Heart health when life is satisfying: evidence from the Whitehall II cohort study
Heart health when life is satisfying: evidence from the Whitehall II cohort study
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DOI：
10.1093/eurheartj/ehr203
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发表时间：
2011-11-01
影响因子：
39.3
通讯作者：
Kubzansky, Laura D.
中科院分区：
文献类型：
--
作者：
Boehm, Julia K.;Peterson, Christopher;Kubzansky, Laura D.
目的消极的心理状态如压力和抑郁与冠心病（CHD）的风险增加有关，但一些积极的心理状态是否具有保护作用尚不清楚。我们调查了对特定生活领域的满意度作为冠心病发生的预测因子。方法和结果对7956名最初健康的Whitehall II队列成员在七个生活领域（如工作和家庭）内的冠状动脉危险因素和满意度进行了评估。冠心病事件（心绞痛、非致死性心肌梗死或冠心病死亡）通过医学筛查、医院数据和超过5人年随访的登记联系来确定。在控制人口统计学特征、健康行为、血压和代谢功能的情况下，各领域的平均满意度与冠心病风险降低相关（HR: 0.87; 95% Cl: 0.78-0.98）。在工作、家庭、性生活和自我这四个生活领域的满意度与冠心病风险有明显的联系，但在爱情关系、休闲活动或生活水平方面没有关系。当单独检查冠心病结局时，平均领域满意度与心绞痛相关，而与心肌梗死或冠状动脉死亡无关。结论：大多数生活领域的满意度与冠心病风险降低有关，明确心绞痛是这种联系的主要原因。这些发现表明，对生活的满意可能会促进心脏健康。进一步的研究应该检查在特定领域提高生活满意度的干预措施是否能降低冠心病风险，以及生活满意度是否主要与动脉粥样硬化相关，而不是与斑块破裂相关的血栓形成因素。
Aims Negative psychological states such as stress and depression are associated with increased risk of coronary heart disease (CHD), but it is unclear whether some positive states are protective. We investigated satisfaction with specific life domains as predictors of incident CHD.Methods and results Coronary risk factors and satisfaction within seven life domains (e. g. job and family) were assessed in 7956 initially healthy members of the Whitehall II cohort. Incident CHD (angina, non-fatal myocardial infarction, or death from CHD) was ascertained from medical screening, hospital data, and registry linkage over five person-years of follow-up. Satisfaction averaged across domains was associated with reduced CHD risk (HR: 0.87; 95% Cl: 0.78-0.98), controlling for demographic characteristics, health behaviours, blood pressure, and metabolic functioning. Associations with CHD risk were evident for satisfaction in four life domains-one's job, family, sex life, and self, but not one's love relationship, leisure activities, or standard of living. When examining CHD outcomes separately, average domain satisfaction was associated with angina but not myocardial infarction or coronary death.Conclusions Satisfaction in most life domains was associated with reduced CHD risk, with definite angina being mostly responsible for this association. These findings suggest that satisfaction with life may promote heart health. Further research should examine whether interventions to enhance life satisfaction in specific domains reduce CHD risk and whether life satisfaction is primarily associated with atherosclerosis rather than thrombotic factors associated with plaque rupture.