Lifestyle Medicine ブログの引用文献
Effect of potentially modifiable risk factors associated with myocardial infarction in 52 countries (the INTERHEART study): case-control study. Yusuf S et al. Lancet 2004; 364: 937–52. PMID: 15364185
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INTERHEART is a large, international, standardised, case-control study, designed as an initial step to assess the importance of risk factors for coronary heart disease worldwide (slides available at http://www.phri.ca/ interheart).5 We aimed to include about 15 000 cases and a similar number of controls from 52 countries, representing all inhabited continents. Specific objectives are to determine the strength of association between various risk factors and acute myocardial infarction in the overall study population and to ascertain if this association varies by geographic region, ethnic origin, sex, or age. A key secondary objective is to estimate the PAR for risk factors and their combinations in the overall population and in various subgroups. This report focuses on the association of nine easily measured protective or risk factors (smoking, lipids, self-reported hypertension or diabetes, obesity, diet, physical activity, alcohol consumption, and psychosocial factors) to first myocardial infarction.
Our study shows that nine easily measured and potentially modifiable risk factors account for an overwhelmingly large (over 90%) proportion of the risk of an initial acute myocardial infarction. The effect of these risk factors is consistent in men and women, across different geographic regions, and by ethnic group, making the study applicable worldwide. The effect of the risk factors is particularly striking in young men (PAR about 93%) and women (about 96%), indicating that most premature myocardial infarction is preventable. Worldwide, the two most important risk factors are smoking and abnormal lipids. Together they account for about two-thirds of the PAR of an acute myocardial infarction. Psychosocial factors, abdominal obesity, diabetes, and hypertension were the next most important risk factors in men and women, but their relative effect varied in different regions of the world. The usual measure of obesity (body-mass index) showed a modest relation with acute myocardial infarction but was not significant when abdominal obesity was included in the analysis.