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目的通过对首都钢铁公司男性职工心血管病危险20年长期随访分析,比较正常血压与高血压人群,总胆固醇(TC)水平对于心肌梗死发病的影响。方法于1974、1979和1980年分三次对首都钢铁公司5137名男性职工进行基线调查,并于1982、1987、1993和2001年分别对这部分人群进行了四次随访,共随访到4986人,平均随访20.84年。将人群分为正常血压组和高血压组,使用Cox回归模型分析两组人群TC升高对于心肌梗死发病的风险,并加以比较。结果在20年长期随访中,正常血压组和高血压组男性职工,TC升高对于心肌梗死的发病均具有统计学意义;TC升高对于心肌梗死发病的风险比,在正常血压组和高血压组中分别为2.05和2.10;人群归因危险度百分比分别为23.58%和3075%。结论TC升高作为心肌梗死的独立危险因素,在正常血压组和高血压组中均具有较强的作用,但在高血压组中其作用更加明显,有更多的心肌梗死的发病可归因于TC水平的升高。因此,为了降低冠心病心肌梗死长期发病风险,应在全人群,尤其是在高血压人群中,在控制血压的同时还应加强对TC水平的控制。
Objective To investigate the effect of total cholesterol (TC) on the incidence of myocardial infarction in 20-year long-term follow-up of cardiovascular risk among male workers in Capital Iron and Steel (Group) Company. Methods A total of 5,137 male workers from Capital Iron and Steel (Group) Company were surveyed in three different times in 1974, 1979 and 1980. Four follow-up visits were conducted to this group in 1982, 1987, 1993 and 2001 respectively, with a total of 4986 follow-up visits, with an average of Follow-up 20.84 years. The population was divided into normotension group and hypertension group. The Cox regression model was used to analyze the risk of myocardial infarction in patients with TC elevation in both groups and compared. Results In the long-term follow-up of 20 years, male workers in the normal blood pressure group and the hypertensive group had a statistically significant increase in the incidence of myocardial infarction; the increased risk of TC in the incidence of myocardial infarction was significantly higher in the normotensive group and in the hypertensive group The groups were 2.05 and 2.10, respectively. The percentage of at-risk among the population was 23.58% and 3075% respectively. Conclusions TC elevated as an independent risk factor for myocardial infarction has a strong effect in both normotensive and hypertensive groups, but its role in hypertensive patients is more pronounced with more attributable to myocardial infarction The level of TC increased. Therefore, in order to reduce the long-term risk of myocardial infarction in coronary heart disease, the control of blood pressure should be strengthened in the whole population, especially in the hypertensive population.