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米国の看護師健康追跡調査、主要道路の50m以内に住む女性は心臓突然死のリスクが増加する

QLife Pro「主要道路の近くに住むと心臓突然死リスクが増加する」(2014年12月17日)は、次のとおり伝えました.

「道路の近くに住むことが心臓突然死(SCD)のリスク増につながるか,そして,その他の冠動脈疾患のリスクがどうか,10万名規模のNurses’ Health Studyを利用し調査した(26年の追跡).期間中のSCDは523例で,住所から住居と道路の距離を算出したところ,主要道路の50m以内に住んでいる女性では交絡因子を調整した上でもSCDリスクが増加していた(HR 1.38; 95%CI 1.04-1.82).また,非致死性心筋梗塞のHRは1.08(95%CI 0.96-1.23),致死性心疾患では1.24(95%CI 1.03-1.50)であった.
Circulation. 2014;130(17):1474-82.」


Roadway proximity and risk of sudden cardiac death in women.

Hart JE1, Chiuve SE2, Laden F2, Albert CM2.
Author information
1From the Channing Division of Network Medicine (J.E.H., F.L.) and Division of Preventative Medicine (S.E.C., C.M.A.), Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA; and Departments of Environmental Health (J.E.H., F.L.) and Nutrition (S.E.C.), Harvard School of Public Health, Boston, MA. jaime.hart@channing.harvard.edu.
2From the Channing Division of Network Medicine (J.E.H., F.L.) and Division of Preventative Medicine (S.E.C., C.M.A.), Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA; and Departments of Environmental Health (J.E.H., F.L.) and Nutrition (S.E.C.), Harvard School of Public Health, Boston, MA.

Abstract

BACKGROUND:
Sudden cardiac death (SCD) is a major source of mortality and is the first manifestation of heart disease for the majority of cases. Thus, there is a definite need to identify risk factors for SCD that can be modified at the population level. Exposure to traffic, measured by residential roadway proximity, has been shown to be associated with an increased risk of cardiovascular disease. Our objective was to determine whether roadway proximity was associated with an increased risk of SCD and to compare that risk with the risk of other coronary heart disease outcomes.

METHODS AND RESULTS:
A total of 523 cases of SCD were identified over 26 years of follow-up among 107 130 members of the prospective Nurses' Health Study. We calculated residential distance to roadways at all residential addresses from 1986 to 2012. In age- and race-adjusted models, women living within 50 m of a major roadway had an elevated risk of SCD (hazard ratio=1.56; 95% confidence interval, 1.18-2.05). The association was attenuated but still statistically significant after controlling for potential confounders and mediators (hazard ratio=1.38; 95% confidence interval, 1.04-1.82). The equivalent adjusted hazard ratios for nonfatal myocardial infarction and fatal coronary heart disease were 1.08 (95% confidence interval, 0.96-1.23) and 1.24 (95% confidence interval, 1.03-1.50), respectively.

CONCLUSIONS:
Among this sample of middle-aged and older women, roadway proximity was associated with elevated and statistically significant risks of SCD and fatal coronary heart disease, even after controlling for other cardiovascular risk factors.

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by medical-law | 2014-12-18 01:50 | 医療