Absolute risk score for stroke, myocardial infarction, and all cardiovascular disease: Japan Arteriosclerosis Longitudinal Study
Absolute risk score for stroke, myocardial infarction, and all cardiovascular disease: Japan Arteriosclerosis Longitudinal Study
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DOI：
10.1038/s41440-019-0220-z
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发表时间：
2019-04-01
影响因子：
5.4
通讯作者：
Ohashi, Yasuo
中科院分区：
文献类型：
--
作者：
Harada, Akiko;Ueshima, Hirotsugu;Ohashi, Yasuo
为了建立一个基于最近数据并适用于日本人的风险图表或评分，我们需要一个代表日本人的大型队列研究，而不需要长期随访。本研究的目的是建立一个风险评分系统来评估5年和10年卒中和急性心肌梗死（AMI）的绝对和累积发生率风险，卒中和AMI的综合结局，以及所有心血管疾病（CVD）的死亡。累积发病率风险比使用多元泊松回归模型和来自日本动脉硬化纵向研究的数据计算，该研究包括67,969名年龄在40-89岁之间的男性和女性。建立了5年和10年的绝对风险评分系统。对于血压类别，所有结果的风险比从正常血压（收缩压（SBP） 120-129 mmHg和舒张压（DBP） 80-89 mmHg）增加到III级高血压（收缩压(SBP) = 180和/或DBP >= 110），基于2014年高血压管理指南，与参考最佳血压（SBP < 120和DBP < 80）相比。接受药物治疗的II级（收缩压160-179和/或舒张压100-109）和III级高血压与未接受药物治疗的高血压相比风险较低。其他风险因素显示出合理的数字。每个危险因素的总得分表明卒中和AMI的估计绝对风险，卒中和AMI的综合结局，以及所有心血管疾病。该评分系统可能有助于患者教育和制定减少人群心血管疾病的策略。
To develop a risk chart or score that is based on recent data and applicable to the Japanese people, we need a large cohort study representative of the Japanese people without a need for long-term follow-up. The purpose of the present study was to develop a risk scoring system to estimate the 5- and 10-year absolute and cumulative incidence risk of stroke and acute myocardial infarction (AMI), composite outcome of stroke and AMI, and death from all cardiovascular disease (CVD). The cumulative incidence risk ratios were calculated using a multiple Poisson regression model and data from the Japan Arteriosclerosis Longitudinal Study, which included 67,969 men and women aged 40-89 years. An absolute risk scoring system for 5- and 10-year risk was developed. For blood pressure categories, the risk ratios for all outcomes increased from normal blood pressure (systolic blood pressure (SBP) 120-129 mmHg and diastolic blood pressure (DBP) 80-89 mmHg) to grade III hypertension (SBP >= 180 and/or DBP >= 110) based on the 2014 Guidelines for the Management of Hypertension compared to the reference optimal blood pressure (SBP < 120 and DBP < 80). Grade II (SBP 160-179 and/or DBP 100-109) and III hypertension treated with medication showed a lower risk compared to counterparts without medication. Other risk factors showed reasonable figures. The total of scores for each risk factor indicated the estimated absolute risk for stroke and AMI, the composite outcome of stroke and AMI, and all CVD. This scoring system may contribute to patient education and to the development of strategies for reducing CVD in the population.