Negative aspects of close relationships and heart disease
Negative aspects of close relationships and heart disease
复制标题
DOI：
10.1001/archinte.167.18.1951
复制
发表时间：
2007-10-08
影响因子：
--
通讯作者：
Marmot, Michael Gideon
中科院分区：
文献类型：
--
作者：
De Vogli, Roberto;Chandola, Tarani;Marmot, Michael Gideon
背景：本研究的目的是：(1)分析亲密关系的消极方面与冠心病风险增加之间的关系；(2)研究这种关系是否在女性和社会地位较低的人群中更强。方法：对9011名英国公务员（男性6114名，女性2897名）进行前瞻性队列研究。在第二阶段（1989-1990年）或第一阶段（1985-1988年）用亲密关系问卷评估亲密关系的消极方面和其他社会支持措施（信任/情感和实际）。在平均12.2年的随访期间，确定了亲密关系的负面方面与冠心病事件之间的关联。协变量包括社会人口学特征（年龄、性别、婚姻状况和就业等级）、生物学因素（肥胖、高血压、糖尿病和胆固醇水平）、心理社会因素（消极情绪、抑郁和工作压力）和健康行为（吸烟、饮酒、锻炼和水果和蔬菜消费）。结果：在对社会人口学特征、生物学因素和社会支持的其他维度进行调整后，经历过负面亲密关系的个体发生冠状动脉事件的风险更高（风险比为1.34；95%置信区间为1.10-1.63）。在对消极情绪和抑郁进行额外调整后，相关性减弱，但仍具有统计学意义（风险比为1.25；95%可信区间为1.02-1.55）。尽管处于较低就业等级的女性和男性更有可能接触到亲密关系的消极方面，但性别和社会地位没有统计学上显著的相互作用影响。倾诉/情感和实际支持与冠心病事件无关。结论：不良的亲密关系可增加患心脏病的风险。
Background: The aims of the study were to (1) analyze the association between negative aspects of close relationships and increased risk for coronary heart disease and (2) examine whether the association is stronger among women and people of lower social position.Methods: Prospective cohort study of 9011 British civil servants (6114 men and 2897 women). Negative aspects of close relationships and other social support measures (confiding/emotional and practical) were assessed with the Close Persons Questionnaire during phase 2 (1989-1990) or phase 1 (1985-1988). Associations between negative aspects of close relationships and incident coronary events were determined during an average follow-up period of 12.2 years. Covariates included sociodemographic characteristics (age, sex, marital status, and employment grade), biological factors (obesity, hypertension, diabetes mellitus, and cholesterol level), psychosocial factors (negative affectivity, depression, and work stress), and health behaviors (smoking, alcohol intake, exercise, and fruit and vegetable consumption).Results: After adjustment for sociodemographic characteristics, biological factors, and other dimensions of social support, individuals who experienced negative aspects of close relationships had a higher risk of incident coronary events (hazard ratio, 1.34; 95% confidence interval, 1.10-1.63). The association was attenuated but remained statistically significant after additional adjustment for negative affectivity and depression (hazard ratio, 1.25; 95% confidence interval, 1.02-1.55). Although women and men in a lower employment grade were more likely to be exposed to negative aspects of close relationships, sex and social position had no statistically significant interaction effects. Confiding/emotional and practical support were not associated with incident coronary events.Conclusion: Adverse close relationships may increase the risk of heart disease.