Madhavan S, Cohen H, Alderman M H
Department of Epidemiology and Social Medicine, Albert Einstein College of Medicine, Bronx, New York, USA.
J Hypertens. 1995 Nov;13(11):1307-12. doi: 10.1097/00004872-199511000-00013.
To determine the predictive value of angina pectoris diagnosed by Rose questionnaire for cardiovascular disease among treated hypertensives.
The cardiovascular experience of 4093 patients who had no history of cardiovascular disease and had been administered the Rose questionnaire for angina in a worksite treatment program was evaluated.
Among 2659 men and 1434 women of similar age (53 versus 54 years), the race distribution was 44 versus 31% whites, 27 versus 41% blacks and 29 versus 28% Hispanics. Overall, the prevalence of angina by Rose questionnaire in women (15%) was twice that in men (7%) in all three races, with Hispanics having the highest (20 versus 10%) prevalence. Those with angina (Rose-plus) and those without (Rose-minus) had similar initial and final blood pressures. In 4.0 years of average follow-up study, the crude incidence rates (per 1000 person-years) of the recorded 120 myocardial infarctions and 35 strokes did not differ significantly between Rose-plus and Rose-minus patients, except for myocardial infarction in Hispanic men (20.5 versus 5.9). When myocardial infarction incidence was adjusted for age within each sex-race subgroup, only Rose-plus Hispanic men had a significantly greater relative risk with Rose-minus as referent (relative risk 3.13, 95% confidence interval 1.31-7.50). Overall, in the Cox proportional hazards regression model, angina by Rose questionnaire was not predictive of myocardial infarction after accounting for other recognized risk factors.
The present data suggest that the Rose questionnaire as a diagnostic tool for angina is not predictive of subsequent clinical events among treated hypertensive patients.
确定通过罗斯问卷诊断的心绞痛对接受治疗的高血压患者心血管疾病的预测价值。
对4093例无心血管疾病史且在工作场所治疗项目中接受过罗斯心绞痛问卷调查的患者的心血管经历进行评估。
在年龄相近(分别为53岁和54岁)的2659名男性和1434名女性中,种族分布情况为白人分别占44%和31%,黑人分别占27%和41%,西班牙裔分别占29%和28%。总体而言,在所有三个种族中,通过罗斯问卷诊断的女性心绞痛患病率(15%)是男性(7%)的两倍,其中西班牙裔的患病率最高(分别为20%和10%)。有心绞痛(罗斯问卷阳性)和无心绞痛(罗斯问卷阴性)的患者初始和最终血压相似。在平均4.0年的随访研究中,记录的120例心肌梗死和35例中风的粗发病率(每1000人年)在罗斯问卷阳性和阴性患者之间无显著差异,但西班牙裔男性的心肌梗死情况除外(分别为20.5和5.9)。当在每个性别 - 种族亚组内对心肌梗死发病率进行年龄调整时,只有罗斯问卷阳性的西班牙裔男性与阴性者相比具有显著更高的相对风险(相对风险3.13,95%置信区间1.31 - 7.50)。总体而言,在Cox比例风险回归模型中,在考虑其他公认的风险因素后,罗斯问卷诊断的心绞痛不能预测心肌梗死。
目前的数据表明,罗斯问卷作为心绞痛的诊断工具不能预测接受治疗的高血压患者随后的临床事件。