人生必经的 8 个轨迹与中风风险:前瞻性队列研究

IF 7.8 1区 医学 Q1 CLINICAL NEUROLOGY Stroke Pub Date : 2024-11-01 Epub Date: 2024-10-02 DOI:10.1161/STROKEAHA.124.046352
Yang Liu, Xueying Qin, Jinguo Jiang, Maoxiang Zhao, Xinyi Peng, Feipeng Cui, Xianxuan Wang, Jun Feng, Shuohua Chen, Shouling Wu
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引用次数: 0

摘要

背景:关于生命必备 8 项指标(LE8)的长期变化模式及其与脑卒中风险的关系尚缺乏证据。我们旨在评估生命八要素的变化轨迹,并研究它们与中国脑卒中风险的关系:本研究在工作场所进行,招募了 26 719 名无脑卒中病史的参与者(平均年龄(46.02±11.27)岁,男性占 73.73%),连续参加了 2006 年至 2016 年的 6 次调查。LE8的重复测量是通过对8个组成部分的得分(0-100分)进行非加权平均来确定的。得分越高的人整体心血管健康状况越好。通过检查参与者的医疗记录,确定了 2016 年至 2020 年期间的中风病例。应用潜混合模型对2006年至2016年的LE8轨迹集群进行分类,并使用Cox比例危险模型对数据进行分析:2006年至2016年间,共发现了5个LE8轨迹。共记录了498例脑卒中事件,包括55例(11.04%)出血性脑卒中和458例(91.97%)缺血性脑卒中。调整协变量后,与中度递减轨迹相比,稳定-低度、中度递增、中度稳定和高度稳定轨迹与卒中事件之间的危险比和 95% CI 分别为 1.42 (1.11-1.84)、0.73 (0.56-0.96)、0.49 (0.39-0.62) 和 0.19 (0.11-0.32)。高 LE8 状态(LE8≥80)的人与低 LE8 状态(LE8≤49;P-趋势)的人相比,中风风险明显降低:长期保持高 LE8 和高基线 LE8 状态与中风风险降低有关。尽管最初的 LE8 水平较低,但 LE8 水平的提高可减轻甚至逆转中风风险。
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Life's Essential 8 Trajectories and Risk of Stroke: A Prospective Cohort Study.

Background: Evidence is lacking regarding long-term patterns of change in Life's Essential 8 (LE8) and their association with the risk of stroke. We aim to evaluate LE8 trajectories and examine their association with the risk of stroke in China.

Methods: This study, conducted in a workplace setting, recruited 26 719 participants (average age, 46.02±11.27 years and a male population of 73.73%) who had no history of stroke and consecutively participated in 6 surveys from 2006 to 2016. Repeated LE8 measurements were determined by taking the unweighted average of the 8 component scores ranging from 0 to 100. People with higher scores had better overall cardiovascular health. By examining the medical records of the participants, stroke cases were identified for the period from 2016 to 2020. A latent mixture model was applied to classify the trajectory clusters of LE8 from 2006 to 2016, and Cox proportional hazard models were used to analyze the data.

Results: Five LE8 trajectories were detected between 2006 and 2016. Four hundred ninety-eight incident strokes including 55 (11.04%) hemorrhagic and 458 (91.97%) ischemic strokes were documented. After adjusting for covariates, the hazard ratios and 95% CIs for the association between stable-low, moderate-increasing, moderate-stable, and high-stable trajectories and incident stroke, compared with the moderate-decreasing trajectory, were 1.42 (1.11-1.84), 0.73 (0.56-0.96), 0.49 (0.39-0.62), and 0.19 (0.11-0.32), respectively. Individuals with high LE8 status (LE8≥80) exhibited a significantly reduced risk of stroke compared with those with low one (LE8≤49; P-trend <0.001). A faster annual growth in LE8 was related to a lower risk of stroke.

Conclusions: Maintaining high LE8 over an extended period and high baseline LE8 status were related to a decreased risk of stroke. Despite the initial low level of LE8, improvement in LE8 attenuates or even reverses the risk of stroke.

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来源期刊
Stroke
Stroke 医学-临床神经学
CiteScore
13.40
自引率
6.00%
发文量
2021
审稿时长
3 months
期刊介绍: Stroke is a monthly publication that collates reports of clinical and basic investigation of any aspect of the cerebral circulation and its diseases. The publication covers a wide range of disciplines including anesthesiology, critical care medicine, epidemiology, internal medicine, neurology, neuro-ophthalmology, neuropathology, neuropsychology, neurosurgery, nuclear medicine, nursing, radiology, rehabilitation, speech pathology, vascular physiology, and vascular surgery. The audience of Stroke includes neurologists, basic scientists, cardiologists, vascular surgeons, internists, interventionalists, neurosurgeons, nurses, and physiatrists. Stroke is indexed in Biological Abstracts, BIOSIS, CAB Abstracts, Chemical Abstracts, CINAHL, Current Contents, Embase, MEDLINE, and Science Citation Index Expanded.
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