Impact of social support, cynical hostility and anger expression on progression of coronary atherosclerosis
Impact of social support, cynical hostility and anger expression on progression of coronary atherosclerosis
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DOI：
10.1016/s0735-1097(00)00944-x
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发表时间：
2000-11-15
影响因子：
24
通讯作者：
von Schacky, C
中科院分区：
文献类型：
--
作者：
Angerer, P;Siebert, U;von Schacky, C
目的研究冠状动脉造影显示的社会支持、愤怒表达和愤世嫉俗的敌意对冠状动脉粥样硬化进展的影响。背景低社会支持、表达愤怒和愤世嫉俗的敌意与冠心病的发病率和死亡率相关。然而，这些因素单独或共同对人类冠状动脉粥样硬化进展的影响尚不清楚。方法在223例冠心病患者中，162例在两年后再次进行了冠状动脉造影。一个不了解患者特征的专家小组对这些电影进行了成对的评估，以确定疾病的进展。在基线时，所有患者被要求回答三个自我报告问卷：关于情绪社会支持的问题，状态-特质-愤怒-表达问卷(STAXI)和库克-梅德利愤世嫉俗敌意量表。每个患者的临床和实验室状况如下。结果150名患者获得了问卷调查和血管造影随访数据。心理变量的双变量分析显示，只有在STAXI愤怒得分高或社会支持得分低的患者中，进展的风险才更高。在多因素分析中，当调整混杂变量并检验心理变量之间的交互作用时，只有高愤怒和低社会支持的患者疾病进展的风险增加(优势比30，可信区间[CI]5.5~165.1；RR3.19)。结论外在表达愤怒的冠心病患者情绪社会支持低的患者疾病进展的风险显著增加，不受药物或其他危险因素的影响。(C)2000年由美国心脏病学会颁发。
OBJECTIVES This prospective cohort study of patients with coronary artery disease (CAD) sought to determine the impact of social support, anger expression and cynical hostility on progression of coronary atherosclerosis as shown by angiography.BACKGROUND Low social support, high levels of expressed anger and cynical hostility are correlated to increased CAD morbidity and mortality. However, the impact of these factors, alone or together, on progression of human coronary atherosclerosis is unknown.METHODS Of 223 patients with CAD documented by standardized angiography at baseline, 162 had a second angiogram after two years. An expert panel who had no knowledge of the patients' characteristics evaluated the films pairwise to determine disease progression. At baseline, all patients were asked to answer three self-report questionnaires: questions concerning emotional social support, the State-Trait-Anger-Expression Inventory (STAXI) and the Cook-Medley cynical hostility scale. Each patient's clinical and laboratory status was followed.RESULTS Questionnaires and angiographic follow-up data were available for 150 patients. Bivariate analysis of the psychological variables showed a higher risk of progression only for patients who scored high on STAXI anger-out or low on social support. In the multivariate analysis, when adjusting for confounding variables and examining the interaction between psychological variables, only patients with both high anger-out and low social support were at highly increased risk for progression (odds ratio 30, confidence interval [CI] 5.5 to 165.1; RR 3.19).CONCLUSIONS Patients with CAD and low emotional social support who express anger outwardly are at a highly increased risk of disease progression, independent of medication or other risk factors. (C) 2000 by the American College of Cardiology.