Primary prevention of coronary heart disease in women through diet and lifestyle.
Primary prevention of coronary heart disease in women through diet and lifestyle.
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DOI：
10.1056/nejm200007063430103
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发表时间：
2000-07-06
影响因子：
158.5
通讯作者：
Willett, WC
中科院分区：
文献类型：
--
作者：
Stampfer, MJ;Hu, FB;Willett, WC
背景：许多与生活方式相关的冠心病危险因素已经被确定，但当它们一起考虑时，对它们对疾病风险的影响知之甚少。方法：我们随访了84,129名参加护士健康研究的妇女，这些妇女在1980年基线时没有诊断出心血管疾病、癌症和糖尿病。有关饮食和生活方式的信息定期更新。在14年的随访中，我们记录了1128例主要冠状动脉事件（296例死于冠心病，832例非致死性梗死）。我们在低风险定义为那些目前没有吸烟,有一个体重指数(用体重(公斤)除以身高(米)的平方25岁以下,平均消耗至少一半每天喝含酒精的饮料,从事强度到高强度的体育运动(其中可能包括快步走)每天至少半个小时,平均得分最高的群体消费的40%高谷物纤维的饮食,海洋n-3脂肪酸和叶酸，多不饱和脂肪与饱和脂肪的比例高，反式脂肪和血糖负荷低，这反映了饮食提高血糖水平的程度。结果：许多因素是相关的，但即使在进一步调整了年龄、家族史、是否诊断出高血压或高胆固醇水平以及绝经状态后，每个因素都独立且显著地预测了风险。低风险类别的妇女（占人口的3%）与所有其他妇女相比，冠状动脉事件的相对风险为0.17（95%置信区间，0.07至0.41）。研究队列中82%的冠状动脉事件（95%置信区间，58%至93%）可归因于缺乏对这种低风险模式的坚持。结论：在女性中，遵守包括饮食、运动和戒烟在内的生活方式指南与患冠心病的风险非常低有关。[J] .中华医学杂志，2000;33(3):16-22。(C) 2000年，马萨诸塞州医学协会。
Background: Many lifestyle-related risk factors for coronary heart disease have been identified, but little is known about their effect on the risk of disease when they are considered together.Methods: We followed 84,129 women participating in the Nurses' Health Study who were free of diagnosed cardiovascular disease, cancer, and diabetes at base line in 1980. Information on diet and lifestyle was updated periodically. During 14 years of follow-up, we documented 1128 major coronary events (296 deaths from coronary heart disease and 832 nonfatal infarctions). We defined subjects at low risk as those who were not currently smoking, had a body-mass index (the weight in kilograms divided by the square of the height in meters) under 25, consumed an average of at least half a drink of an alcoholic beverage per day, engaged in moderate-to-vigorous physical activity (which could include brisk walking) for at least half an hour per day, on average, and scored in the highest 40 percent of the cohort for consumption of a diet high in cereal fiber, marine n-3 fatty acids, and folate, with a high ratio of polyunsaturated to saturated fat, and low in trans fat and glycemic load, which reflects the extent to which diet raises blood glucose levels.Results: Many of the factors were correlated, but each independently and significantly predicted risk, even after further adjustment for age, family history, presence or absence of diagnosed hypertension or diagnosed high cholesterol level, and menopausal status. Women in the low-risk category (who made up 3 percent of the population) had a relative risk of coronary events of 0.17 (95 percent confidence interval, 0.07 to 0.41) as compared with all the other women. Eighty-two percent of coronary events in the study cohort (95 percent confidence interval, 58 to 93 percent) could be attributed to lack of adherence to this low-risk pattern.Conclusions: Among women, adherence to lifestyle guidelines involving diet, exercise, and abstinence from smoking is associated with a very low risk of coronary heart disease. (N Engl J Med 2000;343:16-22.) (C) 2000, Massachusetts Medical Society.