Jousilahti P, Tuomilehto J, Korhonen H J, Vartiainen E, Puska P, Nissinen A
Department of Epidemiology and Health Promotion, National Public Health Institute, Helsinki, Finland.
Prev Med. 1994 Jan;23(1):6-14. doi: 10.1006/pmed.1994.1002.
The study describes 15-year cardiovascular disease risk factor clustering trends in eastern Finland and assesses the degree to which high levels of the risk factors are clustering in the same individuals.
Four independent cross-sectional surveys in randomly selected population samples (in 1972, 1977, 1982, and 1987) have been carried out in two provinces in eastern Finland (North Karelia and Kuopio) to assess the level of cardiovascular disease risk factors and the impact of a community-based prevention program. Each survey included a self-administered questionnaire, blood pressure measurements, and determination of serum cholesterol. Blood pressure and serum cholesterol values were dichotomized. All subjects were classified as either current smokers or nonsmokers. The total sample size was 30,118 and the participation rate varied between 77 and 94%. The common age range in all four surveys was 30 to 59 years.
The proportion of individuals with a combination of two or three risk factors decreased markedly during the survey period. However, smoking tended to cluster increasingly with the other risk factors in 1987 compared with that seen in 1972. Among men, the proportion of smokers having either high blood pressure or high serum cholesterol levels, or both, is still high.
The observed clustering of cardiovascular disease risk factors, particularly among men, underlines the importance of assessing other risk factors in persons with a high level of one risk factor and the need for a multifactorial approach in primary prevention. It is possible that high-risk behaviors, like smoking and high consumption of saturated fat and salt, were normal in 1972, but in 1987 they were declining, though they remained clustered among a particular segment of the population.
该研究描述了芬兰东部地区15年心血管疾病风险因素聚集趋势，并评估了这些风险因素在同一人群中的聚集程度。
在芬兰东部的两个省份（北卡累利阿和库奥皮奥）对随机抽取的人群样本进行了四次独立的横断面调查（分别在1972年、1977年、1982年和1987年），以评估心血管疾病风险因素水平以及一项基于社区的预防计划的影响。每次调查都包括一份自填式问卷、血压测量和血清胆固醇测定。血压和血清胆固醇值被二分法分类。所有受试者被分为当前吸烟者或非吸烟者。总样本量为30118人，参与率在77%至94%之间。所有四次调查的共同年龄范围为30至59岁。
在调查期间，具有两种或三种风险因素组合的个体比例显著下降。然而，与1972年相比，1987年吸烟与其他风险因素的聚集趋势有所增加。在男性中，患有高血压或高血清胆固醇水平或两者兼有的吸烟者比例仍然很高。
观察到的心血管疾病风险因素聚集现象，尤其是在男性中，凸显了在一个风险因素水平较高的人群中评估其他风险因素的重要性以及在一级预防中采用多因素方法的必要性。1972年，吸烟以及高饱和脂肪和盐的高摄入量等高危行为可能很常见，但在1987年这些行为正在减少，尽管它们仍聚集在特定人群中。
