10-YEAR INCIDENCE OF CORONARY HEART-DISEASE IN THE HONOLULU HEART PROGRAM - RELATIONSHIP TO BIOLOGIC AND LIFESTYLE CHARACTERISTICS
10-YEAR INCIDENCE OF CORONARY HEART-DISEASE IN THE HONOLULU HEART PROGRAM - RELATIONSHIP TO BIOLOGIC AND LIFESTYLE CHARACTERISTICS
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DOI：
10.1093/oxfordjournals.aje.a113787
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发表时间：
1984-01-01
影响因子：
5
通讯作者：
MCGEE, DL
中科院分区：
文献类型：
--
作者：
YANO, K;REED, DM;MCGEE, DL
在1965-1968年对居住在美国夏威夷的7705名年龄在45-68岁的日本男性进行的10年随访中，共发现511例新的冠心病病例：致死性冠心病139例，非致死性心肌梗死216例，急性冠状动脉功能不全55例，心肌梗死216例，心肌梗死216例。和单纯性心绞痛（AP），101.该队列的致死性CHD和非致死性MI的发生率不到美国白人的一半，约为日本男性的两倍。在双变量和多变量分析中，研究了基线检查时测量的14个生物学和生活方式特征与总CHD发病率和CHD特异性表现的关系。在双变量分析中，校正年龄后，除心率外的所有变量均与总CHD风险显著相关。然而，当在考虑所有其他变量的多重logistic分析中评估每个变量对CHD风险的独立贡献时，保留显著关联的危险因素的数量因CHD的临床亚组而异。在所研究的特征中，收缩压是除AP外所有表现的最有力和一致的危险因素。吸烟也显示出类似的模式。血清胆固醇与致死性CHD和非致死性MI显著相关，但其对CHD风险的作用不如收缩压或吸烟。葡萄糖不耐症与致死性CHD密切相关，但与CHD的其他表现无关。饮酒对致死性CHD和非致死性MI有很强的保护作用。无并发症AP与其他CHD表现的区别在于与大多数已知的CHD主要危险因素（包括血压、血清胆固醇和吸烟）缺乏相关性。
In 10 yr of follow-up of 7705 Japanese men living in Hawaii, USA aged 45-68 yr and judged free of coronary heart disease (CHD) at the initial examination during 1965-1968, a total of 511 new CHD cases were identified: fatal CHD, 139; nonfatal myocardial infarction (MI), 216; acute coronary insufficiency, 55; and uncomplicated angina pectoris (AP), 101. The incidence rate of fatal CHD and nonfatal MI for this cohort is less than half the rate of USA whites and approximately twice the rate for Japanese men in Japan. The relationships of 14 biologic and lifestyle characteristics measured at baseline examination to the incidence of total CHD and specific manifestations of CHD were examined in bivariate and multivariate analyses. In bivariate analyses, all variables except heart rate were significantly related to the risk of total CHD after adjustment for age. However, when an independent contribution of each variable to CHD risk was evaluated in multiple logistic analyses in which all other variables were taken into account, the numbers of risk factors retaining signiicant associations varied by clinical subgroup of CHD. Among the characteristics studied, systolic blood pressure was the most powerful and consistent risk factor for all manifestations except AP. Cigarette smoking showed a similar pattern. Serum cholesterol was significantly associated with fatal CHD and nonfatal MI, but its contribution to CHD risk was less potent than systolic blood pressure or cigarette smoking. Glucose intolerance was strongly associated with fatal CHD, but with no other manifestations of CHD. Alcohol consumption demonstrated a strong protective effect upon fatal CHD and nonfatal MI. Uncomplicated AP was distinguished from other CHD manifestations by the lack of association with most of the known major risk factors for CHD, including blood pressure, serum cholesterol, and cigarette smoking.