焦虑和抑郁与心血管疾病风险增加有关,因为风险因素的加速发展增加了心血管疾病的风险
Giovanni Civieri1,2, Shady Abohashem1,3, Simran S Grewal1,3
1Cardiovascular Imaging Research Center, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA.
JACC. Advances
|September 6, 2024
概括
焦虑和抑郁加速心脏代谢风险因素,增加心血管疾病风险. 这种影响是由这些风险因素介导的,特别是在年轻女性中,并且与神经免疫通路有关.
科学领域:
- 心脏病学 心脏病学
- 精神病学是一个精神病学.
- 流行病学 流行病学
背景情况:
- 诸如高血压,高脂血症和糖尿病等心脏代谢风险因素 (CVDRF) 是导致心血管疾病 (CVD) 的关键因素.
- 在焦虑/抑郁和心血管疾病之间的关联中,CVDRF发展的调解作用仍然不完全理解.
- 之前的研究还没有完全阐明将心理健康状况与心血管结果联系在一起的途径.
研究的目的:
- 调查焦虑/抑郁和事件CVDRFs.之间的关联.
- 为了确定CVDRF的发展是否会调解与焦虑/抑郁相关的心血管疾病风险增加.
- 探索神经免疫机制,年龄和性别在这些关系中的参与.
主要方法:
- 在10年内对71,214名来自Mass General Brigham生物库的受试者进行了回顾性队列研究.
- 使用ICD代码来识别焦虑/抑郁,CVDRF和CVD.
- 评估了神经免疫标志物 (桃体与皮质活动比,hs-CRP,心率变化),并采用多变量回归和调解分析.
主要成果:
- 以前存在的焦虑/抑郁症显著增加了发展CVDRFs的风险 (OR: 1.71) 并缩短了它们出现的时间.
- 发现CVDRF的发展调解了焦虑/抑郁和心血管疾病事件之间的关联 (日志概率:0.044).
- 神经免疫通路有助于CVDRF的发展,年轻女性在焦虑/抑郁症后表现出CVDRF的最明显加速.
结论:
- 焦虑和抑郁加速了心脏代谢风险因素的发展,从而增加了心血管疾病的风险.
- 神经免疫路径和特定的人口因素,特别是年轻女性,在这种加速风险中发挥着重要作用.
- 对焦虑/抑郁症患者来说,需要量身定制的预防策略,以减轻他们心血管疾病风险的增加.
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