慢性压力和心血管事件:来自CARDIA研究的发现
Tiwaloluwa A Ajibewa1, Kiarri N Kershaw1, J Jeffrey Carr2
1Feinberg School of Medicine, Northwestern University, Chicago, Illinois.
American journal of preventive medicine
|December 24, 2023
概括
慢性压力增加了心血管疾病的风险,但这种联系是由临床因素介导的,而不是社会支持或体力活动. 建议对保护性心理和行为因素进行进一步的研究.
科学领域:
- 心血管健康的心血管健康
- 心理社会因素 心理社会因素
- 流行病学 流行病学
背景情况:
- 感知压力的增加与心血管健康不佳有关.
- 积极的心理因素,如社会支持和健康行为,可能会缓冲与压力有关的心血管风险.
- 需要纵向数据来了解压力,心血管疾病 (CVD) 和潜在的改变因素.
研究的目的:
- 为了调查慢性压力和心血管疾病事件之间的纵向关联.
- 确定社会支持和体力活动 (PA) 是否会改变慢性压力和心血管疾病之间的关系.
- 探索临床调解者在压力-心血管疾病关系中的作用.
主要方法:
- 从年轻成年人冠状动脉风险发展研究 (CARDIA) (2000-2001年至2020年) 中对3,401名成年人的分析.
- 自我报告的慢性压力 (≥6个月在5个领域),体力活动和社会支持.
- 通过多变量阶段性加速失效时间分析确定判定致命/非致命的心血管疾病事件.
主要成果:
- 在调整了社会人口统计和生活方式因素后,慢性压力与生存时间的缩短有关 (时间比:0.92;95% CI:0.854-0.989).
- 当将临床因素纳入模型时,这种关联失去了统计学意义.
- 身体活动和社会支持并没有显著改变慢性压力和心血管疾病事件之间的关联 (所有p>0.05).
结论:
- 慢性压力与中年成人心血管疾病风险增加有关,部分是通过临床调解者.
- 社交支持和体力活动似乎没有改变这个队列中的这种关联.
- 需要进一步的研究来确定可能防止与压力有关的心血管疾病的心理社会和行为因素.
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