Coronary heart disease incidence in northern and southern European populations: a reanalysis of the seven countries study for a European coronary risk chart
Coronary heart disease incidence in northern and southern European populations: a reanalysis of the seven countries study for a European coronary risk chart
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DOI：
10.1136/heart.84.3.238
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发表时间：
2000-09-01
期刊：
影响因子：
5.7
通讯作者：
Kromhout, D
中科院分区：
文献类型：
--
作者：
Menotti, A;Lanti, H;Kromhout, D
目的：对这七个国家的北欧和南欧队列10年来的冠心病发病率数据进行系统的再分析，以间接有助于欧洲冠心病风险图的制作。设计和环境--在芬兰和荷兰的三个北欧队列中(n=2213)以及在意大利、前南斯拉夫和希腊的10个南欧队列中(n=5897)，对年龄在40-59岁的男性进行了研究。对于两个地理分组和他们的池，解决了预测冠状动脉死亡、冠状动脉发生率(硬标准)和冠状动脉发生率(任何标准)的多个Logistic模型。进入模型的危险因素包括年龄、收缩压、血清总胆固醇和吸烟。结果：10年冠心病死亡率和发病率北欧高于南欧，比率约为2.65。在两个文化群体中，三种冠心病表现的比例是相同的。多个Logistic模型的系数在两组间相似且无显著差异。当将系数应用于相同或相反的人群时，在不同的文化中，相对风险很大且相似。冠心病症状越严重，相对风险越大。当将北欧模型应用于南欧人口时，绝对风险被高估了，反之亦然，比率分别约为1.5和0.5。在其他条件相同的情况下，为再现最近欧洲指南中纳入的这些因素的形状而创建的冠状动脉风险图表证实，与南欧队列相比，北欧的绝对风险超标。结论-从理论上讲，通过采用系数来修正不同文化中不同的背景发病率，可以生成更合适的欧洲冠状动脉风险图表。其他系数可以适当地用于将死亡风险转换为发病风险。(心脏2000，84：238-244)
Objective-A systematic reanalysis of 10 year coronary heart disease incidence data from the northern and the southern European cohorts of the seven countries study, to contribute indirectly to the production of a European coronary risk chart. Design and setting-Men aged 40-59 years at entry were studied in three northern European cohorts based in Finland and Netherlands (n = 2213); and in 10 southern European cohorts based in Italy, former Yugoslavia, and Greece (n = 5897). Multiple logistic models for the prediction of coronary deaths, coronary incidence hard criteria), and coronary incidence (any criterion) were solved for the two geographical groups and their pool. Risk factors fed into the models were age, systolic blood pressure, serum total cholesterol, and cigarette smoking. Results-10 year coronary heart disease mortality and incidence were higher in northern than in southern Europe, with ratios around 2.65. Ratios among the three coronary heart disease manifestations were identical in the two cultural groupings. Coefficients of the multiple logistic models were similar and not significantly different between the two groupings. When applying the coefficients back to the same or the opposite population, the relative risk was large and similar in the different cultures. Relative risk was larger for more severe coronary heart disease manifestations. The absolute risk was overestimated when applying the northern European model to southern European populations and vice versa, with ratios of about 1.5 and 0.5, respectively. Coronary risk charts created to reproduce the shape of these incorporated in recent European guidelines confirmed the excess of absolute risk in the northern compared with the southern European cohorts, all else being equal. Conclusions-In theory, a more appropriate European coronary risk chart could be produced by adopting coefficients to correct for different background incidence rates in different cultures. Other coefficients could appropriately be used to transform mortality risk into incidence risk. (Heart 2000,84:238-244)