Bereavement of a child as a risk of heart failure
Bereavement of a child as a risk of heart failure
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失去孩子是心力衰竭的风险
DOI：
10.1002/ejhf.2388
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发表时间：
2022
影响因子：
18.2
通讯作者：
Kasai T
中科院分区：
文献类型：
--
作者：
Naito R;Kasai T
心力衰竭（HF）是心血管疾病发病率和死亡率的主要原因。1在发达国家，1%-2%的人口患有心衰，其中70岁以上人群患病率≥10%。尽管心衰的医疗管理有所改善，但心衰患者的预后仍然不利。发生HF的风险包括传统的动脉粥样硬化因素，如高血压、糖尿病、血脂异常，一些现代因素，如肾脏和肺部疾病、睡眠呼吸障碍3，以及社会经济因素（如教育、收入水平和社会孤立）。心理因素，包括精神压力，也可能是心衰的危险因素。失去一个亲密的家庭成员是一种痛苦的经历，可能会引起巨大的精神压力。特别是，对父母来说，孩子的死亡被认为是极具毁灭性的事件。在这一期的Journal中，Wei及其同事利用丹麦和瑞典医学出生登记处的医疗记录，在一项大规模人群队列研究中，提供了关于儿童死亡与父母HF风险相关的新发现。6在中位22年的随访期间，参与研究的6717349名参与者中有128929人（1.9%）失去了至少一个孩子。丧偶父母的HF发病率为113.4 / 105人年，而非丧偶父母的HF发病率为44.3 / 105人年。多变量发病率比（IRR）（95%可信区间）为1.35 （1.29 ~ 1.41,p< 0.001）。无论死亡原因（即心血管、其他自然原因和非自然原因）如何，均观察到儿童死亡与心衰之间的关联，心血管死亡的IRR相对较高。当对失去亲人的父母进行分类时，这种关联呈u形，当父母失去亲人时（1-2个活着的孩子的IRR最低）或按死亡孩子的年龄（13至18岁的IRR最低），这种关联呈u形。在母亲身上观察到更强的关联，而不是
Heart failure (HF) is a leading cause of cardiovascular morbidity and mortality. 1 In developed countries, 1%–2% of the population suffers from HF, with a prevalence of≥ 10% among people aged 70 years or older. 2 Despite improvements in the medical management of HF, the prognosis of HF patients continues to remain unfavourable.The risks of developing HF include traditional atherosclerotic factors such as hypertension, diabetes mellitus, dyslipidaemia, some modern factors such as kidney and pulmonary diseases, sleep disordered breathing, 3 and socioeconomic factors (eg education, income levels, and social isolation). 4 Psychological factors, including mental stress, may also act as risk factors for HF. 5 A bereavement of a close family member can be a distressing experience that may induce a tremendous amount of mental stress. In particular, the death of a child is presumed to be an extremely devastating event for parents. In this issue of the Journal, Wei and colleagues provide novel findings regarding the death of a child in relation to the risk of HF for the parents in a large-scale population-based cohort study, using medical records of the Danish and Swedish Medical Birth Registers. 6 During a median follow-up of 22 years, 129 829 out of 6 717 349 participants (1.9%) who participated in the study lost at least one child. The incidence rate of HF was 113.4 per 105 person-years in the bereaved parents, while that in non-bereaved parents was 44.3. The multivariable incidence rate ratio (IRR)(95% confidence interval) was 1.35 (1.29–1.41, p< 0.001) in the bereaved parents. The association between the death of a child and HF was observed regardless of the cause of death (ie cardiovascular, other natural, and unnatural causes) with relatively high IRR for cardiovascular deaths. The association was U-shaped when the bereaved parents were categorized in relation to the number of remaining live children when the parents had loss (the lowest IRR for 1–2 live children) or by the age of the deceased child (the lowest IRR for ages from 13 to 18 years). Stronger associations were observed in mothers as opposed to
影响因子：
3.7
作者：
Fagundes, Christopher P.;Murdock, Kyle W.;Heijnen, Cobi
通讯作者：
Heijnen, Cobi
影响因子：
18.2
作者：
Wei, Dang;Li, Jiong;Laszlo, Krisztina D.
通讯作者：
Laszlo, Krisztina D.
影响因子：
37.8
作者：
Sunil M. Shah;I. Carey;T. Harris;S. DeWilde;C. Victor;D. Cook
通讯作者：
D. Cook