Perceived stress is associated with incident coronary heart disease and all-cause mortality in low- but not high-income participants in the Reasons for Geographic And Racial Differences in Stroke study.
Perceived stress is associated with incident coronary heart disease and all-cause mortality in low- but not high-income participants in the Reasons for Geographic And Racial Differences in Stroke study.
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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。
DOI：
10.1161/jaha.113.000447
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发表时间：
2013-12-19
影响因子：
5.4
通讯作者：
Safford MM
中科院分区：
文献类型：
--
作者：
Redmond N;Richman J;Gamboa CM;Albert MA;Sims M;Durant RW;Glasser SP;Safford MM
感知到的压力可能会增加患冠心病(CHD)和死亡的风险，但很少有研究纵向检验这些关系。我们试图确定感知到的压力与冠心病事件和全因死亡率之间的关系。数据来自于一项对24443名基线没有冠心病的参与者的前瞻性研究，这些数据来自全国中风地理和种族差异(CORES)研究队列。结果是专家判定的急性CHD和全因死亡率。在平均4.2年(最长6.9年)的随访中，有659例冠心病事件和1320例死亡。由于与压力有显著的交互作用，分析是按收入水平分层的。对于低收入的个人，3529人(35.4%)报告了高压力，而对于高收入的人，2524人(22.1%)这样做。与无压力报告相比，那些报告最高压力的人如果报告低收入(社会人口学调整后的HR 1.36，95%CI：1.04，1.78)而不是高收入(社会人口学调整后的HR 0.82，95%CI：0.57，1.16)，那么他们发生冠心病的风险更高；低收入个体的发现随着临床和行为因素的调整而减弱(HR 1.29，95%CI：0.99，1.69，P=0.06)。完全调整后，低收入(HR 1.55，95%CI：1.31，1.82)而非高收入(HR 1.13，95%CI：0.88，1.46)的人群中，压力等级越高死亡风险越高。对于低收入但不高收入的个人来说，高压力与患冠心病和死亡的风险更大相关。
Perceived stress may increase risk for coronary heart disease (CHD) and death, but few studies have examined these relationships longitudinally. We sought to determine the association of perceived stress with incident CHD and all‐cause mortality. Data were from a prospective study of 24 443 participants without CHD at baseline from the national Reasons for Geographic And Racial Differences in Stroke (REGARDS) study cohort. Outcomes were expert‐adjudicated acute CHD and all‐cause mortality. Over a mean follow‐up of 4.2 (maximum 6.9) years, there were 659 incident CHD events and 1320 deaths. Analyses were stratified by income level because of significant interactions with stress. For individuals with low income, 3529 (35.4%) reported high stress, and for those with high income, 2524 (22.1%) did so. Compared with reporting no stress, those reporting the highest stress had higher risk for incident CHD if they reported low income (sociodemographic‐adjusted HR 1.36, 95% CI: 1.04, 1.78) but not high income (sociodemographic‐adjusted HR 0.82, 95% CI: 0.57, 1.16); the finding in low income individuals attenuated with adjustment for clinical and behavioral factors (HR 1.29, 95% CI: 0.99, 1.69, P=0.06). After full adjustment, the highest stress category was associated with higher risk for death among those with low income (HR 1.55, 95% CI: 1.31, 1.82) but not high income (HR 1.13, 95% CI: 0.88, 1.46). High stress was associated with greater risks of CHD and death for individuals with low but not high income.