Effect of potentially modifiable risk factors associated with myocardial infarction in 52 countries (the INTERHEART study): case-control study
Effect of potentially modifiable risk factors associated with myocardial infarction in 52 countries (the INTERHEART study): case-control study
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DOI：
10.1016/s0140-6736(04)17018-9
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发表时间：
2004-09-11
期刊：
影响因子：
168.9
通讯作者：
Liu, LS
中科院分区：
文献类型：
--
作者：
Yusuf, S;Hawken, S;Liu, LS
尽管全球80%以上的心血管疾病负担发生在低收入和中等收入国家，但对危险因素重要性的认识主要来自发达国家。因此，这些因素对冠心病风险的影响，在世界上大部分地区是unknown.Methods我们建立了一个标准化的急性心肌梗死病例对照研究，在52个国家，代表每一个有人居住的大陆。纳入病例15152例，对照14820例。本文报告吸烟、高血压或糖尿病史、腰/臀比、饮食结构、体力活动、饮酒、血载脂蛋白（Apo）和心理社会因素与心肌梗死的关系。计算危险因素与心肌梗死及其人群归因危险度（PAR）的比值比及其99%CI。（当前与从未发生的比值比为2.87，当前和既往与从未发生的PAR为35.7%），ApoB/ApoA 1比值升高（最高五分位数与最低五分位数为3.25，最高四分位数与最低五分位数的PAR为49.2%），高血压病史（1.91，PAR 17.9%），糖尿病（2.37，PAR 9.9%），腹型肥胖（最高与最低三分位数为1.12，中间与最低三分位数为1.62，最高两个三分位数与最低三分位数的PAR为20.1%），心理社会因素（2.67，PAR 32.5%）、蔬菜水果日消费量（0 . 70，PAR 13.7%缺乏日常消费），经常饮酒（0。91，PAR 6.7%），以及定期体力活动（0。86，PAR 12.2%），均与急性心肌梗死显著相关（p
Background Although more than 80% of the global burden of cardiovascular disease occurs in low-income and middle-income countries, knowledge of the importance of risk factors is largely derived from developed countries. Therefore, the effect of such factors on risk of coronary heart disease in most regions of the world is unknown.Methods We established a standardised case-control study of acute myocardial infarction in 52 countries, representing every inhabited continent. 15152 cases and 14820 controls were enrolled. The relation of smoking, history of hypertension or diabetes, waist/hip ratio, dietary patterns, physical activity, consumption of alcohol, blood apolipoproteins (Apo), and psychosocial factors to myocardial infarction are reported here. Odds ratios and their 99% CIs for the association of risk factors to myocardial infarction and their population attributable risks (PAR) were calculated.Findings Smoking (odds ratio 2.87 for current vs never, PAR 35.7% for current and former vs never), raised ApoB/ApoA1 ratio (3.25 for top vs lowest quintile, PAR 49.2% for top four quintiles vs lowest quintile), history of hypertension (1.91, PAR 17.9%), diabetes (2.37, PAR 9.9%), abdominal obesity (1.12 for top vs lowest tertile and 1.62 for middle vs lowest tertile, PAR 20.1% for top two tertiles vs lowest tertile), psychosocial factors (2.67, PAR 32.5%), daily consumption of fruits and vegetables (0 . 70, PAR 13.7% for lack of daily consumption), regular alcohol consumption (0 . 91, PAR 6.7%), and regular physical activity (0 . 86, PAR 12.2%), were all significantly related to acute myocardial infarction (p