常规心血管风险因素与男性外围动脉疾病风险之间的关联
Michel M Joosten1, Jennifer K Pai, Monica L Bertoia
1Division of General Medicine and Primary Care, Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA. hpmmj@channing.harvard.edu
JAMA
|October 25, 2012
概括
四个心血管风险因素 - - 吸烟,高血压,高胆固醇和2型糖尿病 - - 在男性中显著增加了周围动脉疾病 (PAD) 的风险. 这些因素的结合导致了大多数PAD病例,强调了管理这些疾病的重要性.
科学领域:
- 心血管健康 心血管健康
- 流行病学 流行病学
- 公共卫生 公共卫生
背景情况:
- 对外围动脉疾病 (PAD) 的个别临床风险因素已被研究,但它们的综合影响在很大程度上仍未知.
- 了解常见风险因素的累积影响对于PAD预防策略至关重要.
研究的目的:
- 量化四个主要心血管风险因素与男性患PAD风险之间的关联.
- 评估吸烟,高血压,高胆固醇和2型糖尿病对PAD发病率的综合贡献.
主要方法:
- 这是一项针对44985名美国男性的前性队列研究,来自于1986年启动的卫生专业人员随访研究,并进行了25年的跟踪.
- 风险因素状况 (吸烟,高血压,高胆固醇,2型糖尿病) 每两年更新一次.
- 临床上显著的PAD是由特定的标准定义的,包括重血管化,截肢或诊断措施,如脚-手臂指数<0.90.
主要成果:
- 这四个风险因素中的每一个都独立地与增加PAD风险有关.
- 随着存在的风险因素的数量,PAD发病率逐渐增加,从零风险因素的9例/100,000人/年增加到所有四种风险因素的186例/100,000人/年.
- 这四个因素的人口归因风险为75%,表明它们在这个队列中负责大多数PAD病例.
结论:
- 吸烟,高血压,高胆固醇和2型糖尿病是男性临床显著PAD的主要原因.
- 有效管理和预防这些风险因素可以大大减少PAD的负担.
- 这些发现强调了在预防心血管疾病的公共卫生倡议中解决这些传统风险因素的关键作用.
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