Long-term outcome of the Malmo Preventive Project:: mortality and cardiovascular morbidity
Long-term outcome of the Malmo Preventive Project:: mortality and cardiovascular morbidity
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DOI：
10.1046/j.1365-2796.2000.00568.x
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发表时间：
2000-01-01
影响因子：
11.1
通讯作者：
Lingärde, F
中科院分区：
文献类型：
--
作者：
Berglund, G;Nilsson, P;Lingärde, F
目的：分析对以人群为基础的样本的死亡率和心血管发病率的影响，邀请参与干预计划，包括基线筛查检查和治疗计划，用于心血管危险因素，高酒精摄入量和女性，怀疑乳腺癌的乳腺X线摄影。瑞典马尔莫大学医院医学部预防医学科。将受邀接受筛选检查的出生队列（年龄32-51岁）（男性= 9.923;女性= 4.422）与未受邀的出生队列（男性= 6.655;女性= 4.290）进行比较。受邀队列的平均参与率为71%筛选检查，在1974年和1992年之间，基线筛选包括体格检查、血压、关于例如家族史、生活方式和社会经济因素的问卷、血清胆固醇、甘油三酯、γ-谷氨酰转移酶、口服葡萄糖负荷之前和之后的幼仔葡萄糖的实验室测试，以及乳房X光检查的妇女，进行了干预，受试者高血压;糖尿病;糖尿病或葡萄糖耐受不良;高酒精摄入量;主要结果测量，从筛选检查到1995年底的总死亡率和原因特异性死亡率、非致命性心肌梗死和中风，在干预组和对照组中，使用国家和/或地方登记。总死亡率在干预组和对照组之间没有显著差异。原因特异性死亡也相似，除了干预组男性中的“其他”死亡显著较低，主要是由于基线时40岁以下男性的“其他”原因（自杀、酒精相关死亡）死亡率较低。干预组40岁以下妇女的癌症死亡率显著低于对照组。非致死性心肌梗死和卒中在干预组和对照组之间没有性别差异。在邀请出生队列中，非参与者的总死亡率和病因特异性死亡率较高。主要疾病的风险因素筛查，如心血管疾病、酗酒、糖尿病和乳腺癌，以及随后对检测到的风险因素/疾病的治疗----马尔莫预防项目----并没有降低干预组整体的总死亡率。在入组时年龄小于40岁的受试者中，干预组的总死亡率低于对照组。在男性中，这似乎是由于与酒精有关的死亡减少，而在女性中，癌症死亡减少。
Objectives, To analyse the effects on mortality and cardiovascular morbidity in a population-based sample, invited to an intervention programme incorporating a baseline screening examination and treatment programmes for subjects with cardiovascular risk factors, high alcohol intake and, in women, suspicion of breast cancer on mammography.Setting. Section of Preventive Medicine, Department of Medicine, University Hospital, Malmo, Sweden.Subjects. Birth cohorts (aged 32-51 years) invited to screening examination (men = 9.923; women = 4.422) were compared to birth cohorts not invited (men = 6.655; women = 4.290). Mean participation rate in the invited cohorts was 71% (range 64-78%).Screening examination, Between 1974 and 1992 a baseline screening including a physical examination, blood pressure, a questionnaire regarding, e.g. family history, lifestyle, and socio-economic factors, laboratory tests of serum cholesterol, triglycerides, gamma-glutamyl-transferase, brood glucose before and after an oral glucose load, as well as a mammography examination in women, was performed.Interventions, Subjects with hypertension; hyperlipidaemia; diabetes or glucose intolerance; high alcohol intake; or, in women, suspicion of breast cancer were referred to special outpatient clinics.Main outcome measures, Total and cause-specific mortality, nonfatal myocardial infarction, and stroke, from the screening examination until the end of 1995, was followed in both the intervention and control groups, using national and/or local registries.Results. Total mortality did not differ significantly between the intervention group and control group. Cause-specific deaths were also similar except for 'other' deaths amongst men being significantly lower in the intervention group, mainly due to a lower mortality from 'other' causes (suicide, alcohol related deaths) in men under 40 years of age at baseline. Women under 40 years of age had a significantly lower mortality from cancer in the intervention group than in the control group. Nonfatal myocardial infarction and stroke did not differ between intervention and control group in either sex, Within the invited birth cohorts, nonparticipants had a higher total and cause-specific mortality.Conclusions. Risk factor screening for major diseases such as cardiovascular disease, alcohol abuse, diabetes mellitus and breast cancer, and subsequent treatment of the detected risk factors/diseases - The Malmo Preventive Project - did not reduce total mortality in the intervention group as a whole. In subjects under 40 years of age at entry, total mortality was lower in the intervention group than in the control group. In men, this seemed to be due to a reduction of alcohol-related deaths, whilst in women death from cancer was reduced.