Seeman T, Mendes de Leon C, Berkman L, Ostfeld A
Laboratory of Epidemiology and Public Health, Yale University School of Medicine, New Haven, CT.
Am J Epidemiol. 1993 Dec 15;138(12):1037-49. doi: 10.1093/oxfordjournals.aje.a116822.
Data from a community-based sample of 2,812 men and women aged 65 years and over, living in New Haven, Connecticut, were used to examine the associations between blood pressure, smoking, diabetes, anginal chest pain, and relative weight and 6-year incidence (1982-1988) of myocardial infarction and coronary heart disease mortality. Multivariate logistic regression analyses revealed that history of diabetes was associated with increased risk of incident myocardial infarction among women (odds ratio (OR) = 3.20; 95% confidence interval 1.46-7.01), while higher relative weight was a significant risk factor among men (OR = 3.46, 95% confidence interval 1.34-8.95 for middle vs. lowest tertile and OR = 3.24; 95% confidence interval 1.10-9.53 for highest versus lowest tertile). For coronary heart disease mortality, age and diabetes (OR = 4.47, 95% confidence interval 1.85-10.79) were associated with increased risk among women, as was current smoking (OR = 3.96; 95% confidence interval 1.66-9.45). Among men, age, prevalent heart disease, and use of antihypertensive medication (OR = 1.84; 95% confidence interval 1.13-3.00) were risk factors for coronary heart disease mortality. These risk estimates and the relatively high prevalences of these risk factors suggest that attributable risks may be substantial. Observed sex differences as well as differences in patterns of risk factor associations for the two endpoints suggest that there may be different risk profiles for older men and women and for different coronary heart disease endpoints.
研究采用了来自康涅狄格州纽黑文市2812名65岁及以上男女的社区样本数据，以检验血压、吸烟、糖尿病、心绞痛以及相对体重与心肌梗死6年发病率（1982 - 1988年）和冠心病死亡率之间的关联。多变量逻辑回归分析显示，糖尿病史与女性发生心肌梗死的风险增加相关（比值比（OR）= 3.20；95%置信区间1.46 - 7.01），而相对体重较高是男性的一个显著风险因素（中等三分位数与最低三分位数相比，OR = 3.46，95%置信区间1.34 - 8.95；最高三分位数与最低三分位数相比，OR = 3.24；95%置信区间1.10 - 9.53）。对于冠心病死亡率，年龄和糖尿病（OR = 4.47，95%置信区间1.85 - 10.79）与女性风险增加相关，当前吸烟也是如此（OR = 3.96；95%置信区间1.66 - 9.45）。在男性中，年龄、现患心脏病和使用抗高血压药物（OR = 1.84；95%置信区间1.13 - 3.00）是冠心病死亡率的风险因素。这些风险估计以及这些风险因素的相对高患病率表明，可归因风险可能很大。观察到的性别差异以及两个终点的风险因素关联模式差异表明，老年男性和女性以及不同的冠心病终点可能存在不同的风险概况。
