Smoking, alcohol consumption, physical activity, and family history and the risks of acute myocardial infarction and unstable angina pectoris: a prospective cohort study
Smoking, alcohol consumption, physical activity, and family history and the risks of acute myocardial infarction and unstable angina pectoris: a prospective cohort study
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DOI：
10.1186/1471-2261-11-13
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发表时间：
2011-03-24
影响因子：
2.1
通讯作者：
van den Brandt, Piet A.
中科院分区：
文献类型：
--
作者：
Merry, Audrey H. H.;Boer, Jolanda M. A.;van den Brandt, Piet A.
背景资料：很少有研究调查吸烟、饮酒或体力活动与不稳定型心绞痛（UAP）风险之间的关系，而这些关系的强度可能与其他冠状动脉疾病（如急性心肌梗死（AMI））不同。因此，我们研究这些生活方式因素与不稳定心绞痛的关系是否与急性心肌梗死的关系不同。此外，我们调查这些影响是否有不同的受试者和没有心肌梗死（MI）的家族史：CAREMA研究包括21,148人，年龄在基线20-59岁，随机抽样从马斯特里赫特地区在1987年至1997年。在基线时，所有参与者都完成了一份自填问卷。经过最长16.9年的随访，登记了420例AMI和274例UAP事件。发病率比（RR）估计使用考克斯比例风险models.Results：对于这两种疾病，吸烟增加风险，而饮酒与保护作用。AMI与两种危险因素的相关性比UAP更强，尽管这种差异仅在吸烟方面具有统计学意义。在男性中，休闲时间的体力活动与不稳定心绞痛的风险呈负相关，似乎比急性心肌梗死的风险更强。相反，女性在闲暇时间进行体力活动与AMI和UAP的风险增加相关，UAP的风险似乎比AMI弱。除了女性的职业体力活动外，在生活方式因素和MI家族史之间没有发现显著的乘法交互作用。尽管如此，最高的风险被发现在科目与积极的家族史和最不利的水平的生活方式factors.Conclusions：与生活方式因素的关联的强度之间没有区别AMI和UAP，除了吸烟。此外，生活方式因素对两种冠状动脉疾病风险的影响在有和无阳性家族史的受试者中相似。
Background: Few studies investigated the association between smoking, alcohol consumption, or physical activity and the risk of unstable angina pectoris (UAP), while the strength of these associations may differ compared to other coronary diseases such as acute myocardial infarction (AMI). Therefore, we investigated whether the associations of these lifestyle factors with UAP differed from those with AMI. Additionally, we investigated whether these effects differed between subjects with and without a family history of myocardial infarction (MI).Methods: The CAREMA study consists of 21,148 persons, aged 20-59 years at baseline and randomly sampled from the Maastricht region in 1987-1997. At baseline, all participants completed a self-administered questionnaire. After follow-up of maximally 16.9 years, 420 AMI and 274 UAP incident cases were registered. Incidence rate ratios (RRs) were estimated using Cox proportional hazards models.Results: For both diseases, smoking increased the risk while alcohol consumption was associated with a protective effect. Associations with both risk factors were stronger for AMI than UAP, although this difference was only statistically significant for smoking. In men, an inverse association was found with physical activity during leisure time which seemed to be stronger for the risk of UAP than of AMI. On the contrary, physical activity during leisure time was associated with an increased risk of both AMI and UAP in women which seemed to be weaker for UAP than for AMI. Except for occupational physical activity in women, no significant interactions on a multiplicative scale were found between the lifestyle factors and family history of MI. Nevertheless, the highest risks were found in subjects with both a positive family history and the most unfavorable level of the lifestyle factors.Conclusions: The strength of the associations with the lifestyle factors did not differ between AMI and UAP, except for smoking. Furthermore, the effects of the lifestyle factors on the risk of both coronary diseases were similar for subjects with and without a positive family history.