RELATIONSHIP OF PSYCHOSOCIAL FACTORS TO CORONARY HEART-DISEASE IN THE FRAMINGHAM-STUDY .3. 8-YEAR INCIDENCE OF CORONARY HEART-DISEASE
RELATIONSHIP OF PSYCHOSOCIAL FACTORS TO CORONARY HEART-DISEASE IN THE FRAMINGHAM-STUDY .3. 8-YEAR INCIDENCE OF CORONARY HEART-DISEASE
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DOI：
10.1093/oxfordjournals.aje.a112873
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发表时间：
1980-01-01
影响因子：
5
通讯作者：
KANNEL, WB
中科院分区：
文献类型：
--
作者：
HAYNES, SG;FEINLEIB, M;KANNEL, WB
对1965-1967年间参加心脏病研究的1674名无冠状动脉患者进行了广泛的社会心理问卷调查。随访调查对象8年以上的冠心病发病情况。患有冠心病的女性（45-64岁）在A型行为、抑制敌意（不显示或讨论愤怒）、紧张和焦虑症状量表上的得分显著高于未患冠心病的女性。A型女性患CHD的几率是男性的两倍，和B型女性一样多心绞痛。在多变量分析中，当控制标准冠状动脉危险因素和其他心理社会量表时，A型行为和不讨论愤怒是冠心病发病率的独立预测因素。表现出A型行为、超负荷工作、压抑敌意（不表现出愤怒）和频繁的工作晋升的男性患冠心病的风险增加（特别是在55-64岁的年龄组）。在45-64岁的男性中，一般而言，A型行为与心绞痛、心肌梗死和冠心病的风险是B型行为的2倍。这种关联仅在白领工人中发现，并且与标准冠状动脉风险因素和其他心理社会量表无关。这项前瞻性研究表明，A型行为和压抑的敌意可能参与了男性和女性冠心病的发病机制。
An extensive psychosocial questionnaire was administered to 1674 coronary free individuals participating in the Framingham Heart Study between 1965-1967. The respondents were followed for the development of coronary heart disease (CHD) over 8 yr. Women (aged 45-64 yr) who developed CHD scored significantly higher on the Framingham Type A behavior, suppressed hostility (not showing or discussing anger), tension and anxiety symptoms scales than women remaining free of CHD. Type A women developed twice as much CHD and 3 .times. as much angina as Type B women. In a multivariate analysis, Framingham Type A behavior and not discussing anger were independent predictors of CHD incidence when controlled for the standard coronary risk factors and other psychosocial scales. Men exhibiting Framingham Type A behavior, work overload, suppressed hostility (not showing anger) and frequent job promotions were at increased risk of developing CHD (especially in the age group 55-64 yr). Among men aged 45-64 yr, Type A behavior was associated with a 2-fold risk of angina, myocardial infarction and CHD in general, as compared to Type B behavior. The association was found only among white-collar workers and was also independent of the standard coronary risk factors and other psychosocial scales. This prospective study suggests that Type A behavior and suppressed hostility may be involved in the pathogenesis of CHD in both men and women.