Abstract:
OBJECTIVE:To evaluate the association between body mass index and mortality from overall cardiovascular disease and specific subtypes of cardiovascular disease in east and south Asians. DESIGN:Pooled analyses of 20 prospective cohorts in Asia, including data from 835,082 east Asians and 289,815 south Asians. Cohorts were identified through a systematic search of the literature in early 2008, followed by a survey that was sent to each cohort to assess data availability. SETTING:General populations in east Asia (China, Taiwan, Singapore, Japan, and Korea) and south Asia (India and Bangladesh). PARTICIPANTS:1,124,897 men and women (mean age 53.4 years at baseline). MAIN OUTCOME MEASURES:Risk of death from overall cardiovascular disease, coronary heart disease, stroke, and (in east Asians only) stroke subtypes. RESULTS:49,184 cardiovascular deaths (40,791 in east Asians and 8393 in south Asians) were identified during a mean follow-up of 9.7 years. East Asians with a body mass index of 25 or above had a raised risk of death from overall cardiovascular disease, compared with the reference range of body mass index (values 22.5-24.9; hazard ratio 1.09 (95% confidence interval 1.03 to 1.15), 1.27 (1.20 to 1.35), 1.59 (1.43 to 1.76), 1.74 (1.47 to 2.06), and 1.97 (1.44 to 2.71) for body mass index ranges 25.0-27.4, 27.5-29.9, 30.0-32.4, 32.5-34.9, and 35.0-50.0, respectively). This association was similar for risk of death from coronary heart disease and ischaemic stroke; for haemorrhagic stroke, the risk of death was higher at body mass index values of 27.5 and above. Elevated risk of death from cardiovascular disease was also observed at lower categories of body mass index (hazard ratio 1.19 (95% confidence interval 1.02 to 1.39) and 2.16 (1.37 to 3.40) for body mass index ranges 15.0-17.4 and <15.0, respectively), compared with the reference range. In south Asians, the association between body mass index and mortality from cardiovascular disease was less pronounced than that in east Asians. South Asians had an increased risk of death observed for coronary heart disease only in individuals with a body mass index greater than 35 (hazard ratio 1.90, 95% confidence interval 1.15 to 3.12). CONCLUSIONS:Body mass index shows a U shaped association with death from overall cardiovascular disease among east Asians: increased risk of death from cardiovascular disease is observed at lower and higher ranges of body mass index. A high body mass index is a risk factor for mortality from overall cardiovascular disease and for specific diseases, including coronary heart disease, ischaemic stroke, and haemorrhagic stroke in east Asians. Higher body mass index is a weak risk factor for mortality from cardiovascular disease in south Asians.
journal_name
BMJjournal_title
BMJ (Clinical research ed.)authors
Chen Y,Copeland WK,Vedanthan R,Grant E,Lee JE,Gu D,Gupta PC,Ramadas K,Inoue M,Tsugane S,Tamakoshi A,Gao YT,Yuan JM,Shu XO,Ozasa K,Tsuji I,Kakizaki M,Tanaka H,Nishino Y,Chen CJ,Wang R,Yoo KY,Ahn YO,Ahsan H,doi
10.1136/bmj.f5446subject
Has Abstractpub_date
2013-10-01 00:00:00pages
f5446eissn
0959-8138issn
1756-1833journal_volume
347pub_type
杂志文章,meta分析,评审abstract::In the existing WHO guidelines, complementary feeding at 4-6 months is advocated. However, many nutrition specialists believe that these guidelines lead to complementary foods being offered from the age of 3 months, or even earlier, subsequently suggesting that the WHO should change its recommendations to about 6 mon...
journal_title:BMJ (Clinical research ed.)
pub_type: 新闻
doi:
更新日期:2000-09-09 00:00:00
abstract::This review summarises the literature on shift work and its relation to insufficient sleep, chronic diseases, and accidents. It is based on 38 meta-analyses and 24 systematic reviews, with additional narrative reviews and articles used for outlining possible mechanisms by which shift work may cause accidents and adver...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,评审
doi:10.1136/bmj.i5210
更新日期:2016-11-01 00:00:00
abstract::Chronic insomnia is a common condition that affects people worldwide and has negative effects on patients' health and wellbeing. The treatment of insomnia can be complex and time consuming for patients and providers. Although behavioral interventions are the first line therapy, there are barriers to access for these t...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,评审
doi:10.1136/bmj.i2123
更新日期:2016-07-06 00:00:00
abstract::A randomised controlled trial of two management regimens was carried out in women patients over 65 years of age with hip fractures. Ninety seven patients were admitted to a designated orthopaedic geriatric unit and 125 to orthopaedic wards. No difference was observed in mortality, length of stay, or placement of patie...
journal_title:BMJ (Clinical research ed.)
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1136/bmj.297.6656.1116
更新日期:1988-10-29 00:00:00
abstract::One hundred and two patients returned structured questionnaires sent to clinics for sickle cell disease in the United Kingdom in order to gain greater insight into the patients' perception of painful crises. Most patients who suffer pain crises experience a prodromal stage that should be investigated further to find o...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.297.6646.452
更新日期:1988-08-13 00:00:00
abstract:OBJECTIVES:To estimate survival after a diagnosis of dementia in primary care, compared with people without dementia, and to determine incidence of dementia. DESIGN:Cohort study using data from The Health Improvement Network (THIN), a primary care database. SETTING:353 general practices in the United Kingdom providin...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,多中心研究
doi:10.1136/bmj.c3584
更新日期:2010-08-05 00:00:00
abstract:OBJECTIVE:To examine the effect of the method of data display on physician investigators' decisions to stop hypothetical clinical trials for an unplanned statistical analysis. DESIGN:Prospective, mixed model design with variables between subjects and within subjects (repeated measures). SETTING:Comprehensive cancer c...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.318.7197.1527
更新日期:1999-06-05 00:00:00
abstract:OBJECTIVE:To determine the effect of withdrawing diuretic drugs on oedema in patients prescribed them for only ankle oedema, excluding patients with cardiac, hepatic, or renal failure. DESIGN:Randomised controlled trial. SETTING:15 general practices in the Netherlands. PATIENTS:1202 patients aged 65 years or older a...
journal_title:BMJ (Clinical research ed.)
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1136/bmj.308.6927.511
更新日期:1994-02-19 00:00:00
abstract::A total of 563 white primigravid patients at Raigmore Hospital, Inverness, were recruited in a prospective study to examine the association between maternal height, shoe size, and the outcome of labour. There was a significantly increased caesarean section rate in women of short stature but no association between mode...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.297.6647.515
更新日期:1988-08-20 00:00:00
abstract:OBJECTIVE:To examine how the relaxation of the one child policy and policies to reduce caesarean section rates might have affected trends over time in caesarean section rates and perinatal and pregnancy related mortality in China. DESIGN:Observational study. SETTING:China's National Maternal Near Miss Surveillance Sy...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.k817
更新日期:2018-03-05 00:00:00
abstract:OBJECTIVE:To determine whether a decision aid designed for adults with low education and literacy can support informed choice and involvement in decisions about screening for bowel cancer. DESIGN:Randomised controlled trial. SETTING:Areas in New South Wales, Australia identified as socioeconomically disadvantaged (lo...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,随机对照试验
doi:10.1136/bmj.c5370
更新日期:2010-10-26 00:00:00
abstract:OBJECTIVE: To determine whether the treatment effect of apixaban versus warfarin differs with increasing numbers of concomitant drugs used by patients with atrial fibrillation. DESIGN: Post hoc analysis performed in 2015 of results from ARISTOTLE (apixaban for reduction in stroke and other thromboembolic events in atr...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1136/bmj.i2868
更新日期:2016-06-15 00:00:00
abstract::Objectives To estimate small for gestational age birth prevalence and attributable neonatal mortality in low and middle income countries with the INTERGROWTH-21st birth weight standard.Design Secondary analysis of data from the Child Health Epidemiology Reference Group (CHERG), including 14 birth cohorts with gestatio...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.j3677
更新日期:2017-08-17 00:00:00
abstract:OBJECTIVE:To determine whether peer review medical audit in a primary care setting changes clinical behaviour in relation to the management of hypertension. DESIGN:Review of medical records in general practices to identify hypertensive patients followed up by assessment of the pre-educational and post-educational mana...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.314.7085.942
更新日期:1997-03-29 00:00:00
abstract:OBJECTIVE:To identify additional factors, such as maternal age or factors related to previous reproductive outcome or family history, and the corresponding probability of carrying a chromosome abnormality in couples with two or more miscarriages. DESIGN:Nested case-control study. SETTING:Six centres for clinical gene...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,多中心研究
doi:10.1136/bmj.38498.669595.8F
更新日期:2005-07-16 00:00:00
abstract:OBJECTIVE:To define the benefit of rice oral rehydration salts solution in relation to the glucose based World Health Organisation oral rehydration salts solution for treating and preventing dehydration in patients with severe dehydrating diarrhoea. DESIGN:Meta-analysis using data from 13 available randomised trials t...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,meta分析
doi:10.1136/bmj.304.6822.287
更新日期:1992-02-01 00:00:00
abstract:OBJECTIVE:To assess the ability of radiographers to identify abnormal radiographs of patients attending accident and emergency departments. DESIGN:Prospective study over six weeks. SETTING:Teaching hospital casualty x ray department. PATIENTS:3394 consecutive patients referred for radiography. INTERVENTIONS:Radiogr...
journal_title:BMJ (Clinical research ed.)
pub_type: 临床试验,杂志文章
doi:10.1136/bmj.302.6776.568
更新日期:1991-03-09 00:00:00
abstract:OBJECTIVE:To estimate changes in the risk of autism and assess the relation of autism to the mumps, measles, and rubella (MMR) vaccine. DESIGN:Time trend analysis of data from the UK general practice research database (GPRD). SETTING:General practices in the United Kingdom. SUBJECTS:Children aged 12 years or younger...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.322.7284.460
更新日期:2001-02-24 00:00:00
abstract:OBJECTIVE:To determine the prevalence of diabetes in relation to birth weight in Pima Indians. DESIGN:Follow up study of infants born during 1940-72 who had undergone a glucose tolerance test at ages 20-39 years. SETTING:Gila River Indian community, Arizona. SUBJECTS:1179 American Indians. MAIN OUTCOME MEASURE:Prev...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.308.6934.942
更新日期:1994-04-09 00:00:00
abstract:OBJECTIVES:To assess the incidence, time of day, and driver morbidity associated with vehicle accidents where the most likely cause was the driver falling asleep at the wheel. DESIGN:Two surveys were undertaken, in southwest England and the midlands, by using police databases or on the spot interviews. SUBJECTS:Drive...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.310.6979.565
更新日期:1995-03-04 00:00:00
abstract:OBJECTIVE:To compare four potential screening strategies, and subsequent interventions, for the prevention and treatment of type 2 diabetes: (a) screening for type 2 diabetes to enable early detection and treatment, (b) screening for type 2 diabetes and impaired glucose tolerance, intervening with lifestyle interventio...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.39545.585289.25
更新日期:2008-05-24 00:00:00
abstract:OBJECTIVES:To determine whether an aid to the diagnosis of pigmented skin lesions reduces the ratio of benign lesions to melanomas excised in general practice. DESIGN:Controlled trial randomised by practice. SETTING:General practices in Perth, Western Australia. PARTICIPANTS:468 general practitioners in 223 practice...
journal_title:BMJ (Clinical research ed.)
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
doi:10.1136/bmj.327.7411.375
更新日期:2003-08-16 00:00:00
abstract:OBJECTIVES:To compare patients' preference for transdermal fentanyl or sustained release oral morphine, their level of pain control, and their quality of life after treatment. DESIGN:Randomised, multicentre, international, open label, crossover trial. SETTING:35 centres in Belgium, Canada, Denmark, Finland, the Unite...
journal_title:BMJ (Clinical research ed.)
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
doi:10.1136/bmj.322.7295.1154
更新日期:2001-05-12 00:00:00
abstract::Since the World Health Organization (WHO) set a goal in 1988 of eradicating polio worldwide by 2000, the incidence of the disease has declined by 90% around the world, with national immunization days conducted in more than 120 countries. More than 450 million children were immunized in 1998 alone. Now, with only abo...
journal_title:BMJ (Clinical research ed.)
pub_type: 新闻
doi:10.1136/bmj.318.7186.756
更新日期:1999-03-20 00:00:00
abstract:OBJECTIVE:To assess the role of rhinoviruses in elderly people living in the community. DESIGN:Prospective community based surveillance of elderly people, without intervention. Subjects were telephoned weekly to identify symptomatic upper respiratory tract infections. Symptoms and impact of illnesses were monitored, a...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.313.7065.1119
更新日期:1996-11-02 00:00:00
abstract::The recent growth in the numbers of published systematic reviews reflects growing recognition of their importance for improving knowledge about the effects of health care. In Britain the NHS R&D Programme has established two centres to prepare systematic reviews of existing information, and the Cochrane Collaboration-...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,评审
doi:10.1136/bmj.309.6958.862
更新日期:1994-10-01 00:00:00
abstract::Cancers of unknown primary (CUPs) are histologically confirmed, metastatic malignancies with a primary tumor site that is unidentifiable on the basis of standard evaluation and imaging studies. CUP comprises 2-5% of all diagnosed cancers worldwide and is characterized by early and aggressive metastasis. Current standa...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,评审
doi:10.1136/bmj.m4050
更新日期:2020-12-07 00:00:00
abstract:OBJECTIVE:To assess whether using intensive blood pressure targets leads to lower blood pressure in a community population of people with prevalent cerebrovascular disease. DESIGN:Open label randomised controlled trial. SETTING:99 general practices in England, with participants recruited in 2009-11. PARTICIPANTS:Peo...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1136/bmj.i708
更新日期:2016-02-24 00:00:00
abstract:OBJECTIVE:To develop and validate a prognostic model for early death in patients with traumatic bleeding. DESIGN:Multivariable logistic regression of a large international cohort of trauma patients. SETTING:274 hospitals in 40 high, medium, and low income countries PARTICIPANTS:Prognostic model development: 20,127 t...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.e5166
更新日期:2012-08-15 00:00:00
abstract:OBJECTIVE:To assess the cost-effectiveness of low dose statins for primary prevention of vascular disease, incorporating current prices, non-adherence (reduced clinical efficacy while maintaining healthcare costs), and the results of the recently published JUPITER trial. DESIGN:Cost-effectiveness analysis using a Mark...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.d1672
更新日期:2011-03-30 00:00:00