Seasonal variation in coronary heart disease in Scotland
Seasonal variation in coronary heart disease in Scotland
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DOI：
10.1136/jech.49.6.575
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发表时间：
1995-12-01
影响因子：
6.3
通讯作者：
Rawles, JM
中科院分区：
文献类型：
--
作者：
Douglas, AS;Dunnigan, MG;Rawles, JM
研究目的-冠心病（CHD）的季节性进行了检查，以确定是否致命和非致命性疾病有相同的年度rhythm.Design -时间序列分析进行了回顾性数据超过10年的时间，并分析了年龄组（75岁）和gender.Setting -按月获得的数据为1962年至1971年。注册总署提供了关于死亡的信息，苏格兰家庭研究和情报股和：卫生部关于入院的信息。主题-在苏格兰，1962年至1971年，123 000名患者因冠心病入院，其中29 000人死亡。另有97，000例CHD死亡发生在医院外。这两组也被视为一个（冠状动脉发病率）-即所有的冠状动脉死亡和冠状动脉入院出院alive.Statistical analysis和主要结果-如果有一个单一的年度峰值，正弦曲线进行了分析余弦分析。当有两个峰时，通过正态近似泊松分布进行分析。在住院的年轻男性（45岁以下）中，有一个占主导地位的春季高峰和秋季低谷。在老年男性年龄组中，春季和冬季高峰的双峰模式对于住院率是明显的：随着年龄的增加，春季高峰减少，冬季高峰增加。相比之下，女性住院表现出占主导地位的冬季/夏季模式的季节性变化。在男性和女性的C：HD死亡的季节性变化表现出冬季高峰和夏季低谷的主导模式，冬季高峰蔓延到春季的两个最年轻的男性年龄组。女性冠心病发病率呈冬夏节律，而男性在55岁以前以春季发病高峰为主。结论：男性冠心病住院患者中与年龄相关的春季发病高峰提示存在一种雄激素性心肌梗死危险因素，其作用机制尚不清楚。随着年龄的增长和生殖变得不那么重要，CHD季节变化的冬/夏模式被叠加，并显示出与环境的密切关系，特别是温度，或秋季和初冬的温度下降。
Study objective - Seasonality of coronary heart disease (CHD) was examined to determine whether fatal and non-fatal disease have the same annual rhythm.Design - Time series analysis was carried out on retrospective data over a 10 year period and analysed by age groups (75 years) and gender.Setting - Data by month were obtained for the years 1962-71. The Registrar General provided information on deaths and the Research and Intelligence Unit of the Scottish Home and :Health Department on hospital admissions.Subjects - In Scotland, between 1962 and 1971, 123 000 patients were admitted to hospital for CHD, of whom 29 000 died. There were a further 97 000 CHD deaths outside hospital. These two groups were also examined as one (coronary incidence) - that is, all coronary deaths and coronary admissions discharged alive.Statistical analysis and main results - Where there was a single annual peak, the sine curve was analysed by cosinor analysis. When there were two peaks the analysis was by normal approximation to Poisson distribution. In younger men (under 45 years) admitted to hospital there was a dominant spring peak and an autumn trough. A bimoidal pattern of spring and winter peaks was evident for hospital admissions in older male age groups: with increasing age the spring peak diminished and the winter peak increased. In contrast, female hospital admissions showed a dominant winter/summer pattern of seasonal variation. In male and female C:HD deaths seasonal variation showed a dominant pattern of winter peaks and summer troughs, with the winter peak spreading into spring in the two youngest male age groups. CHD incidence in women showed a winter/summer rhythm, but in men the spring peak was dominant up to the age of 55.Conclusions - The male, age related spring peak in CHD hospital admissions suggests there is an androgenic risk factor for myocardial infarction operating through an unknown effector mechanism. As age advances and reproduction becomes less important, the well defined winter/summer pattern of seasonal variation in CHD is superimposed, and shows a close relationship with the environment, especially temperature, or the autumn and early winter fall in temperature.