baseline examination to the incidence of total CHD and specific manifestations of CHD were examined in bivariate and multivariate analyses. In bivariate analyses, all variables except heart rate were significantly related to the risk of total CHD after adjustment for age. However, when an independent contribution of each variable to CHD risk was evaluated in multiple logistic analyses in which all other variables were taken into account, the numbers of risk factors retaining significant associations varied by clinical subgroup of CHD. Among the characteristics studied, systolic blood pressure was the most powerful and consistent risk factor for all manifestations except AP. Cigarette smoking showed a similar pattern. Serum cholesterol was significantly associated with fatal CHD and nonfatal MI, but its contribution to CHD risk was less potent than systolic blood pressure or cigarette smoking. Glucose intolerance was strongly associated with fatal CHD, but with no other manifestations of CHD. Alcohol consumption demonstrated a strong protective effect upon fatal CHD and nonfatal MI. Uncomplicated AP was distinguished from other CHD manifestations by the lack of association with most of the known major risk factors for CHD, including blood pressure, serum cholesterol, and cigarette smoking.
在对7705名居住在夏威夷、年龄在45 - 68岁之间且在1965 - 1968年首次检查时被判定无冠心病（CHD）的日本男性进行的10年随访中，共确诊了511例新发冠心病病例：致命性冠心病139例；非致命性心肌梗死（MI）216例；急性冠状动脉供血不足55例；单纯性心绞痛（AP）101例。该队列中致命性冠心病和非致命性心肌梗死的发病率不到美国白人的一半，约为日本本土日本男性发病率的两倍。在双变量和多变量分析中，研究了在基线检查时测量的14种生物学和生活方式特征与冠心病总发病率及冠心病特定表现之间的关系。在双变量分析中，除心率外，所有变量在调整年龄后均与冠心病总风险显著相关。然而，当在考虑所有其他变量的多因素逻辑分析中评估每个变量对冠心病风险的独立贡献时，保留显著关联的危险因素数量因冠心病临床亚组而异。在所研究的特征中，收缩压是除心绞痛外所有表现中最有力且一致的危险因素。吸烟呈现类似模式。血清胆固醇与致命性冠心病和非致命性心肌梗死显著相关，但其对冠心病风险的贡献不如收缩压或吸烟那么显著。葡萄糖耐量异常与致命性冠心病密切相关，但与冠心病的其他表现无关。饮酒对致命性冠心病和非致命性心肌梗死具有强大的保护作用。单纯性心绞痛与冠心病的其他表现不同，它与大多数已知的冠心病主要危险因素（包括血压、血清胆固醇和吸烟）无关。
