用心理健康指标增强心血管健康结构,用于预测死亡风险
Vanessa T Dinh1, Rahul Hosalli1, Pricila H Mullachery2
1Department of Epidemiology, Mailman School of Public Health, Columbia University Irving Medical Center, New York, New York, USA.
将心理健康添加到心血管健康 (CVH) 指标中,可以显著降低死亡风险. 这种增强的CVH方法,使用抑郁症查,为公共卫生和临床环境提供了一个强大的工具.
科学领域:
- 心血管健康 心血管健康
- 公共卫生 公共卫生
- 心理健康 心理健康
背景情况:
- 美国心脏协会的生命必需8 (LE8) 咨询报告承认心理健康对心血管健康 (CVH) 的重要性,但将其作为指标排除在外.
- 这凸显了全面评估整体健康和死亡风险的差距.
研究的目的:
- 评估加强CVH构造之间的关联,包括通过抑郁查的心理健康,以及美国成年人的死亡风险.
- 为了确定是否纳入心理健康改善死亡率的预测与现有的CVH指标相比.
主要方法:
- 利用了来自21183名美国成年人的数据 (2011-2018年NHANES).
- 使用LE8算法和两个包含心理健康的增强构造 (PHQ-2,PHQ-9抑郁查) 评估CVH.
- 采用多变量Cox比例危险模型来比较CVH得分类别中的死亡风险.
主要成果:
- 与较低得分相比,改善的CVH得分 (与PHQ-2/PHQ-9) 与所有原因死亡风险显著降低 (69-70%的降低) 相关.
- 高LE8分数也预测了较低的死亡风险 (减少65%),与增强的CVH相似的预测性表现 (C-统计 ≈0.84).
- 无论是LE8和增强的CVH分数都预测了较低的心血管和癌症死亡率.
结论:
- 加上心理健康的CVH构造是死亡率的强有力的预测指标.
- 应考虑将心理健康整合到CVH指标中,使用可行的抑郁查工具,用于临床和公共卫生应用.
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