Lang T, Ducimetière P, Arveiler D, Amouyel P, Cambou J P, Ruidavets J B, Montaye M, Meyer V, Bingham A
INSERM U258, Hôpital Broussais, Paris, France.
Int J Epidemiol. 1997 Feb;26(1):47-57. doi: 10.1093/ije/26.1.47.
To assess the incidence and case fatality rate (CFR) from acute coronary insufficiency in men among occupational categories and to analyse the relationship between these disparities and the distribution of cardiovascular risk factors in the French population.
Three registers of the WHO-MONICA project in France: the urban area of Lille and two French districts: Bas-Rhin and Haute-Garonne.
Two sets of data were used: 1) the incident cases collected by the three MONICA Collaborating Centres (MCC) of the French WHO-MONICA Project (Lille, Strasbourg and Toulouse), between 1985 and 1989; 2) a cross-sectional study on cardiovascular risk factor prevalence performed in 1985-1989 in the three areas corresponding to the MCC.
The data concern 5133 new coronary events in men aged 30-59 and a sample of 1863 men aged 30-59.
A strong relationship was observed between occupational categories and the incidence of acute myocardial infarction and coronary events as well as CFR. Both incidence and CFR were lower among senior executives. Incidence was higher among employees and workers. However, employees, as opposed to unskilled workers, did not have higher CFR. Using occupational category as a statistical unit, the incidence of first acute myocardial infarction and coronary events was associated with the prevalence of smokers in the population (r = 0.50, P = 0.06 and r = 0.61, P = 0.02). The CFR was associated with systolic blood pressure (r = 0.82, P = 0.002), and the prevalence of smokers (r = 0.65, P = 0.02). None of the measures of incidence or case fatality among categories was related to cholesterol, HDL-cholesterol or body mass index.
Strong differences were observed between occupational categories and the incidence of acute myocardial infarction, coronary events and CFR. These differences were found to be closely related to the social distribution of two major cardiovascular risk factors: tobacco smoking and blood pressure.
评估不同职业类别的男性急性冠状动脉供血不足的发病率和病死率（CFR），并分析这些差异与法国人群心血管危险因素分布之间的关系。
法国世界卫生组织MONICA项目的三个登记处：里尔市区以及法国的两个行政区：下莱茵省和上加龙省。
使用了两组数据：1）法国世界卫生组织MONICA项目的三个合作中心（MCC）（里尔、斯特拉斯堡和图卢兹）在1985年至1989年期间收集的发病病例；2）1985 - 1989年在与MCC对应的三个地区进行的心血管危险因素患病率横断面研究。
数据涉及5133例30 - 59岁男性的新发冠心病事件以及1863例30 - 59岁男性的样本。
观察到职业类别与急性心肌梗死和冠心病事件的发病率以及病死率之间存在密切关系。高级管理人员的发病率和病死率均较低。雇员和工人的发病率较高。然而，与非技术工人相比，雇员的病死率并不更高。以职业类别作为统计单位，首次急性心肌梗死和冠心病事件的发病率与人群中吸烟者的患病率相关（r = 0.50，P = 0.06和r = 0.61，P = 0.02）。病死率与收缩压（r = 0.82，P = 0.002）以及吸烟者的患病率（r = 0.65，P = 0.02）相关。各职业类别中的发病率或病死率指标均与胆固醇、高密度脂蛋白胆固醇或体重指数无关。
不同职业类别在急性心肌梗死、冠心病事件的发病率和病死率方面存在显著差异。发现这些差异与两种主要心血管危险因素的社会分布密切相关：吸烟和血压。
