Similarities and differences between coronary heart disease and stroke in the associations with cardiovascular risk factors: The Japan Collaborative Cohort Study
Similarities and differences between coronary heart disease and stroke in the associations with cardiovascular risk factors: The Japan Collaborative Cohort Study
复制标题
DOI：
10.1016/j.atherosclerosis.2017.03.003
复制
发表时间：
2017-06-01
期刊：
影响因子：
5.3
通讯作者：
Tamakoshi, Akiko
中科院分区：
文献类型：
--
作者：
Matsunaga, Masaaki;Yatsuya, Hiroshi;Tamakoshi, Akiko
背景和目的：冠心病(CHD)和卒中有共同的危险因素，但其中一些在CHD和卒中之间的关联的大小或方向上有所不同。我们评估了每个危险因素对亚洲人冠心病和中风死亡率的影响是否有所不同。方法：在1988年至2009年期间，我们总共跟踪了104 910名年龄在40-79岁之间且无癌症、冠心病和中风病史的受试者。竞争风险分析被用来检验每个危险因素与两个终点(冠心病和中风)的相关性的差异。还计算了这些终点的人群归因分数(PAF)，以估计每个危险因素对人群的影响。结果：在中位数19.1年的随访中，1554人死于冠心病，3163人死于中风。高血压与冠心病的关联在幅度和方向上与中风相似(冠心病的多变量调整风险比：男性为1.63，女性为1.73，女性为1.66)。相反，吸烟(CHD：1.95对中风：男性：1.23，女性：2.45：1.35)和糖尿病(男性：1.49：1.09，女性：2.08：1.39)的关联度不同。男性吸烟和女性高血压引起的PAF最高，而卒中男性和女性都是由高血压引起的。结论：冠心病和卒中与高血压的关系是一致的，但与其他危险因素无关。这些发现可能有助于优化公共卫生干预策略。(C)2017爱思唯尔B.V.保留所有权利。
Background and aims: Coronary heart disease (CHD) and stroke have common risk factors, but some of these differ in the magnitude or direction of associations between CHD and stroke. We assessed whether the impact of each risk factor differed between CHD and stroke mortality in Asians.Methods: In total, 104 910 subjects aged 40-79 years without histories of cancer, CHD and stroke at baseline were followed between 1988 and 2009. Competing- risks analysis was used to test for differences in the associations of each risk factor with two endpoints (CHD and stroke). Population attributable fractions (PAFs) were also calculated for these endpoints to estimate the population impact of each risk factor.Results: During a median 19.1-year follow-up, 1554 died from CHD and 3163 from stroke. The association of hypertension with CHD was similar to that with stroke in terms of the magnitude and direction (multivariable-adjusted hazard ratio for CHD: 1.63 vs. stroke: 1.73 in men and 1.70 vs. 1.66 in women). Conversely, the magnitude of these associations differed for smoking (CHD: 1.95 vs. stroke: 1.23 in men and 2.45 vs. 1.35 in women) and diabetes (1.49 vs. 1.09 in men and 2.08 vs. 1.39 in women). The highest PAF for CHD was caused by smoking in men and by hypertension in women; that for stroke was caused by hypertension in both sexes.Conclusions: Hypertension associations and PAFs were consistent between CHD and stroke, but not for other risk factors. These findings may be useful to optimize public health intervention strategies. (C) 2017 Elsevier B.V. All rights reserved.