海南省成年人吸烟与心血管疾病发病风险的前瞻性研究  

Prospective study on tobacco smoking and the risk of cardiovascular disease among adults in Hainan Province

作　　者：王小焕[1] 胡锡敏[1] 郭彧 卞铮 李立明[3] 陈铮鸣[4] 李惠梅 李贻磊 符智芳 WANG Xiao-huan;HU Xi-min;GUO Yu;BIAN Zheng;LI Li-ming;CHEN Zheng-ming;LI Hui-mei;LI Yi-lei;FU Zhi-fang(Hainan Center for Disease Control and Prevention,Haikou,Hainan 570203,China)

机构地区：[1]海南省疾病预防控制中心,海南海口570203 [2]中国医学科学院,北京102308 [3]北京大学公共卫生学院,北京100191 [4]英国牛津大学临床与流行病学研究中心纳菲尔德人群健康系,英国牛津OX12JD [5]海口市美兰区疾病预防控制中心,海南海口570203

出　　处：《现代预防医学》2020年第2期287-291,299,共6页Modern Preventive Medicine

基　　金：国家重点研发计划精准医学研究重点专项（2016YFC0900500,2016YFC0900501）;香港Kadoorie Charitable基金;英国Wellcome Trust（202922/Z/16/Z,088158/Z/09/Z,104085/Z/14/Z）

摘　　要：目的探讨海南省成年人吸烟与各类心血管疾病发病风险的关联。方法利用中英合作项目“中国慢性病前瞻性研究”项目海南省人群数据,剔除基线调查时自报患有冠心病、脑卒中和恶性肿瘤的个体后,纳入基线年龄为30~79岁的研究对象共28940人,利用Cox回归分析计算非吸烟者、戒烟者和当前吸烟者的心血管疾病发病风险HR值和95%CI。结果研究人群平均随访6.2年,累积随访177279人年。随访期间男性1310人,女性2200人发病。男性吸烟率(47.0%)远高于女性吸烟率(0.3%)。多因素调整后,与非吸烟者相比,吸烟人群心血管疾病的发病风险有所增加,HR值(95%CI)分别为急性冠心病1.63(1.12~2.38)和缺血性心脏病1.53(1.22~1.91)。在当前吸烟者中,每天吸烟量多于30支的人群急性冠心病、缺血性脑卒中和出血性脑卒中的发病风险最高。结论吸烟能够增加心血管疾病的发病风险,应基于不同心血管疾病风险制定吸烟者戒烟目标和全人群控烟措施。Objective To explore the relationship between tobacco smoking and risk of cardiovascular diseases in adults in Hainan province.Methods The present analysis included 28940 participants from the China-UK cooperation project"China Kadoorie Biobank"after excluding those with coronary heart diseases,stroke and cancer at baseline survey.The participants were permanent residents of Hainan province,aged between 30 and 79.Cox regression analysis was used to calculate the cardiovascular disease risk hazard ratios and 95%CI of nonsmokers,ex-smoker and current smokers.Results During a median follow-up of 6.2 years(a total of 177279 person years),1310 men and 2200 women developed the disease.The smoking rate of men(47.0%)was much higher than that of women(0.3%).After adjustment for multiple covariates,smoking increased risk of all subtypes of cardiovascular diseases.Compared with nonsmokers,the multivariable-adjusted HRs(95%CI)for current smokers were 1.63(1.12-2.38)for acute coronary heart disease,1.24(1.04-1.47)for ischemie heart disease,respectively.Among current smokers,those who smoked more than 30 cigarettes a day had the highest risk of acute coronary heart discase,ischemic stroke and hemorrhagic stroke.Conclusion This prospective study confirms increased risk of all subtypes of cardiovascular diseases in smokers.Smoking cessation targets and smoking control measures should be established for smokers based on the risk of different cardiovascular diseases.

关 键 词：吸烟 心血管疾病 发病风险 前瞻性研究 

分 类 号：R181.3[医药卫生—流行病学]