Njølstad I, Arnesen E, Lund-Larsen P G
Institute of Community Medicine, University of Tromsø, Norway.
Circulation. 1996 Dec 1;94(11):2877-82. doi: 10.1161/01.cir.94.11.2877.
Geographical differences in stroke mortality are not fully explained by population variations in blood pressure and antihypertensive treatment. Some studies have suggested that factors connected with health and nutrition in early life may be related to stroke morbidity and mortality. Body height is a sensitive marker for socioeconomic conditions, but results are conflicting as to whether height is associated with stroke.
In a population-based study, we investigated stroke incidence in relation to height and classic cardiovascular risk factors. A total of 13,266 men and women 35 to 52 years of age were followed for 14 years, and 241 first events of stroke were registered. Stroke incidence was 36% higher in men. Height was inversely related to stroke in a dose-response manner. Per 5-cm increase in height, the age-adjusted risk of stroke was 25% lower in women (P < .0001) and 18% lower in men (P = .0007). Systolic blood pressure and daily smoking were positively associated with stroke in both sexes, while serum triglyceride level was a significant risk factor in women only (relative risk per 1 mmol/L, 1.3; 95% CI, 1.1 to 1.5). The associations remained after adjustment for possible confounders and were also observed in certain subtypes of stroke.
The results are consistent with the theory that factors influencing early growth as well as adult lifestyle factors contribute to cerebrovascular disease in adult age.
中风死亡率的地理差异不能完全由血压和抗高血压治疗的人群差异来解释。一些研究表明,早年与健康和营养相关的因素可能与中风的发病率和死亡率有关。身高是社会经济状况的一个敏感指标,但关于身高是否与中风相关,结果存在矛盾。
在一项基于人群的研究中,我们调查了中风发病率与身高及经典心血管危险因素之间的关系。对总共13266名年龄在35至52岁的男性和女性进行了14年的随访,记录了241例首次中风事件。男性的中风发病率高36%。身高与中风呈剂量反应关系的负相关。身高每增加5厘米,女性经年龄调整后的中风风险降低25%(P <.0001),男性降低18%(P =.0007)。收缩压和每日吸烟在两性中均与中风呈正相关,而血清甘油三酯水平仅在女性中是一个显著的危险因素(每1 mmol/L的相对风险为1.3;95% CI,1.1至1.5)。在对可能的混杂因素进行调整后,这些关联仍然存在,并且在某些中风亚型中也观察到了。
这些结果与以下理论一致,即影响早期生长的因素以及成人生活方式因素导致成年期脑血管疾病。