Cholesterol, coronary heart disease, and stroke in the Asia Pacific region
Cholesterol, coronary heart disease, and stroke in the Asia Pacific region
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DOI：
10.1093/ije/dyg106
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发表时间：
2003-08-01
影响因子：
7.7
通讯作者：
Woodward, M
中科院分区：
文献类型：
--
作者：
Zhang, X;Patel, A;Woodward, M
许多亚洲国家的胆固醇水平正在上升。对这对心血管疾病发病率可能产生的影响的预测主要依赖于西方人群的数据。总胆固醇和心血管疾病之间的关联是否是类似的在Asia.Methods亚太队列研究协作（APCSC）是一个个人参与者的数据荟萃分析的前瞻性研究，从亚太地区。考克斯模型应用于29个队列的综合数据，估计主要心血管疾病的地区，性别和年龄特异性的风险比的五分之一总cholesterol.Results在基线时，年龄/性别调整的总胆固醇的平均值是在澳大利亚和新西兰（ANZ）（5.52+/-1.05 mmol/l）高于亚洲（4.87+/-1.05 mmol/l）。在对352033人进行的200万人年随访期间，记录了4841例心血管死亡。总胆固醇与冠心病和中风的相关性在亚洲和ANZ队列中相似。总的来说，总胆固醇水平每升高1 mmol/l，（95% CI：26-44%）冠心病死亡风险增加，25%（95% CI：13-40%）致死性或非致死性缺血性卒中风险增加，20%（95%置信区间：8-30%）降低致命性出血性中风的风险。结论在亚太地区的亚洲和非亚洲人群中，总胆固醇同样与CHD和缺血性中风的风险密切相关，但与出血性中风无关。预计整个人口胆固醇水平的上升将导致该区域心血管疾病的总体负担大幅增加。
Background Cholesterol levels in many Asian countries are rising. Predictions of the likely effects of this on the incidence of cardiovascular diseases have mostly relied on data from Western populations. Whether the associations between total cholesterol and cardiovascular diseases are similar in Asia is not established.Methods The Asia Pacific Cohort Studies Collaboration (APCSC) is an individual-participant data meta-analysis of prospective studies from the Asia-Pacific region. Cox models were applied to the combined data from 29 cohorts to estimate the region-, sex-, and age-specific hazard ratios of major cardiovascular diseases by the fifths of total cholesterol.Results At baseline, the age/sex-adjusted mean value of total cholesterol was higher in Australia and New Zealand (ANZ) (5.52+/-1.05 mmol/l) than in Asia (4.87+/-1.05 mmol/l). During 2 million person-years of follow-up among 352 033 individuals, 4841 cardiovascular deaths were recorded. The association of total cholesterol with coronary heart disease and stroke was similar in Asian and ANZ cohorts. Overall, each 1-mmol/l higher level of total cholesterol was associated with 35% (95% CI: 26-44%) increased risk of coronary death, 25% (95% CI: 13-40%) increased risk of fatal or non-fatal ischaemic stroke, and 20% (95% CI: 8-30%) decreased risk of fatal haemorrhagic stroke.Conclusions In both Asian and non-Asian populations in the Asia-Pacific region, total cholesterol is similarly strongly associated with the risk of CHD and ischaemic, but not haemorrhagic, stroke. Rising population-wide levels of cholesterol would be expected to contribute to a substantial increase in the overall burden of cardiovascular diseases in this region.