A prospective study of social networks in relation to total mortality and cardiovascular disease in men in the USA
A prospective study of social networks in relation to total mortality and cardiovascular disease in men in the USA
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DOI：
10.1136/jech.50.3.245
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发表时间：
1996-06-01
影响因子：
6.3
通讯作者：
Willett, WC
中科院分区：
文献类型：
--
作者：
Kawachi, I;Colditz, GA;Willett, WC
研究目的-以前的研究已经确定了低水平的社会网络与总死亡率之间的关系，但很少有研究考察特定原因的死亡率或疾病发病率。这项研究旨在前瞻性地检查社会网络与总死亡率和特定原因死亡率以及心血管疾病发病率之间的关系。设计--这是一项对正在进行的男性队列的为期四年的跟踪研究，这些男性的社会网络信息是在基线上收集的。主要的观察指标是总死亡率，进一步分类为心血管疾病(中风和冠心病)、总癌症、意外/自杀和所有其他原因的死亡，以及中风和冠心病的发生率。参与者-1988年共有32 624名美国男性卫生专业人员，年龄在42岁到77岁之间，他们在基线上没有冠心病、中风和癌症。结果-在122911人年的随访中，总共有511人死亡。与社交网络水平最高的男性相比，与世隔绝的男性(未婚，不到6个朋友或亲戚，没有加入教会或社区团体)心血管疾病死亡率(年龄调整后的相对风险为1.90；95%可信区间为1.07，3.37)以及死于事故和自杀的风险(年龄调整后的相对风险为2.22；95%可信区间为0.76，6.47)。没有发现其他死因的额外风险。与世隔绝的男性也有更高的中风风险(相对风险，2.21；95%可信区间，1.12，4.35)，但非致命性心肌梗死的发生率没有增加。结论-社会网络通过减少心血管疾病和事故/自杀的死亡，与较低的总死亡率相关。强大的社会网络与中风发病率的降低有关，但与冠心病的发病率无关。然而，社交网络可能有助于延长已确诊的冠心病患者的存活率。
Study objective - Previous studies have established a relationship between low levels of social networks and total mortality, but few have examined cause specific mortality or disease incidence. This study aimed to examine prospectively the relationships between social networks and total and cause specific mortality, as well as cardiovascular disease incidence.Design - This was a four year follow up study in an ongoing cohort of men, for whom information on social networks was collected at baseline. The main outcome measures were total mortality, further categorised into deaths from cardiovascular disease (stroke and coronary heart disease), total cancer, accidents/suicides, and all other causes; as well as stroke and coronary heart disease incidence.Participants - Altogether 32 624 US male health professionals aged 42 to 77 years in 1988, who were free of coronary heart disease, stroke, and cancer at baseline.Results - A total of 511 deaths occurred during 122 911 person years of follow up. Compared with men with the highest level of social networks, socially isolated men (not married, fewer than six friends or relatives, no membership in church or community groups) were at increased risk for cardiovascular disease mortality (age adjusted relative risk, 1.90; 95% CI 1.07, 3.37) and deaths from accidents and suicides (age adjusted relative risk 2.22; 95% CI 0.76, 6.47). No excess risks were found for other causes of death. Socially isolated men were also at increased risk of stroke incidence (relative risk, 2.21; 95% CI, 1.12, 4.35), but not incidence of non-fatal myocardial infarction.Conclusions - Social networks were associated with lower total mortality by reducing deaths from cardiovascular disease and accidents/suicides. Strong social networks were associated with reduced incidence of stroke, though not of coronary heart disease. However, social networks may assist in prolonging the survival of men with established coronary heart disease.