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1、心血管疾病与骨质疏松症,广州市第一人民医院 刘丰,妇女的年发生率,1. National Institute of Arthritis and Musculoskeletal Diseases. 2. National Osteoporosis Foundation. 3. American Heart Association. 2001 Heart and Stroke Statistical Update. 4. American Cancer Society. Cancer Facts & Figures 2001.,0,100,000,200,000,300,000,400,000,5
2、00,000,每年发生的病例数,1,500,000,骨质疏松症的最大危害是骨折,Cooper, 1997,骨松性髋部骨折的严重危害性,高血压是骨折的危险因素,Osteoprosis Int (2007) 18:1355-1362,所有骨折的风险,高血压与髋部骨折,Osteoprosis Int (2007) 18:1355-1362,髋部骨折的风险（危险因素调节后）,心衰与髋部骨折,瑞典研究证明女性心衰病人髋部骨折的发生率增加2-3倍 加拿大研究证明心衰病人第一年髋部骨折的发生率比无心衰的其他心血管疾病组增加6倍 髋部骨折是心衰病人死亡的主要因素,心衰病人髋部骨折发病率显著提高,Europea
3、n Heart Journal(2010)31,77-84,心血管疾病与髋部骨折-加拿大,Circulation. 2008;118:1946-1952,心血管疾病与髋部骨折, Table 2 Odds ratios (OR) and 95% confidence intervals (CI) of hip fracture associated with previous diseases Crude Adjusted* Adjusted* OR (95% CI) OR (95% CI) OR (95% CI) OR (95% CI) Any cardiovascular disease 2
4、.56 (2.173.01) 2.75 2.243.37 2.38 (1.922.94) Hypertension 2.94 (2.293.78) 3.72 2.745.05 2.76 (1.983.84) IHD 1.64 (1.292.09) 1.70 1.272.28 0.97 (0.701.35) Atherosclerosis 2.57 (1.604.13) 1.80 0.993.28 1.28 (0.672.45) Heart failure 2.64 (1.943.60) 2.51 1.683.74 1.82 (1.172.84) CVL 3.49 (2.604.69) 3.82
5、 2.615.60 2.76 (1.854.13) CVD only 2.64 (2.163.23) 2.76 2.163.52 2.76 (2.163.52) CVD and any other disease 3.13 (2.424.04) 3.38 2.434.68 2.53 (1.294.96) IHD ischemic heart disease including heart infarction and angina pectoris CVL cerebrovascular lesion CVD cardiovascular disease *Adjusted for age (
6、60, 6064, 6569, 7074, 7577, 7881 year), BMI (5 35 19 5.20 2.969.13 7.11 3.2115.78 5.70 2.5312.82 *Adjusted for age (60, 6064, 6569, 7074, 7577, 7881 year), BMI (1825 62 (4.7) 87 (2.7) 2.01 1.442.81 1.96 1.292.97 1.62 1.052.48 (5 years) *Adjusted for age (60, 6064, 6569, 7074, 7577, 7881 year), BMI (
7、20, 2024.9, 2529.9 and 30+ kg/m2 ), smoker (never, former and current), alcohol consumption (yes/no), physical activity (-1 and 2+ h/w), and use of HRT (yes/no). * Including the covariates included above* and the following diseases as separate marker variables: malignancy, diabetes mellitus, psychiatric disorder, drug dependence, pneumonia, chronic obstructive lung disease, liver failure and kidney failure,
