Association of Perceived Stress With Incident Heart Failure.
Association of Perceived Stress With Incident Heart Failure.
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DOI：
10.1016/j.cardfail.2022.04.013
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发表时间：
2022-09
影响因子：
6
通讯作者：
中科院分区：
文献类型：
--
作者：
心理压力与心力衰竭（HF）之间的关系尚未得到充分研究。我们试图评估感知压力与心力衰竭事件之间的关系。我们使用了国家中风地理和种族差异原因 (REGARDS) 研究的数据，这是一项大型前瞻性混血儿队列研究，招募了 2003 年至 2007 年间 45 岁及以上的社区居民，并进行了随访。我们纳入了未疑似流行心力衰竭且完成了科恩四项感知压力量表 (PSS-4) 的参与者。我们的结果变量是偶发性心力衰竭事件、射血分数降低的心力衰竭事件和射血分数保留的心力衰竭事件。我们估计了 Cox 比例风险模型，以确定 PSS-4 四分位数是否与心力衰竭事件独立相关，并根据社会人口统计学、社会支持、不健康行为、合并症和生理参数进行调整。鉴于他汀类药物的抗炎特性，我们还通过基线使用他汀类药物来测试相互作用。在 25,785 名平均年龄为 64 ± 9.3 岁的参与者中，55% 是女性，40% 是黑人。在中位随访 10.1 年中，1109 ± 4.3% 的人经历过心力衰竭事件。在完全调整的模型中，PSS-4 与 HF 或射血分数降低的 HF 无关。然而，PSS-4 四分位数 2-4（与最低四分位数相比）与射血分数保留的心力衰竭相关（Q2 风险比 1.37，95% 置信区间 1.00-1.88；Q3 风险比 1.42，95% 置信区间 1.03-1.95；Q4 风险比 1.41，95% 置信区间1.04–1.92）。值得注意的是，这种关联在基线时服用他汀类药物的参与者中减弱（交互作用 P = 0.07）。感知压力升高与射血分数保留的心力衰竭相关，但与射血分数降低的心力衰竭无关。需要预防心力衰竭（HF）的新策略。我们研究了心理压力是否是发生心力衰竭的危险因素。我们发现，压力水平较高的人患一种特定类型心力衰竭（称为射血分数保留性心力衰竭（HFpEF））的风险增加。这一发现表明心理压力可能对预防心力衰竭很重要。
The relationship between psychological stress and heart failure (HF) has not been well studied. We sought to assess the relationship between perceived stress and incident HF. We used data from the national REasons for Geographic And Racial Differences in Stroke (REGARDS) study, a large prospective biracial cohort study that enrolled community-dwellers aged 45 years and older between 2003 and 2007, with follow-up. We included participants free of suspected prevalent HF who completed the Cohen 4-item Perceived Stress Scale (PSS-4). Our outcome variables were incident HF event, HF with reduced ejection fraction events, and HF with preserved ejection fraction events. We estimated Cox proportional hazard models to determine if PSS-4 quartiles were independently associated with incident HF events, adjusting for sociodemographics, social support, unhealthy behaviors, comorbid conditions, and physiologic parameters. We also tested interactions by baseline statin use, given its anti-inflammatory properties. Among 25,785 participants with a mean age of 64 ± 9.3 years, 55% were female and 40% were Black. Over a median follow-up of 10.1 years, 1109 ± 4.3% experienced an incident HF event. In fully adjusted models, the PSS-4 was not associated with HF or HF with reduced ejection fraction. However, PSS-4 quartiles 2–4 (compared with the lowest quartile) were associated with incident HF with preserved ejection fraction (Q2 hazard ratio 1.37, 95% confidence interval 1.00–1.88; Q3 hazard ratio 1.42, 95% confidence interval 1.03–1.95; Q4 hazard ratio 1.41, 95% confidence interval 1.04–1.92). Notably, this association was attenuated among participants who took a statin at baseline (P for interaction = .07). Elevated perceived stress was associated with incident HF with preserved ejection fraction but not HF with reduced ejection fraction. New strategies for preventing heart failure (HF) are needed. We studied whether psychological stress is a risk factor for developing HF. We found that those with higher levels of stress were at increased risk of developing a specific type of HF called HF with preserved ejection fraction, or HFpEF. This finding suggests that psychological stress may be important for preventing HF.
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影响因子：
5
作者：
COHEN, S;KAMARCK, T;MERMELSTEIN, R
通讯作者：
MERMELSTEIN, R
在“中风地理和种族差异的原因”研究中，低收入参与者的感知压力与冠心病和全因死亡率相关，但高收入参与者则不然。
影响因子：
5.4
作者：
Redmond N;Richman J;Gamboa CM;Albert MA;Sims M;Durant RW;Glasser SP;Safford MM
通讯作者：
Safford MM
影响因子：
3.8
作者：
Clark SM;Song C;Li X;Keegan AD;Tonelli LH
通讯作者：
Tonelli LH
DOI：
10.1161/circoutcomes.110.960112
发表时间：
2011-03-01
影响因子：
6.9
作者：
Okin, Peter M.;Kjeldsen, Sverre E.;Devereux, Richard B.
通讯作者：
Devereux, Richard B.
影响因子：
12.7
作者：
Roy, Samit S.;Foraker, Randi E.;Mansfield, Alyssa J.
通讯作者：
Mansfield, Alyssa J.