Caregiving and risk of coronary heart disease in US women - A prospective study
Caregiving and risk of coronary heart disease in US women - A prospective study
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DOI：
10.1016/s0749-3797(02)00582-2
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发表时间：
2003-02-01
影响因子：
5.5
通讯作者：
Kawachi, I
中科院分区：
文献类型：
--
作者：
Lee, S;Colditz, GA;Kawachi, I
背景：越来越多的女性照顾残疾或患病的亲属。许多研究已将照顾行为与精神疾病发病率、较低的自感健康状况、血压升高以及免疫功能下降联系起来。然而，尚无研究探讨照顾行为与心血管疾病发病率之间的关联。
方法：我们在“护士健康研究”中的54412名女性中进行了此项研究，该研究是对居住在美国11个州的女性注册护士进行的前瞻性队列研究。这些女性年龄在46岁至71岁之间，在基线（1992年）时没有被诊断出患有冠心病、中风或癌症。我们收集了1992年的照顾责任信息以及从基线（1992年6月1日）到1996年调查问卷回收期间的冠心病信息。
结果：在4年的随访期间，我们记录了321例冠心病发病病例（231例非致命性心肌梗死病例和90例冠心病死亡病例）。在对年龄、吸烟、运动、饮酒量、体重指数、高血压病史、糖尿病及其他协变量进行控制的多变量分析中，每周照顾残疾或患病配偶≥9小时与冠心病风险增加相关（相对危险度为1.82；95%置信区间为1.08 - 3.05）。然而，照顾残疾或患病的父母或其他残疾或患病者与冠心病风险增加无显著相关性。
结论：这些数据表明，女性照顾患病配偶的高负担可能会增加患冠心病的风险。
Background: A growing number of women provide care to disabled or ill relatives. Many studies have linked caregiving to psychiatric morbidity, lower perceived health status, elevated blood pressure, and poorer immune function. However, no studies have examined the association between caregiving and cardiovascular disease incidence.Methods: We conducted the study in 54,412 women from the Nurses' Health Study, a prospective cohort of female registered nurses residing in 11 U.S. states. These women were aged 46 to 71 years and did not have diagnosed coronary heart disease (CHD), stroke, or cancer at baseline (1992). We collected information on caregiving responsibilities in 1992 and coronary heart disease between baseline (June 1, 1992) and return of the 1996 questionnaire.Results: During 4 years of follow-up, we documented 321 incident cases of CHD (231 nonfatal cases of myocardial infarction and 90 CHD deaths). In multivariate analyses controlling for age, smoking, exercise, alcohol intake, body mass index, history of hypertension, diabetes mellitus, and other covariates, caregiving for disabled or ill spouse for greater than or equal to9 hours per week was associated with increased risk of CHD (RR, 1.82; 95% confidence interval, 1.08-3.05). However, caregiving for disabled or ill parents or disabled or ill others was not significantly associated with increased risks of CHD.Conclusion: These data indicate that high levels of caregiving burden for ill spouses may increase the risk of CHD among women.