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Algengi og nýgengi blóðþurrðarhelti meðal íslenskra karla 1968-1986 : sterk tengsl við reykingar og kolesteról í blóði

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Authors
Ingimar Örn Ingólfsson
Gunnar Sigurðsson
Helgi Sigvaldason
Guðmundur Þorgeirsson
Nikulás Sigfússon
Issue Date
1994-03-01

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Citation
Læknablaðið 1994, 80(3):105-13
Abstract
The prospective Reykjavik study gave an opportunity to monitor secular trends from 1968-1986 of clinical intermittent claudication amongst Icelandic males, age 34-80 (n=9.141), and to assess the importance of possible risk factors. Both prevalence and incidence of intermittent claudication decreased sharply after 1970 in all age groups, and this decline (more than 50%) occurred a few years earlier than the decline of coronary heart disease in Iceland. The only significant risk factors for intermittent claudication, in addition to age, were smoking which increased the risk 8-10-fold and serum cholesterol level. This decline in prevalence and incidence of intermittent claudication can largely be explained by decreased smoking and cholesterol levels amongst Icelandic' men. A follow-up study verified that patients with intermittent claudication stood twice the risk of cardiovascular and total mortality as non-intermittent claudication patients, indicating that this is a high risk group which should receive all possible preventive measures.
Í hóprannsókn Hjartaverndar mætti 9141 karl á aldrinum 34-80 ára einu sinni eða oftar 1968-1986. Gögn sem þar hefur verið aflað um blóðþurrðarhelti gefa gott tækifæri til að kanna algengi og nýgengi sjúkdómsins og tengsl við áhættuþætti. Lækkun algengis frá 1968-1986 var 55%. Meðal sjötugra karlmanna lækkaði algengið úr 6,7% í 3,1% og meðal sextugra karla úr 3,2% í 1,4%. Algengið óx mjög hratt frá fimmtugsaldri fram undir sjötugt en þá dró úr aukningunni. Nýgengið lækkaði enn meira á tímabilinu (66%). Af samtímaþáttum var marktæk fylgni við aldur, ártal, reykingar, kólesteról, slagbilsþrýsting og hlébilsþrýsting. En aðeins aldur, reykingar og kólesteról höfðu marktækt forspárgildi um blóðþurrðarhelti á rannsóknartímabilinu. Áhættan á blóðþurrðarhelti var átt- til tíföld meðal þeirra sem reyktu 15 sígarettur eða meira á dag. Aldur, reykingar, slagbilsþrýstingur og kólesteról í blóði höfðu sterkari fylgni við blóðþurrðarhelti en kransæðasjúkdóma. Hlutfallslega fleiri voru með blóðþurrðarhelti eftir því sem kransæðasjúkdómurinn varð verri. Blóðþurrðarhelti hafði marktækt forspárgildi um heildardánartíðni og dánartíðni af völdum kransæðasjúkdóma og heilablóðfalls eftir að búið var að leiðrétta fyrir mörgum þekktum áhættuþáttum. Minnkandi reykingar og lækkandi meðalgildi kólesteróls í blóði skýra mestan hluta þeirrar lækkunar sem varð á algengi og um helminginn af lækkuðu nýgengi.
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