Tervahauta M, Pekkanen J, Nissinen A
Department of Community Health and General Practice, University of Kuopio, Finland.
J Am Coll Cardiol. 1995 Dec;26(7):1623-9. doi: 10.1016/0735-1097(95)00395-9.
We attempted to determine whether elevated levels of the classic coronary heart disease risk factors are associated with increased coronary risk and all-cause mortality among elderly men with and without coronary heart disease at baseline.
The strength of any association between the classic coronary risk factors and survival among elderly men with and without coronary heart disease has not been established.
The classic coronary risk factor levels and risk of coronary events and total mortality during a 5-year follow-up interval were studied among men aged 65 to 84 years. Coronary events were fatal myocardial infarction (n = 71), any myocardial infarction (n = 96) and, among the men without disease, other nonfatal coronary heart disease events (n = 80).
Among the 171 men with prevalent coronary heart disease, significant (p < 0.05) risk factors for fatal myocardial infarction (n = 42) in multivariate analyses were low high density lipoprotein cholesterol (odds ratio [OR] 0.2, 95% confidence interval [CI] 0.1 to 0.8 for 1-mmol/liter increase), high ratio of total to high density lipoprotein cholesterol (OR 1.4, 95% CI 1.1 to 1.7 for 1-U increase), and smoking more than nine cigarettes daily (OR 6.0, 95% CI 1.5 to 24.9 vs. values in men who had never smoked). Among the 476 men without prevalent coronary heart disease, only high serum total cholesterol was a risk factor for fatal myocardial infarction (n = 29) (OR 1.4, 95% CI 1.0 to 2.0 for 1-mmol/liter increase). Among men with prevalent coronary heart disease, the only significant (p < 0.05) risk factor for total mortality was smoking more than nine cigarettes daily (OR 3.9, 95% CI 1.1 to 13.4 vs. values among men who had never smoked). Among men without prevalent coronary heart disease, only the use of antihypertensive medication (OR 2.0, 95% CI 1.2 to 3.3 between men with and without such medication) was a risk factor for total mortality.
The classic risk factors for coronary heart disease appear to be of importance even in old age, especially among men with prevalent coronary heart disease.
我们试图确定，在基线时患有和未患有冠心病的老年男性中，经典冠心病危险因素水平升高是否与冠心病风险增加及全因死亡率相关。
经典冠心病危险因素与患有和未患有冠心病的老年男性生存率之间的任何关联强度尚未确定。
对65至84岁男性的经典冠心病危险因素水平以及5年随访期间的冠心病事件风险和总死亡率进行了研究。冠心病事件包括致命性心肌梗死（n = 71）、任何心肌梗死（n = 96），以及在无疾病男性中的其他非致命性冠心病事件（n = 80）。
在171例患有冠心病的男性中，多因素分析显示，致命性心肌梗死（n = 42）的显著（p < 0.05）危险因素为高密度脂蛋白胆固醇水平低（每升高1 mmol /升，比值比[OR] 0.2，95%置信区间[CI] 0.1至0.8）、总胆固醇与高密度脂蛋白胆固醇比值高（每升高1 U，OR 1.4，95% CI 1.1至1.7）以及每天吸烟超过9支（与从不吸烟男性相比，OR 6.0，95% CI 1.5至24.9）。在476例无冠心病的男性中，只有血清总胆固醇水平高是致命性心肌梗死（n = 29）的危险因素（每升高1 mmol /升，OR 1.4，95% CI 1.0至2.0）。在患有冠心病的男性中，全因死亡率的唯一显著（p < 0.05）危险因素是每天吸烟超过9支（与从不吸烟男性相比，OR 3.9，95% CI 1.1至13.4）。在无冠心病的男性中，只有使用抗高血压药物（使用与未使用此类药物的男性相比，OR 2.0，95% CI 1.2至3.3）是全因死亡率的危险因素。
冠心病的经典危险因素即使在老年时似乎也很重要，尤其是在患有冠心病的男性中。
