SUBCLINICAL DISEASE AS AN INDEPENDENT RISK FACTOR FOR CARDIOVASCULAR-DISEASE
SUBCLINICAL DISEASE AS AN INDEPENDENT RISK FACTOR FOR CARDIOVASCULAR-DISEASE
复制标题
DOI：
10.1161/01.cir.92.4.720
复制
发表时间：
1995-08-15
期刊：
影响因子：
37.8
通讯作者：
TRACY, R
中科院分区：
文献类型：
--
作者：
KULLER, LH;SHEMANSKI, L;TRACY, R
背景本研究的主要目的是确定5201名参加心血管健康研究的65岁或65岁以上的成年人中亚临床心血管疾病指标与临床心血管疾病发病率之间的关系。肱动脉血压、颈动脉狭窄和壁厚、ECG和超声心动图异常以及Rose心绞痛和跛行问卷的阳性应答。参与者平均随访2.39年（最长3年）。对于基线时无临床心血管疾病证据的参与者，与无亚临床疾病相比，亚临床疾病的存在与男性和女性总冠心病事件（包括CHD死亡和非致死性MI和心绞痛）的风险显著增加相关。对于亚临床疾病的个体，男性总冠心病风险增加2.0，女性增加2.5，男性总死亡风险增加2.9，女性增加1.7。增加的风险变化不大调整后的其他危险因素，包括脂蛋白水平，血压，吸烟，和diabetes.Conclusions的测量亚临床疾病提供了一种方法，用于确定高风险的老年人谁可能是候选人更积极的干预，以防止临床疾病。
Background The primary aim of the present study was to determine the relation between measures of subclinical cardiovascular disease and the incidence of clinical cardiovascular disease among 5201 adults 65 years of age or older who were participating in the Cardiovascular Health Study.Methods and Results A new method of classifying subclinical disease at baseline examination in the Cardiovascular Health Study included measures of ankle-brachial blood pressure, carotid artery stenosis and wall thickness, ECG and echocardiographic abnormalities, and positive response to the Rose Angina and Claudication Questionnaire. Participants were followed for an average of 2.39 years (maximum, 3 years). For participants without evidence of clinical cardiovascular disease at baseline, the presence of subclinical disease compared with no subclinical disease was associated with a significant increased risk of incident total coronary heart disease including CHD deaths and nonfatal MI and angina pectoris for both men and women. For individuals with subclinical disease, the increased risk of total coronary heart disease was 2.0 for men and 2.5 for women, and the increased risk of total mortality was 2.9 for men and 1.7 for women. The increased risk changed little after adjustment for other risk factors, including lipoprotein levels, blood pressure, smoking, and diabetes.Conclusions The measurement of subclinical disease provides an approach for identifying high-risk older individuals who may be candidates for more active intervention to prevent clinical disease.