Low risk-factor profile and long-term cardiovascular and noncardiovascular mortality and life expectancy: findings for 5 large cohorts of young adult and middle-aged men and women.

摘要: ContextThree major coronary risk factors—serum cholesterol level, blood pressure, and smoking—increase incidence of heart disease (CHD) and related end points. In previous investigations, risks for low-risk reference groups were estimated statistically because samples contained too few such people to measure risk.ObjectiveTo long-term mortality rates individuals with favorable levels all 3 factors, compared others.DesignTwo prospective studies, involving 5 cohorts based on age sex, that enrolled persons a range factors. Low was defined as serum cholesterol level less than 5.17 mmol/L (<200 mg/dL), blood pressure less than or equal to120/80 mm Hg, no current cigarette smoking. All persons with history diabetes, myocardial infarction (MI), or, in cohorts, electrocardiogram (ECG) abnormalities, excluded.Setting ParticipantsIn 18 US cities, total 72,144 men aged 35 through 39 years and 270,671 40 57 screened (1973-1975) the Multiple Risk Factor Intervention Trial (MRFIT); Chicago, 10,025 men aged years, 7490 59 6229 women aged (1967-1973) Chicago Heart Association Detection Project Industry (CHA) (N = 366,559).Main Outcome MeasuresCause-specific during 16 (MRFIT) 22 relative risks (RRs) death, greater life expectancy, comparing low-risk subcohorts vs others by strata.ResultsLow-risk comprised only 4.8% 9.9% cohorts. low-risk groups experienced significantly markedly lower CHD cardiovascular disease death those who had elevated smoked. For example, age-adjusted RRs ranged from 0.08 CHA 0.23 through 59 years. The relative cardiovascular disease mortality ranged from 0.15 MRFIT 0.28 for RR all-cause mortality rate 0.42 0.60 CHA women Estimated expectancy 5.8 women 9.5 years years.ConclusionsBased these very large cohort do not smoke have diabetes, MI, ECG is much and longevity greater. A substantial increase proportion the population at lifetime low could contribute decisively ending the CHD epidemic.