30 year patterns of mortality in tobago, west indies, 1976-2005 impact of glucose intolerance and alcohol intake30年的死亡率模式多巴哥、西印度群岛,1976 - 2005葡萄糖耐受不良和酒精摄入量的影响.pdf

30 Year Patterns of Mortality in Tobago, West Indies, 1976-2005: Impact of Glucose Intolerance and Alcohol Intake 1 1 2 3 Mariam Molokhia *, Dorothea Nitsch , Alan Leslie Patrick , Paul McKeigue 1 Division of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, United Kingdom, 2 Kavanagh Street Medical Centre, Port of Spain, Trinidad, West Indies, 3 Public Health Sciences/Molecular Medicine Centre, University of Edinburgh, Edinburgh, United Kingdom Abstract Objectives: To determine the main predictors of all-cause and cardiovascular (CV) mortality in a rural West Indian population in Plymouth, Tobago over 30 years. Methods: Questionnaire survey for CV risk factors and alcohol consumption patterns administered at baseline in 1976 with 92.5% response rate. 831/832 patients were followed up until 2005 or death. Results: Hypertension (.140/90 mm Hg) was prevalent in 48% of men and 44% of women, and 21% of men and 17% of women had diabetes. Evidence showed most predictors for all cause and cardiovascular mortality having the main effects at ages ,60 years, (p-value for interaction,0.01) but no risk factors having sex-specific effects on mortality. The main predictors of all-cause mortality at age ,60 years in the fully adjusted model were high sessional alcohol intake (hazard ratio (HR) 2.04, 95% CI 1.10-3.80), severe hypertension .160/95 mm Hg (HR 1.68, 95% CI 1.09-2.60), diabetes (HR 3.28, 95% CI 1.89-5.69), and BMI (HR 1.04, 95% CI 1.00-1.07). The main predictors of cardiovascular mortality were similar in the fully adjusted model: high sessional alcohol intake (HR 2.47 95% CI 1.10-5.57), severe hypertension (HR 2.78 95% CI 1.56-4.95), diabetes (HR 3.68 95% CI 1.77-7.67) a