吸烟与冠心病

可能造成冠心病发展的因素即是冠心病的危险因素。冠心病的危险因素有:脂蛋白异常,吸烟,高血压,糖尿病,缺乏运动,高半胱氨酸水平升高,高凝状态,紧张型个性,冠状动脉钙化,冠心病家族史,老年和男性等。有些因素是可以纠正的,而有些则不能。前三个最主要危险因素,即脂蛋白异常及高血压,一般被认为是最重要的可纠正的冠心病危险因素;三个最后的因素,即冠心病家族史,老年及男性是不可纠正的,但也是重要的危险因素。随着生活水平的提高,人口的老龄化,冠心     

早发冠心病患者182例危险因素临床分析

目的研究早发冠心病患者的危险因素特点。方法 182例经冠状动脉造影确诊的冠心病患者,根据年龄分为早发冠心病组（男性〈55岁,女性〈65岁〉90例和对照组92例。对2组患者的相关资料进行回顾性统计分析,比较两者的血脂水平、高血压病史、糖尿病病史、冠心病家族史、吸烟史、饮酒史等。评价在2组人群间是否存在差异性。结果早发冠心病组中吸烟史、冠心病家族史、血清总胆固醇高于老年冠心病组;而高血压病史、糖尿病史低于老年冠心病组。结论早发冠心病患者吸烟、冠心病阳性家族史及高胆固醇血症是主要危险因素。     

年轻男性冠心病临床特点危险因素分析

目的探讨年轻男性冠心病患者的冠状动脉病变的临床特点以及心血管疾病的危险因素。方法以我院2008年1月～2010年6月收治的年轻男性冠心病患者68例作为青年组,回顾性分析其临床资料,并选择同期来我院的老年男性冠心病患者作为老年组,对两组患者的危险因素进行统计学比较。结果青年冠心病组中冠心病家族史和吸烟史的比例明显高于老年冠心病组（P〈0．05）,老年组的高血压病史、糖尿病史明显高于青年冠心病组（P〈O．05）;青年冠心病组的胆固醇（Tc）、三酰甘油（TG）明显高于老年冠心病组,老年冠心病组的低密度脂蛋白胆固醇（LDL—C）高于青年冠心病组,差异具有统计学意义（P〈0．05）,两组的高密度脂蛋白胆固醇（HDL—C）的水平无差异。结论冠心病家族史、吸烟、高脂血症、高血压是年轻男性早发冠心病患者的危险因素,且年轻男性冠心病患者起病急、病变严重。预防冠心病应尽早积极控制心血管病危险因素,改变不良生活方式,注重生活质量。     

皖南地区中青年与老年冠心病患者危险因素的研究

目的:研究皖南地区中青年与老年冠心病患者危险因素的差异。方法:选择在弋矶山医院住院经冠状动脉造影确诊的冠心病患者337例,按年龄分为中青年组(<60岁)和老年组(≥60岁)。分析2组之间男性比例、高血压、糖尿病、吸烟史、冠心病家族史、血脂水平等危险因素的差异。结果:老年组冠心病患者的吸烟比例及有高血压病史的比例均高于中青年组(P<0.05),但中青年冠心病组则具有更高的BMI、TC、TG、LDL-C水平(P<0.05)。按性别区分后,男性中青年冠心病组具有更高的BMI、TG水平以及更低的HDL-C水平(P<0.05),而男性老年冠心病组有高血压病史和吸烟史的比例更高。女性中青年冠心病组的LDL-C水平高于女性老年冠心病组(P<0.05),女性老年冠心病组有高血压病史的比例更高(P<0.05)。结论:皖南地区中青年冠心病患者可能应注重体质量指数和血脂的控制,而老年患者则可能更应关注控制吸烟及高血压。     

老年冠心病患者危险因素分析

目的:分析老年冠心病患者的危险因素特点。方法:行冠状动脉造影的年龄≥60岁的老年患者150例。通过冠脉造影确诊为冠心病患者96例作为冠心病组,冠状动脉狭窄程度50%或未见异常者54例作为对照组。详细记录纳入样本的临床资料,分析冠心病各危险因素,包括年龄、性别、吸烟、高血压病史、糖尿病史、血脂紊乱、体重指数、家族史等。结果:两组患者在吸烟、高血压病史、糖尿病史之间的差异有统计学意义(P0.05);冠心病组的TG、LDL较对照组升高(P0.05),HDL较对照组降低(P0.05);回归分析显示,糖尿病史、高血压病史、吸烟、LDL是老年冠心病患者的独立危险因素(均P0.05)。结论:糖尿病、高血压病、吸烟、血脂异常是老年冠心病患者的独立危险因素,临床应警惕高危因素,关注高危人群,尽早干预。     

老年冠心病患者危险因素探讨

目的 探究老年冠心病的病因以及危险因素.方法 选择2009年4月～2011年9月收治的老年冠心病患者200例做为试验组.选取同期体检中心身体健康的老年人200例做为对照组;比较两组研究对象的一般资料与生化指标.结果 试验组男性(79.0%)、吸烟(61.5%)、冠心病家族史(21.0%)、糖尿病(34.0%)以及高血压(67.5%)等比例均明显高于对照组男性(52.0%)、吸烟(32.0%)、冠心病家族史(8.0%)、糖尿病(16.0%)以及高血压(45.0%),差异有统计学意义(P＜0.05);试验组患者TC、TG、LDL-C水平明显高于对照组,HDL-C水平明显低于对照组(P＜0.05).结论 老年冠心病患者的危险因素包括高血压、糖尿病、血脂异常、吸烟指数等,对老年患者必须积极控制危险因素,定期复查,安全规律用药,才能降低冠心病的发病率.     

冠心病病人的家庭护理

冠心病是一种严重危害人民健康的常见病,多发生于40岁以后,男性多于女性,脑力劳动者较多.在欧美国家极为常见.我国近年来随着生活水平的提高,冠心病的发病率有所增加. 1 冠心病的危险因素及预防 公认的冠心病的危险因素包括:男性,过早得冠心病的家族史(父母兄弟在55岁前患确定的心肌梗死或突然死亡)、吸烟(现吸香烟≥10支/日)、高血压、高血脂、糖尿病、有明确的脑血管或周围血管阻塞的既往史、重度肥胖(超重≥30).除性别与家族史外其他危险因素都可以治疗或预防.     

不同性别早发冠心病患者临床危险因素对比分析

目的 比较不同性别早发冠心病(PCAD)患者临床危险因素的差异,并探讨其意义.方法 选取经冠状动脉造影确诊的PCAD患者270例,分为男性组(158例)和女性组(112例),采集两组患者常见心血管危险因素(高血压、糖尿病、高脂血症、早发冠心病家族史、吸烟、BMI等)和血液指标(血脂、纤维蛋白原、C反应蛋白等),并作对比分析.结果 两组间高血压、糖尿病、早发冠心病家族史、肥胖、血脂异常的差异均无统计学意义(均P ＞0.05),男性组吸烟比例显著高于女性组(P＜0.01),男性组血HDL-C和载脂蛋白a(Apoa)水平显著低于女性组(P＜0.01).结论 男性吸烟和血脂紊乱比例高于女性,提示吸烟和血脂紊乱是男性PCAD患者发病时间提前的重要危险因素,HDL-C和Apoa水平下降可导致冠状动脉保护机制降低.     

广州市南沙区海庭社区老年人群冠心病患病现状及危险因素分析

目的 探讨广州市南沙区海庭社区老年人群冠心病患病现状及危险因素。方法 回顾性分析2019年3月—2021年3月广州市南沙区海庭社区1 896名年龄> 65岁有慢性病的居民体检资料,所有入选者均完成检查,统计冠心病患病率。根据检查结果将患者分为冠心病与非冠心病组,对比2组基础资料,分析发生冠心病的危险因素。结果1 896名广州市南沙区海庭社区老年人群常规体检发现100例冠心病,患病率为0.53%(100/1 896);单因素分析中,冠心病组男性、年龄≥80岁、高血压、吸烟史、家族史、糖尿病占比均高于非冠心病组,差异有统计学意义（P<0.05）;2组文化程度、饮酒史、合并高脂血症、合并脑血管疾病与冠心病相比,差异无统计学意义（P> 0.05）;Logistic回归分析,男性、年龄≥80岁、高血压、吸烟史、家族史、糖尿病是老年人群发生冠心病的独立危险因素（P<0.05且OR≥1）。结论广州市南沙区海庭社区老年人群冠心病发病率较高,男性、年龄≥80岁、高血压、吸烟史、家族史、糖尿病是冠心病发病的独立危险因素,临床需予以高度重视。     

心房利尿钠肽C-664G基因多态性与冠心病危险因素的分析

目的:探讨心房利尿钠肽(ANP)C-664G基因多态性与冠心病(CHD)危险因素的相关关系。方法:采用聚合酶链反应和限制型片断长度多态性(PCR-RFLP)的方法,分析158例CHD患者和165例非冠心病对照人群的C-664G(RsaI)基因多态性分布。结果:总研究人群中ANPC-664G的G和C两种等位基因分布频率为2.0%和98.0%。ANPC-664G基因型分布在两组人群中未发现显著性差异(P>0.05)。Logistic分析结果提示,男性、吸烟、高血压病史、糖尿病史、高血压家族史、血浆高胆固醇为冠心病的独立危险因素,但ANPC-664G型未能进入回归方程。且这种基因多态性分布与研究人群中的性别、体重指数、血脂、高血压病家族史、高血压病史、糖尿病家族史、糖尿病史、脑卒中家族史,脑卒中病史以及冠心病家族史之间并无显著关联(P>0.05)。结论:研究结果提示,ANPC-664G基因型与冠心病史并无显著相关性,可能不是冠心病的基因易感因素。     

Factors Influencing the Different Incidences\= between Coronary Heart Disease and Stroke

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Prognostic importance of the white blood cell count for coronary, cancer, and all-cause mortality

The relationship of white blood cell count (WBC) to fatal and nonfatal coronary heart disease (CHD) incidence and all-cause and cancer mortality was assessed in a subset of participants in the Multiple Risk Factor Intervention Trial (MRFIT). For this group of 6,222 middle aged men, total WBC count was found to be strongly and significantly related to risk of CHD, independent of smoking status. Change in WBC count from baseline to the annual examination just prior to the CHD event was found to be a significant and independent predictor of CHD risk. For each decrease in WBC count of 1,000/cu mm the risk for CHD death decreased 14%, controlling for baseline WBC count and other CHD risk factors (smoking, cholesterol level, diastolic blood pressure). The WBC count was strongly related cross-sectionally to cigarette smoking and smoking status as indicated by serum thiocyanate concentration. Smokers on average had a WBC count of 7,750/cu mm compared with 6,080/cu mm for nonsmokers. The WBC count was also significantly associated with cancer death, independent of reported smoking and serum thiocyanate levels.     

冠心病传统心血管病危(险因素的评价

目的 探讨传统的心血管病危险因素对冠心病(CHD)的价值.方法 对283例急性冠脉综合征(ACS)患者传统的心血管病危险因素(性别、年龄、高血压、糖尿病、血脂异常、吸烟)作回顾性分析.结果 男女CHD均以老年多见(χ2 =15.204,P＜0.001));＜60岁男女对比差异有统计学意义(χ2 =8.803,P＜0.01);283例CHD患者仅高血压与其它各危险因素对比差异有统计学意义(P＜0.001),等级相关及回归分析仅高血压与CHD有显著相关(r =0.993,t=15.654,P＜0.001).男性CHD以合并高血压及吸烟因素居多,女性CHD以高血压及糖尿病因素居多,男女CHD对比吸烟、糖尿病因素差异均有统计学意义(χ2 =23.916、χ2 =11.740,P＜0.001).高TG、低HDL-C与高TC、高LDL-C对比均差异有统计学意义(P＜0.05).除外性别、年龄随着危险因素数目的 增多CHD增加,合并2个危险因素组最多见,为35.3%,2个以上危险因素组冠心病并未随着危险因素增多而增加.结论 老年、高血压是CHD独立的危险因素;吸烟是男性CHD主要的危险因素,糖尿病是女性CHD主要的危险因素;男女CHD患病率与年龄有关,＜60岁时男性CHD发病率高于女性;血脂异常中高TG、低HDL-C为CHD主要的危险因素;CHD合并2个危险因素最多见.CHD的防治不仅要重视高危人群,也要加强低危人群的宣教和预防,综合干预和积极控制已明确的危险因素,可能对降低心血管疾病的发病率和死亡率具有积极作用.     

胰岛素抵抗与冠心病关系的病例对照研究

目的　探讨胰岛素抵抗及其他危险因素与冠心病发病的关系 .方法　选择住院确诊的冠心病患者 84例为病例组 ,排除冠心病的住院患者或健康体检者 16 3例为对照组 ,对冠心病常见危险因素进行调查 ,检测空腹血糖、胰岛素水平、血脂、脂蛋白 (a)等相关指标 ,用单因素和多因素分析计算危险因素的优势比 (OR)及 OR 95 %可信限 (95 % CI) ,比较胰岛素水平和胰岛素敏感性等指标 .结果　病例组的空腹胰岛素水平显著高于对照组 ,胰岛素敏感性指数显著低于对照组 (P<0 .0 5 ) ;其他危险因素的单因素分析显示 ,吸烟、高血压病史、高脂饮食习惯、冠心病家族史 ,脂蛋白 (a)水平升高是冠心病的危险因素 ,其 OR分别为 2 .49,2 .5 5 ,3.2 3,2 .5 1和3.76 ,高密度脂蛋白水平是冠心病的保护因素 ,OR值为 0 .2 1;多因素分析结果显示 ,被筛选进入 L ogistic回归方程的变量分别为高密度脂蛋白、脂蛋白 (a)、胆固醇水平和每日吸烟量 .结论　空腹胰岛素水平显著升高和 (或 )胰岛素敏感性降低与冠心病的发病有病因学联系 (P<0 .0 5 ) ,吸烟、高血压病史、高脂饮食习惯、冠心病家族史、脂蛋白 (a)水平升高是冠心病的危险因素 ,高密度脂蛋白水平是冠心病的保护因素 .     

Prevention of coronary heart disease among Indians: focus on primary prevention

Epidemiological transition with increasing life expectancy and demographic shifts in population age-profile combined with lifestyle related increases in the levels of cardiovascular risk factors is accelerating coronary heart disease (CHD) epidemic in India. As prospective cohort studies for evaluation of coronary risk factors do not exist, urban-rural differences in prevalence of coronary risk factors and case-control studies provide important information regarding coronary risk factors that need prevention to control the CHD epidemic. The risk factors more in urban Indians or associated with increased risk in case-control studies are: Sedentary lifestyle, smoking, truncal obesity, hypertension, hypercholesterolaemia, impaired glucose tolerance, insulin resistance and diabetes. Primordial prevention ie, prevention of risk factors can be achieved by encouragement of positive health behaviour and promotion of the concept of health as a social value. Special target groups are children, adolescents, family unit, under-privileged and high-risk groups. Behavioural and environmental changes relevant to primordial prevention are changes in eating patterns, drinking, smoking, physical activity and stress management. Primary prevention focuses on population and on high-risk groups. Specific high-risk subjects are those with family history of CHD, hypertension or diabetes or those having sedentary lifestyle, obesity, truncal obesity and biochemical coronary risk factors. The interventions are smoking cessation, increased physical activity, weight regulation, blood pressure control, lipid regulation and diabetes management.     

CASE-CONTROL STUDY ON MYOCARDIAL INFARCTION

This case-control study was made in olrder to study the risk factors for coronary heart disease (CHD). Patients who survived acute stage of myocardial infarct.ion (Ml) diagnosed with certainty clinically were chosen as index cases. Controls were matched in sex and occupation, with an age difference olC less than 5 years. They were free from evidence of CHD and had negative electrocardiographic exercise tests. Altogether, 200 consecutive Mi cases ad- mitted to our hospitals were investigated. They included 179 males and 21 females. Average ages of patients and controls were 60.5 and 60.3 years. Association of hypertension xvith myocardial infarction is far greater than with controls. rl:hc. relative risk is 5.5-7.6 depending on the hyper- tension diagnostic criteria. There is also a higher association between cigarette smoking and Ml with relative risk at 3.6. No association is found with serum cholesterol level, body weight index, quantities of meat or rice intake, sleep, physical exercise, past history of diabetes mellitus or CHD family history. Hypertension and smoking are apparently the Ml risk factors Jn this part of China. - 873 -     

Impact of smoking, diabetes and hypertension on survival time in the elderly: the Dubbo Study

OBJECTIVE: To study the impact of various risk factors on survival time in a cohort of elderly Australians. DESIGN, SETTING AND PARTICIPANTS: A longitudinal, prospective cohort study conducted in Dubbo, NSW. Participants were men and women aged 60 years or over living in the community, first assessed in 1988-1989 and followed for 15 years. MAIN OUTCOME MEASURES: Mortality rates; risk factors; survival times. RESULTS: There were 668 deaths in 1233 men (54%) and 625 deaths in 1572 women (40%). Coronary heart disease was the major cause of death, rates being higher in men than women until age group 80+ years; stroke death rates were similar in both sexes; cancer and respiratory death rates were higher in men than women across all ages. In a proportional hazards model, the independent predictors of mortality were cigarette smoking, diabetes, very high blood pressure (BP), impaired peak expiratory flow (PEF), physical disability, and zero intake of alcohol. Over 15 years, the average reductions in survival time associated with various risk factors, in men and women respectively, were smoking, 22 and 15 months; diabetes, 18 and 18 months; very high BP, 16 and 9 months; impaired PEF, 14 and 17 months; physical disability, 16 and 12 months; zero alcohol intake, 9 and 5 months. Combinations of selected risk factors were associated with a multiplier effect. CONCLUSION: The reduction in survival time in elderly citizens demonstrated in the presence of smoking, diabetes and hypertension highlights a potential benefit to healthy ageing to be gained from prevention and intervention.     

ANP T2238C, C-664G Gene Polymorphism and Coronary Heart Diseasein Chinese Population

The association between atrial natriuretic peptide (ANP) polymorphism and coronary heart disease (CHD) was studied in Chinese population. The genotypes of ANP T2238C and ANP C-664G were detected by polymerase chain reaction and restriction fragment length polymorphism (PCR-RFLP) methods in 158 consecutive CHD patients and 165 controls. It was found that the distribution of A2A2 genotype in CHD group was significantly higher than that in control group (P<0.05). Stepwise Logistic regression analysis revealed that male, smoking, history of hypertension, history of diabetes, family history of hypertension, high level of serum cholesterol, and ANP T2238C polymorphism were the possible risk factors in patients with CHD (P<0.05). However, there was no significant difference between the patients with CHD and the control group in the distribution of ANP C-664G polymorphism (P>0.05). The results suggest that A2A2 T2238C genotype could be one of the risk factors for CHD (P<0.05, OR: 1.80, 95 % CI: 1.03-3.15).     

外周血白细胞分类计数与冠心病及其危险因素聚集性的关系

目的 分析外周血白细胞各亚群细胞数量与冠心病及其危险因素聚集性的关系,探讨白细胞各亚型在冠心病发病机制中的作用.方法 选择156例冠心病患者为研究对象,其中急性心肌梗死(AMI)组32例,不稳定型心绞痛(UAP)组71例,稳定型心绞痛(SAP)组53例;另选择同期冠状动脉造影正常者64例为对照组.检测外周血白细胞分类计数,评价冠心病危险因素累计积分.结果 AMI组、UAP组、SAP组及对照组的外周血单核细胞和淋巴细胞计数间差异均有统计学意义(P＜0.05);多元线性回归分析显示,外周血单核细胞和淋巴细胞计数与冠心病危险因素累计积分相关(相关系数分别为0.249、0.526,P＜0.01).结论 外周血单核细胞和淋巴细胞计数可反映冠心病的严重程度,与冠心病危险因素聚集性有关.