Smoking and elevated blood pressure are the most important risk factors for subarachnoid hemorrhage in the Asia-Pacific region - An overview of 26 cohorts involving 306,620 participants
Smoking and elevated blood pressure are the most important risk factors for subarachnoid hemorrhage in the Asia-Pacific region - An overview of 26 cohorts involving 306,620 participants
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DOI：
10.1161/01.str.0000170710.95689.41
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发表时间：
2005-07-01
期刊：
影响因子：
8.3
通讯作者：
Ueshima, H
中科院分区：
文献类型：
--
作者：
Feigin, V;Parag, V;Ueshima, H
背景和目的-蛛网膜下腔出血（SAH）的病因尚不清楚，而且很少有关于SAH危险因素的大型队列研究。我们调查了在亚太地区与常见的心血管危险因素相关的SAH死亡率和发病率的风险，并研究了这些协会的优势是否在亚洲和澳大利亚（主要是白色）population.Methods不同队列研究确定从互联网电子数据库，搜索会议程序，和个人通信。收缩压（SBP）、当前吸烟、血清总胆固醇、体重指数（BMI）的风险比（HR），根据考克斯模型计算饮酒量，该模型按性别和队列分层，并根据风险年龄进行调整。（参与者总数306 620）报告了SAH（致死性和/或非致死性）事件病例，可用于分析。在8.2年的中位随访期内，共观察到236例SAH事件。目前吸烟（HR，2.4; 95% CI，1.8 - 3.4）和SBP > 140 mmHg（HR，2.0; 95% CI，1.5 - 2.7）是SAH的显著独立危险因素。与当前吸烟和SBP升高（类似于140 mm Hg）相关的SAH归因风险分别为29%和19%。SAH的风险与胆固醇、BMI或饮酒之间没有显著相关性。亚洲和澳大拉西亚regions.Conclusions -吸烟和SBP是SAH在亚太地区最重要的危险因素。
Background and Purpose - The cause of subarachnoid hemorrhage ( SAH) is poorly understood and there are few large cohort studies of risk factors for SAH. We investigated the risk of SAH mortality and morbidity associated with common cardiovascular risk factors in the Asia-Pacific region and examined whether the strengths of these associations were different in Asian and Australasian ( predominantly white) populations.Methods - Cohort studies were identified from Internet electronic databases, searches of proceedings of meetings, and personal communication. Hazard ratios (HRs) for systolic blood pressure (SBP), current smoking, total serum cholesterol, body mass index (BMI), and alcohol drinking were calculated from Cox models that were stratified by sex and cohort and adjusted for age at risk.Results - Individual participant data from 26 prospective cohort studies ( total number of participants 306 620) that reported incident cases of SAH ( fatal and/or nonfatal) were available for analysis. During the median follow-up period of 8.2 years, a total of 236 incident cases of SAH were observed. Current smoking (HR, 2.4; 95% CI, 1.8 to 3.4) and SBP > 140 mm Hg ( HR, 2.0; 95% CI, 1.5 to 2.7) were significant and independent risk factors for SAH. Attributable risks of SAH associated with current smoking and elevated SBP ( similar to 140 mm Hg) were 29% and 19%, respectively. There were no significant associations between the risk of SAH and cholesterol, BMI, or drinking alcohol. The strength of the associations of the common cardiovascular risk factors with the risk of SAH did not differ much between Asian and Australasian regions.Conclusions - Cigarette smoking and SBP are the most important risk factors for SAH in the Asia-Pacific region.