Coronary heart disease death,nonfatal acute myocardial infarction and other clinical outcomes in the multiple risk factor intervention trial |
| |
| Affiliation: | 1. PsyQ The Hague, Department of Mood Disorders, The Hague, The Netherlands;2. Leiden University, Institute of Psychology, Section of Clinical Psychology, Leiden, The Netherlands;3. Leiden University Medical Center, Department of Psychiatry, Leiden, The Netherlands;4. PsyQ Rijnmond, Department of mood and anxiety disorders, Rotterdam, The Netherlands;1. Division of Metabolic Diseases, Beatrix Children''s Hospital, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands;2. Department of Clinical Child and Adolescents Studies, Leiden Institute for Brain and Cognition, Leiden University, Leiden, The Netherlands;3. Department of Developmental and Clinical Neuropsychology, University of Groningen, Groningen, The Netherlands;4. Department of Pediatrics, Emma Children''s Hospital, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands;5. Department of Internal Medicine, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands;6. Department of Pediatrics, Maastricht University Medical Center, Maastricht, The Netherlands;7. Department of Internal Medicine and Endocrinology, Maastricht University Medical Center, Maastricht, The Netherlands;8. Wilhelmina Children''s Hospital, University Medical Center Utrecht, Utrecht, The Netherlands;9. Department of Pediatrics, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands;10. Department of Internal Medicine, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands;11. Department of Pediatrics, Erasmus University Medical Center, Rotterdam, The Netherlands;12. Department of Internal Medicine, Erasmus University Medical Center, Rotterdam, The Netherlands |
| |
| Abstract: | The Multiple Risk Factor Intervention Trial was a randomized clinical study to test whether a special intervention (SI) program aimed at reducing serum cholesterol levels, blood pressure and cigarette smoking would prevent coronary heart disease (CHD) in middle-aged men. The main endpoint reported here is the percentage of participants experiencing first major CHD events (either nonfatal acute myocardial infarction [AMI] or CHD death) during 7 years of follow-up. This outcome was slightly less frequent in the 6,428 SI men than in the 6,438 men assigned to their usual source of care (UC). However, the relative difference—either 1% (95% confidence interval −17% to 16%) or 8% (95% confidence interval −5% to 20%), depending on how AMI was classified—was not statistically significant.Regression analyses within the SI and UC groups suggested that the cholesterol and cigarette smoking interventions reduced the number of first major CHD events: the associations between lowering the levels of these 2 factors and reductions in CHD rates were significant (p < 0.001) and of the anticipated magnitude. A similar analysis of antihypertensive treatment in the SI group revealed no favorable association between lowering blood pressure and CHD rate, and other subgroup comparisons suggested that a mixture of beneficial and adverse effects may underlie this finding. Thus, the nonsignificant overall UC/SI contrast in CHD rates may reflect a combination of the expected beneficial effects of the cholesterol and smoking interventions with unexpected heterogeneous effects of the antihypertensive intervention.Seven of 8 other prespecified cardiovascular endpoihts occurred less frequently among SI than among UC men, the difference being nominally significant (p < 0.05) for angina pectoris, congestive heart failure and peripheral arterial disease. |
| |
| Keywords: | |
| 本文献已被 ScienceDirect 等数据库收录！ |
|
