A prospective study of risk factors for pulmonary embolism in women
A prospective study of risk factors for pulmonary embolism in women
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DOI：
10.1001/jama.277.8.642
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发表时间：
1997-02-26
影响因子：
120.7
通讯作者：
Hennekens, CH
中科院分区：
文献类型：
--
作者：
Goldhaber, SZ;Grodstein, F;Hennekens, CH
目的：-调查女性肺栓塞的危险因素。设计-基于两年一次的邮寄问卷的前瞻性研究。设置-护士健康研究，从1976年到1992年进行了16年的随访。患者-1976年的一组112 822名年龄在30岁到55岁之间的女性，在基线水平上没有确诊的心血管疾病或癌症。总体而言，有1619770人年的随访。测量。-基于自我报告和医疗记录，我们记录了280例肺栓塞，其中125例是原发的(没有确定的既往癌症、创伤、手术或制动)。通过问卷调查收集有关身高、体重、吸烟、高血压、糖尿病和高胆固醇血症的信息。结果：在多因素分析中，肥胖、吸烟和高血压是肺栓塞的独立预测因素。具体地说，肥胖女性(体重指数大于或等于29.0 kg/m(2))患原发性肺栓塞的风险增加(多变量相对风险=2.9；95%可信区间[CI]，1.5-5.4)。吸烟量大的人患原发性肺栓塞的风险也增加了。与从不吸烟的女性相比，目前每天吸烟25~34支的女性发生原发性肺血栓的相对风险为1.9(95%CI，0.9~3.7)，而每天吸烟35支或以上的女性发生原发性肺血栓的相对危险度(RR)为3.3(95%CI，1.7~6.5)。即使在调整了体重指数后，高血压也与原发肺栓塞风险增加(RR=1.9；95%可信区间，1.2-2.8)、高血清胆固醇水平(RR=1.1；95%可信区间，0.62-1.8)和糖尿病(RR=0.7；95%可信区间，0.3-1.9)似乎并不相关。结论：这些前瞻性数据表明，肥胖、吸烟和高血压与女性肺栓塞风险增加有关。控制这些危险因素将降低肺栓塞和冠心病的风险。
Objective.-To investigate risk factors for pulmonary embolism in women.Design.-Prospective study based on biennial, mailed questionnaires.Setting.-Nurses' Health Study with 16 years of follow-up from 1976 to 1992.Patients.-A group of 112 822 women aged 30 to 55 years in 1976, free from diagnosed cardiovascular disease or cancer at baseline. Overall, there were 1 619 770 person-years of follow-up.Measurements.-Based on self-report and medical records, we documented 280 cases of pulmonary embolism, of which 125 were primary (no identified antecedent cancer, trauma, surgery, or immobilization). information on height, weight, cigarette smoking, hypertension, diabetes, and hypercholesterolemia was collected by questionnaire.Results.-In multivariate analysis, obesity, cigarette smoking, and hypertension were independent predictors of pulmonary embolism. Specifically, obese women (body mass index greater than or equal to 29.0 kg/m(2)) had an increased risk of primary pulmonary embolism (multivariate relative risk=2.9; 95% confidence interval [CI], 1.5-5.4). Heavy cigarette smokers also had an increased risk of primary pulmonary embolism. The relative risk (RR) of primary pulmonary embolism was 1.9 (95% CI, 0.9-3.7) for women currently smoking 25 to 34 cigarettes per day and 3.3 (95% CI, 1.7-6.5) for those smoking 35 cigarettes or more daily as compared with never smokers. Hypertension, even after adjustment for body mass index, was also associated with an increased risk of primary pulmonary embolism (RR=1,9; 95% CI, 1.2-2.8), High serum cholesterol levels (RR=1.1;95% CI, 0.62-1.8) and diabetes (RR=0.7; 95% CI, 0.3-1.9) did not appear to be related to primary pulmonary embolism.Conclusion.-These prospective data indicate that obesity, cigarette smoking, and hypertension are associated with increased risk of pulmonary embolism in women. Control of these risk factors will decrease risks of pulmonary embolism as well as coronary heart disease.