DO CHANGES IN CARDIOVASCULAR RISK-FACTORS EXPLAIN CHANGES IN MORTALITY FROM STROKE IN FINLAND

被引:78
作者
VARTIAINEN, E
SARTI, C
TUOMILEHTO, J
KUULASMAA, K
机构
[1] Department of Epidemiology and Health Promotion, National Public Health Institute Mannerheimintie 166, Helsinki
来源
BMJ-BRITISH MEDICAL JOURNAL | 1995年 / 310卷 / 6984期
关键词
D O I
10.1136/bmj.310.6984.901
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Objectives-To estimate the extent to which the changes in the main cardiovascular risk factors (blood pressure, smoking, and serum cholesterol concentration) can explain the observed changes in mortality from stroke in Finland during the past 20 years. Design-Predicted changes in mortality from cerebrovascular disease mortality were calculated by a proportional hazards model from data obtained in cross sectional population surveys in 1972, 1977, 1982, 1987, and 1992. Predicted changes were compared with the observed changes in mortality statistics. Setting-North Karelia and Kuopio provinces, Finland. Subjects-16 741 men and 16 389 women aged 30-59 randomly selected from the national population register, of whom 14 054 men and 14 546 women participated. Main outcome measures-levels of risk factors and predicted and observed changes in mortality from cerebrovascular disease. Results-The observed changes in diastolic blood pressure, total serum cholesterol concentration, and smoking in the population from 1972 to 1992 predicted a 44% fall in mortality from stroke in men and changes in diastolic blood pressure and smoking predicted a 34% fall in women. The observed fall in mortality from stroke was 66% in men and 60% in women. Conclusions-Two thirds of the fall in mortality hom stroke in men and half in women can be explained by changes in the three main cardiovascular risk factors.
引用
收藏
页码:901 / 904
页数:4
相关论文
共 24 条
[11]  
Iso H., Jacobs D.R., Wentworth D., Neaton J.D., Cohen J., Serum cholesterol levels and six-years mortality from stroke in 350,977 men screened for the multiple risk factor intervention trial, N Engl J Med, 14, pp. 904-910, (1989)
[12]  
Boysen G., Nyboe J., Appleyard M., Sorensen O.S., Boas J., Somnier F., Et al., Stroke incidence and risk factors for stroke in Copenhagen, Denmark, Stroke, 19, pp. 1345-1353, (1988)
[13]  
Benfante R., Yano K., Hwang L.-J., Curb D., Kagan A., Ross W., Elevated serum cholesterol is a risk factor for both coronary heart disease and thromboembolic stroke in Hawaiian Japanese men. Implications of shared risk, Stroke, 25, pp. 814-820, (1994)
[14]  
Vartiainen E., Puska P., Pekkanen J., Tuomilehto J., Jousilahti P., Changes in risk factors explain changes in mortality from ischaemic heart disease in Finland, BMJ, 309, pp. 23-27, (1994)
[15]  
1971 Tarrytown, (1971)
[16]  
Dobson A.J., Proportional hazard models for average data for groups, Stat Med, 7, pp. 613-618, (1988)
[17]  
Maxwell M.H., Scroth P.C., Waks A.U., Karama M., Dornfield L.P., Error in blood pressure measurement due to incorrect cuff size in obese patients, Lancet, ii, pp. 33-35, (1982)
[18]  
Beevers D.G., Sphygmomanometer cuff sizes—new recommendations, J Hum Hypertens, 4, pp. 587-588, (1990)
[19]  
Wolf P.A., D'Agostino R.B., Kannel W.B., Bonita R., Belanger A.J., Cigarette smoking as a risk of stroke. The Framingham study, JAMA, 259, pp. 1025-1029, (1988)
[20]  
Tuomilehto J., Sarti C., Narva E., Salmi K., Sivenius J., Kaarsalo E., Et al., The FINMONICA stroke register: description of the community-based stroke registration and analysis of stroke incidence during 1983 to 1985 in Finland, Am J Epidemiol, 135, pp. 1259-1270, (1992)