Sex differences in lifetime risk and first manifestation of cardiovascular disease: prospective population based cohort study.
Sex differences in lifetime risk and first manifestation of cardiovascular disease: prospective population based cohort study.
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终生风险和心血管疾病首发表现的性别差异：基于人群的前瞻性队列研究。
DOI：
10.1136/bmj.g5992
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发表时间：
2014-11-17
期刊：
影响因子：
--
通讯作者：
Roos-Hesselink JW
中科院分区：
文献类型：
--
作者：
Leening MJ;Ferket BS;Steyerberg EW;Kavousi M;Deckers JW;Nieboer D;Heeringa J;Portegies ML;Hofman A;Ikram MA;Hunink MG;Franco OH;Stricker BH;Witteman JC;Roos-Hesselink JW
目的评价在竞争风险框架下男性和女性心血管疾病首发症状的差异。设计前瞻性人群队列研究。背景生活在社区的人在鹿特丹，荷兰.受试者8419例受试者（60.9%女性），年龄≥55岁，基线时无心血管疾病。主要结果测量首次诊断冠心病（心肌梗死、血运重建和冠心病死亡）、脑血管疾病（卒中、短暂性脑缺血发作和颈动脉血运重建）、心力衰竭或其他心血管死亡;或非心血管原因死亡。数据用于计算心血管疾病的终生风险及其首次发病表现，并根据竞争性非心血管死亡进行调整。结果在长达20.1年的随访中，2888名参与者发生了心血管疾病（826名冠心病，1198名脑血管疾病，762名心力衰竭和102名其他心血管疾病死亡）。在55岁时，男性心血管疾病的总体终生风险为67.1%（95%置信区间为64.7%至69.5%），女性为66.4%（64.2%至68.7%）。男性心血管疾病首次发病表现的终生风险为冠心病27.2%（24.1%至30.3%），脑血管疾病22.8%（20.4%至25.1%），心力衰竭14.9%（13.3%至16.6%），其他心血管疾病死亡2.3%（1.6%至2.9%）。妇女的数字分别为16.9%（13.5%至20.4%）、29.8%（27.7%至31.9%）、17.5%（15.9%至19.2%）和2.1%（1.6%至2.7%）。与男性相比，女性一生中发生的事件数量差异（每1000人）为任何心血管疾病-7，冠心病-102，脑血管疾病70，心力衰竭26，其他心血管疾病死亡-1;所有结果在女性中表现为更高的年龄。当分析仅限于硬动脉粥样硬化性心血管疾病结局时，模式相似，但男性和女性之间冠心病和卒中的绝对风险差异减弱。结论在55岁时，尽管男性和女性有相似的心血管疾病的终生风险，但在首发症状方面有相当大的差异。男性更有可能以冠心病为首发事件，而女性更有可能以脑血管疾病或心力衰竭为首发事件，尽管这些表现最常出现在老年人身上。
Objective To evaluate differences in first manifestations of cardiovascular disease between men and women in a competing risks framework. Design Prospective population based cohort study. Setting People living in the community in Rotterdam, the Netherlands. Participants 8419 participants (60.9% women) aged ≥55 and free from cardiovascular disease at baseline. Main outcome measures First diagnosis of coronary heart disease (myocardial infarction, revascularisation, and coronary death), cerebrovascular disease (stroke, transient ischaemic attack, and carotid revascularisation), heart failure, or other cardiovascular death; or death from non-cardiovascular causes. Data were used to calculate lifetime risks of cardiovascular disease and its first incident manifestations adjusted for competing non-cardiovascular death. Results During follow-up of up to 20.1 years, 2888 participants developed cardiovascular disease (826 coronary heart disease, 1198 cerebrovascular disease, 762 heart failure, and 102 other cardiovascular death). At age 55, overall lifetime risks of cardiovascular disease were 67.1% (95% confidence interval 64.7% to 69.5%) for men and 66.4% (64.2% to 68.7%) for women. Lifetime risks of first incident manifestations of cardiovascular disease in men were 27.2% (24.1% to 30.3%) for coronary heart disease, 22.8% (20.4% to 25.1%) for cerebrovascular disease, 14.9% (13.3% to 16.6%) for heart failure, and 2.3% (1.6% to 2.9%) for other deaths from cardiovascular disease. For women the figures were 16.9% (13.5% to 20.4%), 29.8% (27.7% to 31.9%), 17.5% (15.9% to 19.2%), and 2.1% (1.6% to 2.7%), respectively. Differences in the number of events that developed over the lifespan in women compared with men (per 1000) were −7 for any cardiovascular disease, −102 for coronary heart disease, 70 for cerebrovascular disease, 26 for heart failure, and −1 for other cardiovascular death; all outcomes manifested at a higher age in women. Patterns were similar when analyses were restricted to hard atherosclerotic cardiovascular disease outcomes, but absolute risk differences between men and women were attenuated for both coronary heart disease and stroke. Conclusions At age 55, though men and women have similar lifetime risks of cardiovascular disease, there are considerable differences in the first manifestation. Men are more likely to develop coronary heart disease as a first event, while women are more likely to have cerebrovascular disease or heart failure as their first event, although these manifestations appear most often at older ages.
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影响因子：
37.8
作者：
Go AS;Mozaffarian D;Roger VL;Benjamin EJ;Berry JD;Blaha MJ;Dai S;Ford ES;Fox CS;Franco S;Fullerton HJ;Gillespie C;Hailpern SM;Heit JA;Howard VJ;Huffman MD;Judd SE;Kissela BM;Kittner SJ;Lackland DT;Lichtman JH;Lisabeth LD;Mackey RH;Magid DJ;Marcus GM;Marelli A;Matchar DB;McGuire DK;Mohler ER 3rd;Moy CS;Mussolino ME;Neumar RW;Nichol G;Pandey DK;Paynter NP;Reeves MJ;Sorlie PD;Stein J;Towfighi A;Turan TN;Virani SS;Wong ND;Woo D;Turner MB;American Heart Association Statistics Committee and Stroke Statistics Subcommittee
通讯作者：
American Heart Association Statistics Committee and Stroke Statistics Subcommittee
影响因子：
37.8
作者：
Cook NR;Paynter NP;Eaton CB;Manson JE;Martin LW;Robinson JG;Rossouw JE;Wassertheil-Smoller S;Ridker PM
通讯作者：
Ridker PM
影响因子：
37.8
作者：
Lloyd-Jones, DM;Larson, MG;Levy, D
通讯作者：
Levy, D
影响因子：
15.8
作者：
Ferket BS;van Kempen BJ;Heeringa J;Spronk S;Fleischmann KE;Nijhuis RL;Hofman A;Steyerberg EW;Hunink MG
通讯作者：
Hunink MG
DOI：
10.1136/hrt.2011.225482
发表时间：
2011-08
期刊：
Heart (British Cardiac Society)
影响因子：
--
作者：
Butler J;Kalogeropoulos AP;Georgiopoulou VV;Bibbins-Domingo K;Najjar SS;Sutton-Tyrrell KC;Harris TB;Kritchevsky SB;Lloyd-Jones DM;Newman AB;Psaty BM
通讯作者：
Psaty BM