Hematocrit and the risk of coronary heart disease mortality

医学 红细胞压积 全国健康与营养检查调查 糖尿病 体质指数 内科学 人口 人口学 比例危险模型 死亡率 心力衰竭 内分泌学 环境卫生 社会学
作者
David Brown,Wayne H. Giles,Janet B. Croft
出处
期刊:American Heart Journal [Elsevier BV]
卷期号:142 (4): 657-663 被引量:90
标识
DOI:10.1067/mhj.2001.118467
摘要

Background An association between hematocrit (Hct) and coronary heart disease (CHD) mortality has been previously observed. However, the relationship of Hct and CHD independent of other cardiovascular disease (CVD) risk factors and differences between men and women remain unclear. Methods We examined the association between Hct and CHD mortality with Cox regression analyses of data from 8896 adults, aged 30-75 years, in the Second National Health and Nutrition Examination Survey (NHANES II) Mortality Study (1976-1992). Covariates included age, sex, race, education, smoking status, hypertensive status, total serum cholesterol, body mass index, white blood cell count, and history of CVD and diabetes. Hct was categorized by use of sex-specific tertiles, and all analyses were stratified by sex. Results During 16.8 years of follow-up, there were 545 (men 343, women 202) deaths from CHD (International Classification of Diseases, 9th revision [ICD-9] 410–414), 778 (men 426, women 279) deaths from diseases of the heart (ICD-9 390-398, 402, 404, 410-414, 415-417, 420-429), and 2046 (men 1216, women 830) all-cause deaths. Among men, the crude CHD mortality rate per 10,000 population was 42.6, 31.9, and 46.3 among those with Hct in the lower, middle, and upper tertiles, respectively. The corresponding crude CHD mortality rates among women were 12.6, 18.6, and 27.7. After adjustment for age and other CVD risk factors, there was no association between Hct in the upper tertile compared with the lower tertile and mortality from either CHD, diseases of the heart, or all causes among men. Women with Hct in the upper tertile were 1.3 times (95% CI 0.9–1.9) more likely to die from CHD than were women with Hct in the lowest tertile, after multivariate adjustment. The effect of high Hct on CHD mortality among women younger than 65 years of age was slightly stronger (relative risk 2.2, 95% CI 1.0–4.6). Conclusions These results suggest that the association between Hct and mortality from CHD and all causes is complex, differing both by sex and age. Further research is needed to gain a better understanding of these age and sex differences. (Am Heart J 2001;142:657-63.)
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