老年男性保健人群六年累计缺血陛心血管病发病率及其危险因素的前瞻陛研究

目的 研究老年保健人群6年累计缺血性心血管病(ICVD)的发病率及其相关危险因素.方法 基线人群为2003年5月某医院数据库记录在案的、出生于1938年1月1日前(即年龄＞65岁)的所有老年保健对象,剔除基线时已患有ICVD者.收集的危险因素有:基线时年龄、性别、体重指数、收缩压、血总胆固醇浓度、血甘油三酯浓度、血高密度脂蛋白胆固醇(HDL-C)浓度、血肌酐浓度、血载脂蛋白A1浓度、糖尿病、吸烟,以人年作为观察时间,计算基线危险因素不同分期水平下的人年发病率及累计发病率,进行单因素分析.使用Cox比例风险回归模型进行多因素分析.结果 基线人群为2271名男性老年人,6年内ICVD累计发病率为23.56%,人年发病率达到了45.41‰.单因素分析表明,与ICVD事件正相关的变量是:收缩压、体重指数、血总胆固醇水平、血甘油三酯水平、血载脂蛋白A1水平、糖尿病、吸烟;与ICVD事件负相关的变量是:血HDL-C浓度、血肌酐浓度;多元Cox比例风险模型的分析结果显示:收缩压、糖尿病、血总胆固醇、体重指数是最主要的危险因素,血HDL-C是主要的保护因素.结论 老年保健人群ICVD发病率较高.控制血压、血糖,提高血HDL-C水平可能是降低未来ICVD事件最为有效的措施.

A prospective study on 6-year accumulative incidence rate of ischemic cardiovascular disease and related risk factors among the elderly male population under health care programme

Objective To investigate the 6-year accumulative incidence rate of ischemic cardiovascular disease (ICVD) and its related risk factors. Methods Baseline population was all from an elderly population with members all born before 1-1,1938 and under health care programm.Data was recorded in a database of a hospital and baseline of subjects under research was aged ＞65years. People that had had ICVD at baseline were excluded. Risk factors under research would include: age at the baseline study, gender, body mass index, systolic blood pressure, serum cholesterol level, serum triglyceride level, serum high-density lipoprotein level, serum triglyceride level, serum apolipoprotein A1 level, history of diabetes mellitus and cigarette smoking etc. Single factor analysis was carried out using person-years as time of study, then calculating the person-year incidence and the accumulative incidence rate at different levels related to baseline risk factors.Multivariate analysis was under Cox Proportional Hazards Regression Model. Results Baseline population included 2271 elderly men, with the 6-year cumulative prevalence rate of ICVD as 23.56%, and the person-year prevalence rate was 45.41‰. Single factor analysis showed that the ICVD events positively related to variables which including systolic blood pressure, body mass index,serum cholesterol level and serum triglyceride level, serum apolipoprotein A1 level, status of diabetes mellitus and cigarette smoking. The ICVD events negatively related to variables as serum high-density lipoprotein levcl and serum creatinine level. Results of multivariate analysis showed that high systolic pressure, diabetes mellitus, serum creatinine level, Body Mass Index were the main risk factors. The serum high-density lipoprotein level served as the main protective factor. Conclusion The aged male population under health care programme was high in the ICVD prevalence rate, suggesting that programmes as controlling blood pressure, blood glucose, and increasing serum high-density lipoprotein levels were effective measures to decrease the ICVD events.