日本人群中心电图缺血性异常与缺血性心脏病危险因素之间的关联。

Association between electrocardiographic ischemic abnormalities and ischemic heart disease risk factors in a Japanese population.

作者信息

Choudhury S R, Yoshida Y, Kita Y, Nozaki A

机构信息

Department of Health Science, Shiga University of Medical Science, Japan.

出版信息

J Hum Hypertens. 1996 Apr;10(4):225-34.

PMID:8736453

Abstract

This cross-sectional study was undertaken to investigate the association of electrocardiographic (ECG) ischemic abnormalities with ischemic heart disease (IHD) risk factors in a Japanese population. Resting ECGs of 1201 subjects (572 men and 629 women, aged 30 to 89 years), were coded independently by two coders according to the Minnesota Code. Blood pressure (BP) was recorded using a standard sphygmomanometer, and non-fasting serum total cholesterol and high-density lipoprotein cholesterol were measured. Codes 1.1 and 1.2 were classified as myocardial infarction and codes 1.3, 4.1-4.4, 5.1-5.3 and 7.1 were classified as ischemia. Prevalence of ECG with evidence of IHD (IHD ECG) was defined as myocardial infarction and ischemia together. Levels of risk factors were compared between subjects with IHD ECGs and those without IHD ECGs. Multiple logistic regression analysis was used to ascertain the associations between IHD ECG and risk factors. The prevalence of myocardial infarction in the total population was 1.5% and 0.7% in men and women, respectively and the prevalence of IHD ECGs was 10% and 11.3% in men and women, respectively. Systolic blood pressure (SBP) was consistently higher in subjects with IHD ECGs in the total population of both sexes (P < 0.001, P = 0.001 for men and women respectively). Diastolic blood pressure (DBP) was higher only in men with IHD ECGs (P = 0.002). In middle-aged men (aged 30-59 years), total cholesterol was considerably higher in subjects with IHD ECGs, although this relationship was statistically not significant. In multiple logistic regression analysis, SBP was independently associated with IHD ECGs in both sexes (P = 0.001). Associations between IHD ECGs with total cholesterol, alcohol intake and smoking were not statistically significant. This study showed that electro-cardiographic IHD evidences in Japanese are predominantly associated with blood pressure level in both sexes.

摘要

本横断面研究旨在调查日本人群中心电图（ECG）缺血性异常与缺血性心脏病（IHD）危险因素之间的关联。1201名受试者（572名男性和629名女性，年龄30至89岁）的静息心电图由两名编码员根据明尼苏达编码独立编码。使用标准血压计记录血压，并测量非空腹血清总胆固醇和高密度脂蛋白胆固醇。编码1.1和1.2被归类为心肌梗死，编码1.3、4.1 - 4.4、5.1 - 5.3和7.1被归类为缺血。有IHD证据的心电图（IHD ECG）的患病率定义为心肌梗死和缺血的总和。比较有IHD ECG的受试者和没有IHD ECG的受试者的危险因素水平。采用多因素logistic回归分析确定IHD ECG与危险因素之间的关联。总人群中心肌梗死的患病率男性为1.5%，女性为0.7%，IHD ECG的患病率男性为10%，女性为11.3%。在男女总人群中，有IHD ECG的受试者收缩压（SBP）始终较高（男性和女性分别为P < 0.001，P = 0.001）。舒张压（DBP）仅在有IHD ECG的男性中较高（P = 0.002）。在中年男性（30 - 59岁）中，有IHD ECG的受试者总胆固醇显著更高，尽管这种关系在统计学上不显著。在多因素logistic回归分析中，SBP在男女中均与IHD ECG独立相关（P = 0.001）。IHD ECG与总胆固醇、饮酒和吸烟之间的关联在统计学上不显著。本研究表明，日本人心电图IHD证据在男女中主要与血压水平相关。