終身リスクと,心血管疾患の総発生から解放された生存年数
John T Wilkins1, Hongyan Ning, Jarett Berry
1Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, USA. j-wilkins@fsm.northwestern.edu
JAMA
|November 3, 2012
まとめ
心血管疾患 (CVD) の生涯リスクは,最適な危険因子を持つ人でも,誰もが高いです. 健康的な習慣を維持すると,心血管疾患のない寿命が大幅に増加します.
科学分野:
- 心血管疾患の疫学について
- 予防的な心臓病学
- 公衆衛生は公衆衛生である.
背景:
- 心血管疾患 (CVD) 全体の生涯リスクの推定は,将来の疾患負担を予測し,臨床コミュニケーションを支援するために不可欠です.
- 過去の研究では,全CVDに対する包括的な生涯リスクの推定値が報告されていません.
研究 の 目的:
- 年齢とリスク因子プロファイルに基づいて,全CVDの生涯リスク推定値を計算します.
- 異なるリスク因子層において,個人が心血管疾患を患わずに生きる年数を推定する.
主な方法:
- 5つの主要な米国コホート研究からの900,000人年以上のデータを利用したプール生存分析.
- 分析は,血圧,コレステロール,糖尿病,喫煙状況に関するデータと,ベースラインでCVDのない参加者を含めました.
- 致死性および非致死性アウトカムを含むCVDイベントの総数は追跡されました.
主要な成果:
- 45歳の全生涯CVDリスクは,男性では60.3%,女性では55.6%でした.
- 危険因子が高かったり,重大な危険因子を持っていた個人は,95歳までに生涯リスクが50%を超えるリスクに直面しました.
- 55歳で最適な危険因子を持つ人々でさえ,生涯にわたるCVDリスクが有意であったが,複数の危険因子を持つ人々と比較して,CVDから解放された寿命は最大14年長かった.
結論:
- 総CVDの生涯リスクは,中年期に最適な危険因子を持つ人々を含め,すべての個人において実質的です.
- 中年の心血管リスクファクターの最適なレベルを維持することは,CVDから解放された signicantly longer duration of lifeと強く関連しています.
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