医学
冲程(发动机)
内科学
危险系数
血压
比例危险模型
队列
置信区间
脑出血
心脏病学
前瞻性队列研究
混淆
队列研究
人口
蛛网膜下腔出血
工程类
环境卫生
机械工程
作者
Audrey Bonaventure,Tobias Kurth,Fernando Pico,Pascale Barberger‐Gateau,Karen Ritchie,Christian Stapf,Christophe Tzourio
标识
DOI:10.1016/j.atherosclerosis.2009.10.043
摘要
Background Few studies have assessed the relationship between triglycerides and the risk of hemorrhagic stroke, which contrasts the considerable number of studies about triglycerides and ischemic vascular events. We analyzed the association pattern between triglycerides and incident intracerebral hemorrhage as compared with coronary events and ischemic stroke, in a large cohort of elderly. Methods Population-based, prospective cohort study among 8393 men and women participating in the Three-City Study, aged ≥65 years at baseline. Fasting blood lipids, including triglycerides, were measured at baseline. Fatal and non-fatal strokes and coronary events were adjudicated and validated by scientific committees. Cox proportional hazards models were used to adjust for potential confounders. Results During a mean follow-up of 5.0 years, 36 hemorrhagic strokes, 143 ischemic strokes, and 393 coronary events occurred. An increased level of triglycerides was associated with an increased risk of ischemic vascular events. Conversely, a low level of triglycerides (≤0.94 mmol/L) was associated with an increased risk of hemorrhagic stroke (adjusted hazard ratio 2.35; 95% confidence interval 1.18–4.70). The relationship with hemorrhagic stroke was mainly apparent in men, in individuals with high blood pressure, and in those with low levels of cholesterol. Conclusions In this large cohort of elderly men and women, low triglycerides levels were associated with an increased risk of hemorrhagic stroke and a decreased risk of ischemic vascular events. The association between triglycerides and hemorrhagic stroke was particularly strong in men, in subjects with high blood pressure and in those with low cholesterol levels.
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