スイスでは,より高い標高で冠動脈疾患と脳卒中による死亡率が低くなります
David Faeh1, Felix Gutzwiller, Matthias Bopp
1University of Zurich, Institute of Social and Preventive Medicine, Hirschengraben 84, 8001 Zürich, Switzerland.
Circulation
|July 29, 2009
まとめ
高地での生活は,冠動脈疾患と脳卒中による死亡率の低下と関連しています. 高 altitude で生まれたことは,追加の保護を提供しており,気候要因が役割を果たす可能性があることを示唆しています.
科学分野:
- 環境衛生 環境衛生 環境衛生
- 心血管伝染病学 心血管伝染病学
- 地理医学 地理医学
背景:
- 標高と心血管疾患に関する以前の研究は,人口の異質性と生態学的設計のために矛盾する結果をもたらしました.
- 心血管疾患による死亡率に対する出生地の高さの影響は十分に検討されていない.
- この研究では,住宅地と出生地の高さとの関係で冠動脈疾患と脳卒中死亡率を調査しています.
研究 の 目的:
- 住宅の高さと冠動脈疾患と脳卒中の死亡率との関連性を評価する.
- 心血管疾患による死亡率に対する出生地の高さの影響を決定する.
- 潜在的混乱要因と,気候などの根本的なメカニズムを探求する.
主な方法:
- スイス・ナショナル・コホート (Swiss National Cohort) のデータを活用し,縦断的な国勢調査に基づく研究を行いました.
- 259mから1960mまでの高さに住む164万人 (40-84歳) の死亡率データ (1990-2000年) を分析した.
- 相対リスクの計算に多変数ポアソン回帰を用いて,社会人口統計情報と出生地で調整した.
主要な成果:
- 冠動脈疾患による死亡率は,高度が1000m上昇するごとに22%減少した.
- 脳卒中による死亡率は,高度が1000m上昇するごとに12%減少した.
- 居住地よりも高いまたは低い高さで生まれた個人は,死亡リスクが変化したことを示しました.
結論:
- 高地での生活は,冠動脈疾患と脳卒中の死亡率に対する一貫した保護効果を示しており,これは混同因子とは無関係です.
- 高地での出産は,冠動脈疾患の死亡率に対する追加の独立した利点を提供します.
- 観察された保護効果は,従来の心血管疾患の危険因子に起因する可能性は低いため,気候の影響が有意である可能性を示唆しています.
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