Lifetime risk and years lived free of total cardiovascular disease.
Lifetime risk and years lived free of total cardiovascular disease.
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DOI：
10.1001/jama.2012.14312
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发表时间：
2012-11-07
影响因子：
120.7
通讯作者：
Lloyd-Jones, Donald M.
中科院分区：
文献类型：
--
作者：
Wilkins, John T.;Ning, Hongyan;Berry, Jarett;Zhao, Lihui;Dyer, Alan R.;Lloyd-Jones, Donald M.
对总心血管疾病(TCVD)的终生风险(LTR)的估计可以提供对未来心血管疾病人群负担的预测，并有助于临床医生和患者之间的风险沟通。到目前为止，还没有关于tCVD的LTR值的报告。按年龄[45、55、65、75岁(Y)]和危险因素层计算tCVD的LTR值，并估计各危险因素层的无心血管疾病生存年限。从1964年到2008年，NHLBI资助的5个基于社区的队列研究：Framingham心脏研究、Framingham子孙研究、社区动脉粥样硬化风险研究、芝加哥心脏协会检测项目行业研究和心血管健康研究，对多达905,115人年的数据进行了汇总生存分析。所有有危险因素数据(血压(BP)、总胆固醇(TC)、糖尿病和吸烟状况)和tCVD结局数据(包括致命和非致命性冠心病、所有形式的中风、充血性心力衰竭和其他心血管死亡)的基线无心血管疾病的参与者在指标年龄45岁时，tCVD的总体LRR男性为60.3%(95%CI，59.3~61.2)，女性为55.6%(95%CI，54.5~56.7)。在所有指数年龄段，男性的LTR估计值都高于女性。在55岁和65岁时，≥-1升高危险因素(BP140-149/90-99毫米汞柱或TC200-239 mg/dL，但无糖尿病或吸烟)、或1或≥-2主要危险因素(BP≥160/100毫米汞或正在治疗中；TC≥240 mg/dL或正在治疗、糖尿病或当前吸烟)的男性和女性在95岁时的LTR值超过50%。尽管存在最佳的危险因素(BP<；120/80 mm Hg，TC<；180 mg/dl，以及不吸烟或不患糖尿病)，指标年龄为55岁的男性和女性在85岁和85岁的总心血管疾病中的LTR值分别为40%和30%。与具有≥2主要危险因素的参与者相比，具有最佳风险因素的参与者无tCVD的寿命延长了14年。对于所有个体，即使是那些在中年有最佳危险因素的人，tCVD的LTR值也很高(30%)。然而，在中年时期保持最佳的危险因素水平与更长的无病生存期相关。
Estimates of lifetime risk (LTR) for total cardiovascular disease (tCVD) may provide projections of the future population burden of cardiovascular disease and may assist in clinician-patient risk communication. To date, no LTR estimates of tCVD have been reported. To calculate LTR estimates of tCVD by index age [45, 55, 65, 75 years(y)] and risk factor strata and to estimate years lived free of CVD across risk factor strata. Pooled survival analysis of up to 905,115 person-years of data from 1964 through 2008 from 5 NHLBI-funded community-based cohorts: Framingham Heart Study, Framingham Offspring Study, Atherosclerosis Risk in Communities Study, Chicago Heart Association Detection Project in Industry Study and Cardiovascular Health Study. All participants free of CVD at baseline with risk factor data (blood pressure (BP), total cholesterol (TC), diabetes and smoking status) and tCVD outcome data Any tCVD event (including fatal and non-fatal coronary heart disease, all forms of stroke, congestive heart failure and other CVD deaths) At an index age of 45y, overall LTR for tCVD was 60.3% (95% CI, 59.3 to 61.2) for men and 55.6% (95% CI, 54.5 to 56.7) for women. Men had higher LTR estimates than women across all index ages. At index ages 55 and 65y, men and women with ≥1 elevated risk factor (BP 140-149/90-99 mmHg or TC 200-239 mg/dL but no diabetes or smoking), or 1, or ≥ 2 major risk factors (BP ≥ 160/100mmHg or on treatment; TC ≥ 240mg/dL or on treatment, diabetes mellitus, or current smoking) had LTR estimates to age 95y that exceeded 50%. Despite an optimal risk factor profile (BP < 120/80 mmHg, TC < 180 mg/dL, and no smoking or diabetes) men and women at an index age of 55y had LTR for total CVD to age 85y > 40% and 30% respectively. Compared with participants with ≥ 2 major risk factors, those with an optimal risk factor profile lived up to 14y longer free of tCVD. LTR estimates for tCVD are high (>30%) for all individuals, even those with optimal risk factors in middle age. However, maintenance of optimal risk factor levels in middle age is associated with substantially longer morbidity-free survival.
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影响因子：
37.8
作者：
Lloyd-Jones, DM;Larson, MG;Levy, D
通讯作者：
Levy, D
影响因子：
37.8
作者：
Berry JD;Liu K;Folsom AR;Lewis CE;Carr JJ;Polak JF;Shea S;Sidney S;O'Leary DH;Chan C;Lloyd-Jones DM
通讯作者：
Lloyd-Jones DM
DOI：
10.1056/nejmoa1012848
发表时间：
2012-01-26
期刊：
The New England journal of medicine
影响因子：
--
作者：
Berry JD;Dyer A;Cai X;Garside DB;Ning H;Thomas A;Greenland P;Van Horn L;Tracy RP;Lloyd-Jones DM
通讯作者：
Lloyd-Jones DM
影响因子：
37.8
作者：
Lloyd-Jones, DM;Leip, EP;Levy, D
通讯作者：
Levy, D
影响因子：
120.7
作者：
Vasan, RS;Beiser, A;Levy, D
通讯作者：
Levy, D