Chadha S L, Ramachandran K, Shekhawat S, Tandon R, Gopinath N
Sitaram Bhartia Institute of Science and Research, New Delhi, India.
Bull World Health Organ. 1993;71(1):67-72.
A follow-up study of coronary heart disease (CHD) was carried out among adults in Delhi 3 years after an initial community-based epidemiological survey of the same population. A total of 575 of the 814 cases of CHD detected clinically and by electrocardiogram (ECG) in the initial survey took part. On re-examination of the original cohort of 4151 adults who were free of CHD both clinically and by ECG in the initial survey, 245 new cases of CHD were detected - 73 on a clinical basis (21 with myocardial infarction and 52 with angina pectoris) and 172 by ECG (13 with myocardial infarction and 159 with probable CHD based on ST and T changes). The overall incidence of CHD was 19.7 per 1000 (males, 17.3 per 1000; females, 21.0 per 1000). The incidence on a clinical basis was 5.9 per 1000 (males, 6.5 per 1000; females, 5.5 per 1000) compared with 13.8 per 1000 by ECG (males, 10.8 per 1000; females, 15.5 per 1000). Although the incidence of myocardial infarction was higher in men (3.6 per 1000) than women (2.2 per 1000), the incidence of angina pectoris was 36.5% higher in women (18.7 per 1000) than in men (13.7 per 1000). Hypercholesterolaemia and systemic hypertension were the commonest risk factors in the 245 new cases.
在对同一人群进行首次基于社区的流行病学调查3年后，对德里的成年人开展了一项冠心病（CHD）随访研究。在首次调查中通过临床检查和心电图（ECG）检测出的814例冠心病病例中，共有575例参与了此次随访。对首次调查时临床和心电图检查均无冠心病的4151名成年人的原始队列进行重新检查时，发现了245例新的冠心病病例——73例基于临床诊断（21例心肌梗死和52例心绞痛），172例通过心电图检测出（13例心肌梗死，159例基于ST段和T波改变诊断为可能的冠心病）。冠心病的总体发病率为每1000人中有19.7例（男性为每1000人中有17.3例；女性为每1000人中有21.0例）。基于临床诊断的发病率为每1000人中有5.9例（男性为每1000人中有6.5例；女性为每1000人中有5.5例），而通过心电图检测的发病率为每1000人中有13.8例（男性为每1000人中有10.8例；女性为每1000人中有15.5例）。虽然男性心肌梗死的发病率（每1000人中有3.6例）高于女性（每1000人中有2.2例），但女性心绞痛的发病率（每1000人中有18.7例）比男性（每1000人中有13.7例）高36.5%。高胆固醇血症和系统性高血压是这245例新病例中最常见的危险因素。
