Financial Stress and Risk of Coronary Heart Disease in the Jackson Heart Study
Financial Stress and Risk of Coronary Heart Disease in the Jackson Heart Study
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DOI：
10.1016/j.amepre.2018.09.022
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发表时间：
2019-02-01
影响因子：
5.5
通讯作者：
Clark, Cheryl R.
中科院分区：
文献类型：
--
作者：
Moran, Kaitlyn E.;Ommerborn, Mark J.;Clark, Cheryl R.
简介：经济困难与冠心病风险因素有关，可能会对一些非洲裔美国人群体产生不成比例的影响。本研究探讨是否压力，因为经济困难与冠心病事件在非洲裔American.Methods：杰克逊心脏研究是一个纵向队列研究心血管疾病的风险，在非裔美国人在杰克逊，密西西比大都市统计区。参与者登记始于2000年。分析于2017年进行，包括截至2012年12月的裁定终点。根据杰克逊心脏研究每周压力清单评估财务压力，并将其分为四个级别：（1）没有经历财务压力，（2）没有压力，（3）轻度压力，（4）中度至高度压力。冠心病事件定义为明确或很可能心肌梗死、明确致死性心肌梗死、明确致死性冠心病或心脏手术的首次事件。有2，256人在此analysis.Results：参与者有中度到高度（相对于没有）的经济压力更容易有冠心病事件后，控制人口统计学，SES，获得护理，和传统的临床危险因素（风险比=2.42，95%CI =1.13，5.17）。调整三个特定的风险因素：抑郁症，吸烟状况和糖尿病（风险比=1.99，95%CI =0.91，4.39）模型中，财务压力和冠心病之间的关联不再具有统计学意义。结论：财务压力可能是非裔美国人冠心病的一个未被认识的危险因素。在干预研究中，除了其他冠心病风险因素外，还应检查这些相关性，这些干预研究涉及经历经济压力的患者的感知压力。(C)2018年美国预防医学杂志。爱思唯尔公司出版All rights reserved.
Introduction: Financial hardship is associated with coronary heart disease risk factors, and may disproportionately affect some African American groups. This study examines whether stress because of financial hardship is associated with incident coronary heart disease in African Americans.Methods: The Jackson Heart Study is a longitudinal cohort study of cardiovascular disease risks in African Americans in the Jackson, Mississippi metropolitan statistical area. Participant enrollment began in 2000. Analyses were performed in 2017 and included adjudicated endpoints through December 2012. Financial stress was assessed from the Jackson Heart Study Weekly Stress Inventory and categorized into four levels: (1) did not experience financial stress, (2) no stress, (3) mild stress, and (4) moderate to high stress. Incident coronary heart disease was defined as the first event of definite or probable myocardial infarction, definite fatal myocardial infarction, definite fatal coronary heart disease, or cardiac procedure. There were 2,256 individuals in this analysis.Results: Participants with moderate to high (versus no) financial stress were more likely to have incident coronary heart disease events after controlling for demographics, SES, access to care, and traditional clinical risk factors (hazard ratio=2.42, 95% CI=1.13, 5.17). The association between financial stress and coronary heart disease was no longer statistically significant in a model adjusting for three specific risk factors: depression, smoking status, and diabetes (hazard ratio=1.99, 95% CI=0.91, 4.39).Conclusions: Financial stress may be an unrecognized risk factor for coronary heart disease for African Americans. Additional research should examine these associations in intervention studies that address perceived stress, in addition to other coronary heart disease risk factors, in patients experiencing financial stress. (C) 2018 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.