Simons L A, Friedlander Y, McCallum J, Simons J
University of New South Wales, Lipid Research Department, St. Vincent's Hospital, Darlinghurst, Sydney, Australia.
Atherosclerosis. 1995 Sep;117(1):107-18. doi: 10.1016/0021-9150(94)05564-y.
A new prospective study of non-institutionalised Australian elderly 60 years and over commenced in Dubbo in 1988, comprising 1236 men and 1569 women. This report examines clinical and socio-demographic predictors of coronary heart disease (CHD) over a median 62 months follow-up. CHD incidence rates (ICD-9-CM codes 410-414) were higher in men than women until 79 years, thereafter, the rates for recurrent disease were higher in women. Incidence rates for recurrent disease were three-fold those for initial disease. In Cox proportional hazards analysis, the significant predictors of all CHD were: advancing age, prior CHD (relative risk (RR) = 2.50 and 2.15 in men and women, respectively), use of anti-hypertensive medication (RR = 1.92 and 1.75 in men and women, respectively). diabetes (RR = 1.67 and 1.53 in men and women, respectively), serum cholesterol, low density lipoprotein cholesterol and serum apo B in men (RR = 1.24), serum triglycerides in women (RR = 1.23), high density lipoprotein cholesterol in men (RR = 0.82), lipoprotein (a) in women (RR = 1.99), and poorer self-rating of health (RR =1.48 and 1.93 in men and women, respectively). Serum cholesterol was not predictive of CHD in men beyond 74 years. Isolated systolic hypertension predicted CHD in women (RR = 3.76), but not in men (RR = 1.20). The findings highlight key risk factors for CHD in the elderly.
1988年在达博开始了一项针对60岁及以上非机构化澳大利亚老年人的新前瞻性研究，其中包括1236名男性和1569名女性。本报告在中位随访62个月期间，研究了冠心病（CHD）的临床和社会人口统计学预测因素。在79岁之前，男性的冠心病发病率（国际疾病分类第九版临床修订本代码410 - 414）高于女性，此后，女性复发性疾病的发病率更高。复发性疾病的发病率是初始疾病的三倍。在Cox比例风险分析中，所有冠心病的显著预测因素为：年龄增长、既往冠心病（男性和女性的相对风险分别为2.50和2.15）、使用抗高血压药物（男性和女性的相对风险分别为1.92和1.75）、糖尿病（男性和女性的相对风险分别为1.67和1.53）、男性的血清胆固醇、低密度脂蛋白胆固醇和血清载脂蛋白B（相对风险 = 1.24）、女性的血清甘油三酯（相对风险 = 1.23）、男性的高密度脂蛋白胆固醇（相对风险 = 0.82）、女性的脂蛋白(a)（相对风险 = 1.99）以及较差的健康自评（男性和女性的相对风险分别为1.48和1.93）。74岁以上男性的血清胆固醇不能预测冠心病。单纯收缩期高血压可预测女性的冠心病（相对风险 = 3.76），但不能预测男性的冠心病（相对风险 = 1.20）。这些发现突出了老年人冠心病的关键危险因素。
