Midlife risk factors and healthy survival in men
Midlife risk factors and healthy survival in men
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DOI：
10.1001/jama.296.19.2343
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发表时间：
2006-11-15
影响因子：
120.7
通讯作者：
Curb, J. David
中科院分区：
文献类型：
--
作者：
Willcox, Bradley J.;He, Qimei;Curb, J. David
上下文健康的生存没有明确的表型定义，很少有人知道它的属性，特别是在男性objectives.Objective测试是否中年的生物，生活方式和社会人口的危险因素与总生存和特殊生存（一组主要疾病和损伤）。设计，设置和参与者前瞻性队列研究在檀香山心脏计划/檀香山亚洲老龄化研究。共有5820例日裔美国中年男性（平均年龄，54 [范围，45-68]岁）无发病率和功能障碍，随访长达40年（1965-2005年），以评估总体和特殊生存率。特殊存活率定义为存活至特定年龄（75、80、85或90岁）无6种主要慢性疾病的发生率，无身体和认知障碍。主要结果测量总体生存率和特殊生存率。2451名参与者（42%）存活至85岁，655名参与者（11%）符合例外存活至85岁的标准。高握力和避免超重、高血糖、高血压、吸烟和过度饮酒与总体和特殊生存率相关。此外，高教育和避免高血脂症与特殊的生存率相关，缺乏配偶与85岁以前的死亡率相关。基于累积风险因素（生存风险评分）的风险因素模型表明，无风险因素时生存至最大年龄的概率高达69%，而有6个或更多风险因素时则低至22%。无危险因素时，例外生存至85岁的概率为55%，但有6个或6个以上危险因素时，例外生存至85岁的概率下降至9%。结论这些数据表明，中年时避免某些危险因素与男性健康长寿的概率有关。
Context Healthy survival has no clear phenotypic definition, and little is known about its attributes, particularly in men.Objective To test whether midlife biological, lifestyle, and sociodemographic risk factors are associated with overall survival and exceptional survival ( free of a set of major diseases and impairments).Design, Setting, and Participants Prospective cohort study within the Honolulu Heart Program/Honolulu Asia Aging Study. A total of 5820 Japanese American middle-aged men ( mean age, 54 [ range, 45-68] years) free of morbidity and functional impairments were followed for up to 40 years (1965-2005) to assess overall and exceptional survival. Exceptional survival was defined as survival to a specified age ( 75, 80, 85, or 90 years) without incidence of 6 major chronic diseases and without physical and cognitive impairment.Main Outcome Measure Overall survival and exceptional survival.Results Of 5820 original participants, 2451 participants (42%) survived to age 85 years and 655 participants (11%) met the criteria for exceptional survival to age 85 years. High grip strength and avoidance of overweight, hyperglycemia, hypertension, smoking, and excessive alcohol consumption were associated with both overall and exceptional survival. In addition, high education and avoidance of hypertriglyceridemia were associated with exceptional survival, and lack of a marital partner was associated with mortality before age 85 years. Risk factor models based on cumulative risk factors ( survival risk score) suggest that the probability of survival to oldest age is as high as 69% with no risk factors and as low as 22% with 6 or more risk factors. The probability of exceptional survival to age 85 years was 55% with no risk factors but decreased to 9% with 6 or more risk factorsConclusion These data suggest that avoidance of certain risk factors in midlife is associated with the probability of a long and healthy life among men.