Berglund G, Eriksson K F, Israelsson B, Kjellström T, Lindgärde F, Mattiasson I, Nilsson J A, Stavenow L
Department of Medicine, University Hospital, Lund University, Sweden.
J Intern Med. 1996 Jun;239(6):489-97. doi: 10.1046/j.1365-2796.1996.483819000.x.
To describe the size, overlap and mortality of four cardiovascular risk groups, in order to give a scientific background for the prevention of cardiovascular disease in a representative urban population.
Section of Preventive Medicine, Department of Medicine, Malmö University Hospital, Malmö, Sweden.
Between 1974 and 1984 22444 men born between 1949 and 1921, constituting 75% of the total male population in these age groups, took part in a comprehensive screening examination aimed at detecting risk factors for cardiovascular disease.
Those at high-risk of developing cardiovascular disease were referred to their general practitioner or to special clinics for hypertension, hyperlipidaemia and diabetes. The follow-up, which lasted until the end of 1991, averaged 12.2 years.
Total death (n = 1450) and death from ischaemic heart disease (IHD) (n = 471).
Hypertension was found in 13%, hypercholesterolaemia in 19% and diabetes mellitus in 2.6% of the subjects; 49% of the subjects smoked. Multiple risk factors were found in over 17% of the total cohort. Despite the intervention, all-cause mortality during follow-up was increased three-fold in smokers and in men with hypercholesterolaemia, four-fold in hypertensive men and five-fold in men with diabetes, compared to men with no risk factors. The vast majority of deaths (81%) occurred in men who smoked, had hypertension or had high serum cholesterol. Ischaemic heart disease (IHD) was increased five-fold in smokers, seven-fold in men with hypercholesterolaemia, nine-fold in hypertensive men and 12-fold in men with diabetes. Again, the vast majority of IHD deaths (86%) occurred in the first three categories. Combinations of risk factors substantially increased total mortality as well as IHD mortality.
The large proportion (64%) of the population with risk factors for cardiovascular disease and the substantially (5-12-fold) increased IHD mortality in those risk groups, calls for actions aimed at preventing premature IHD deaths. Such action should include measures directed towards the whole population and comprehensive treatment programmes for high-risk individuals, including intervention to stop smoking. The substantial overlap between risk factors calls for one high-risk clinic caring for all risk groups.
描述四个心血管疾病风险组的规模、重叠情况及死亡率，以便为具有代表性的城市人群预防心血管疾病提供科学依据。
瑞典马尔默大学医院医学部预防医学科。
1974年至1984年间，22444名出生于1949年至1921年的男性参与了一项旨在检测心血管疾病风险因素的综合筛查检查，这些男性占该年龄组男性总人口的75%。
心血管疾病高风险者被转诊至其全科医生处或高血压、高脂血症及糖尿病专科诊所。随访持续至1991年底，平均时长为12.2年。
全因死亡（n = 1450）和缺血性心脏病（IHD）死亡（n = 471）。
13%的研究对象患有高血压，19%患有高胆固醇血症，2.6%患有糖尿病；49%的研究对象吸烟。超过17%的总队列人群存在多种风险因素。尽管采取了干预措施，但与无风险因素的男性相比，随访期间吸烟者和高胆固醇血症男性的全因死亡率增加了三倍，高血压男性增加了四倍，糖尿病男性增加了五倍。绝大多数死亡（81%）发生在吸烟、患有高血压或血清胆固醇高的男性中。吸烟者的缺血性心脏病（IHD）发病率增加了五倍，高胆固醇血症男性增加了七倍，高血压男性增加了九倍，糖尿病男性增加了十二倍。同样，绝大多数IHD死亡（86%）发生在前三类人群中。风险因素的组合显著增加了全因死亡率以及IHD死亡率。
心血管疾病风险因素人群占比很大（64%），且这些风险组的IHD死亡率大幅增加（5至12倍），这就需要采取行动预防IHD过早死亡。此类行动应包括针对全体人群的措施以及针对高风险个体的综合治疗方案，包括戒烟干预。风险因素之间存在大量重叠，因此需要一个高危诊所来照顾所有风险组的人群。
