Roadway proximity and risk of sudden cardiac death in women.
Roadway proximity and risk of sudden cardiac death in women.
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DOI：
10.1161/circulationaha.114.011489
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发表时间：
2014-10-21
期刊：
影响因子：
37.8
通讯作者：
Albert CM
中科院分区：
文献类型：
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作者：
Hart JE;Chiuve SE;Laden F;Albert CM
心源性猝死（SCD）是死亡率的主要来源，并且是大多数病例的心脏病的第一表现。因此，有一个明确的需要，以确定SCD的危险因素，可以修改的人口水平。暴露于交通，衡量住宅道路接近，已被证明与心血管疾病的风险增加。我们的目的是确定道路接近是否与SCD风险增加相关，并与其他冠心病（CHD）结局的风险进行比较。在前瞻性护士健康研究的107,130名成员中，经过26年的随访，共发现523例SCD病例。我们计算了1986年至2012年所有住宅地址与道路的距离。在年龄和种族调整模型中，居住在主要道路50米范围内的女性SCD风险升高（HR=1.56; 95%CI：1.18-2.05）。在控制了潜在的混杂因素和介质后，相关性减弱，但仍具有统计学意义（HR=1.38; 95%CI：1.04-1.82）。非致死性心肌梗死和致死性CHD的等效校正HR分别为1.08（95%CI：0.96-1.23）和1.24（95%CI：1.03-1.50）。在中年和老年妇女的样本中，即使在控制了其他心血管危险因素后，接近道路与SCD和致死性CHD的风险升高和统计学显著性相关。
Sudden cardiac death (SCD) is a major source of mortality and is the first manifestation of heart disease for the majority of cases. Thus, there is a definite need to identify risk factors for SCD that can be modified on the population level. Exposure to traffic, measured by residential roadway proximity, has been shown to be associated with an increased risk of cardiovascular disease. Our objective was to determine if roadway proximity was associated with an increased risk of SCD and to compare to the risk of other coronary heart disease (CHD) outcomes. A total of 523 cases of SCD were identified over 26 years of follow-up among 107,130 members of the prospective Nurses’ Health Study. We calculated residential distance to roadways at all residential addresses from 1986–2012. In age- and race-adjusted models, women living within 50 meters of a major roadway had an elevated risk of SCD (HR=1.56; 95%CI: 1.18–2.05). The association was attenuated but still statistically significant after controlling for potential confounders and mediators (HR=1.38; 95%CI:1.04–1.82). The equivalent adjusted HRs for nonfatal myocardial infarction and fatal CHD were 1.08 (95%CI: 0.96–1.23) and 1.24 (95%CI: 1.03–1.50), respectively. Among this sample of middle-aged and older women, roadway proximity was associated with an elevated and statistically significant risks of SCD and fatal CHD, even after controlling for other cardiovascular risk factors.