对缺血性心脏病的因果途径的洞察:不良童年经历研究研究
Maxia Dong1, Wayne H Giles, Vincent J Felitti
1National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Ga 30341, USA. mfd7@cdc.gov
Circulation
|September 24, 2004
概括
童年不良经历 (ACE) 显著增加缺血性心脏病 (IHD) 的风险. 心理因素,而不是传统风险,调解了这种联系,突出了儿童时期的压力对成人心脏健康的影响.
科学领域:
- 心脏病学 心脏病学
- 心理学 心理学 心理学
- 公共卫生 公共卫生
背景情况:
- 不利的童年经历 (ACE) 包括虐待,忽视和家庭功能障碍.
- 儿童时期的逆境越来越被认为是成人健康结果的重要决定因素.
- 了解将ACE与心血管疾病联系在一起的途径对于预防策略至关重要.
研究的目的:
- 调查ACE与发展缺血性心脏病 (IHD) 的风险之间的关联.
- 确定传统的IHD风险因素和心理因素在ACEs-IHD关系中的调解作用.
主要方法:
- 对17,337名成年健康计划成员 (1995-1997) 的回顾性队列研究.
- 对人口统计因素 (年龄,性别,种族,教育程度) 进行调整后的物流回归分析.
- 评估心理和传统IHD风险因素的调解影响.
主要成果:
- 10个ACE类别中的9个与IHD风险增加1.3至1.7倍有关.
- 患有7个或更多ACE的个体患上IHD的几率增加了3.6倍.
- 心理因素 (抑郁情绪,愤怒) 和传统因素 (吸烟,不活动,肥胖,糖尿病,高血压) 调解了ACEs-IHD联系,而心理因素显示出更强烈的影响.
结论:
- 在ACE和IHD风险之间存在剂量反应关系.
- 心理因素在调解ACEs对IHD的影响方面比传统的风险因素发挥更重要的作用.
- 童年逆境是影响成人心血管健康的关键途径.
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