吸烟、饮酒对高血压病人死亡危险的研究——北京市东城区一千余例高血压病人平均7年前瞻性研究报告之一

A STUDY ON MORTALITY RISK AMONG HYPERTENSIVES WITH SMOKING AND DRINKING

本研究对1981年北京市居民中发现的1586名高血压患者作前瞻性观察,观察截止于1991年,平均追访7年(11340人年),死亡329人.分析结果表明,高血压患者每日吸烟量与总死亡及心血管病死亡均呈显著的正相关,用M-H法分层及Cox模型调整年龄、性别、血压、糖尿病等危险因素,趋势无改变.戒烟≥5年者,总死亡、心血管病及脑卒中死亡危险明显降低,心血管病、脑卒中死亡危险趋势同于非吸烟者.年龄≤65岁的高血压患者,特别是15～54岁年龄组,吸烟≥10支时可增高心血管病死亡危险2倍及以上,死亡危险在大量吸烟(每日≥20支)时也明显上升.结果还提示,少量饮酒(每天约0.8两白酒)有降低高血压病人死亡、心血管病死亡危险的作用.

A prospective study of 1586 hypertensives was conducted in East City Beijing. During a seven years following - up(11340 person - years), 329 deaths were ocurred. The patients with a history of stroke or coronary heart disease in the two years preceding the baseline survey were excluded in the analyses of cardiovascular disease and stroke.The number of cigarettes smoked per day was associated positively with the risk of death from all causes and cardiovascular disease. The RR was 40% higher for those smoked 10 to 19 cigarettes per day,and was 60% higher for those who smoked 20 or more cigarettes per day as compared to nonsmokers. The RR of deth from stroke for those smoked 10 or more cigarettes per day was also 40 percent higher than nonsmokers. The association existed after adjustment for age, sex, blood pressure, diabetes alcohol intake was made by Cox model. The adjusted ralative risks of death from all causes, cardiovascular disease and stroke had a marked decrease among those who stopped smoking more than 5 years, closing to nosmokers'. Hypertensives aged less than 65 years,especially 15 to 54 years, who smoked 10 or more cigarettes per day had a two times or more RR of death from cardiovascu-lar disease,and those smoked 20 or more cigarettes per day also had and significantly increased RR of death.This study also showed moderate alchol consumption had a lower risk of death from all causes and cardiovascular diseases compared to nondrinkers after adjusting for smoking, appearing to exert a protective effect on hypertensives.