Victimization in the workplace: a new target for cardiovascular prevention?
Victimization in the workplace: a new target for cardiovascular prevention?
复制标题
工作场所受害：心血管预防的新目标？
DOI：
10.1093/eurheartj/ehy728
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发表时间：
2018
影响因子：
39.3
通讯作者：
C. Herrmann
中科院分区：
文献类型：
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作者：
C. Herrmann
心理社会心血管危险因素的相关性日益得到承认。抑郁和其他精神障碍，但亚临床抑郁症状，生命衰竭，愤怒和人格特征，如敌意，是心血管疾病(CVD)的独立预测因素。与心血管疾病风险增加相关的社会因素包括低社会经济地位、社会孤立、低社会支持以及工作或家庭生活的压力。1、2心理和社会因素具有很强的相互关联性，往往聚集在特定的个体中。3为可能与心血管疾病风险有关的另一个心理社会因素提供证据。他们分析了斯堪的纳维亚的四项队列研究的数据，共有79 201名健康的男性和女性，他们将工作场所欺凌和暴力作为心血管事件的预测因素，心血管疾病的定义是首次因冠心病或中风住院。在平均12.4年的随访期内，作者观察到3229例新发心血管疾病。在对混杂因素进行调整后，在报告工作场所欺凌的基线人群中，心血管疾病的发病率增加了59%，在报告身体暴力或工作中暴力威胁的人群中，心血管疾病的发病率增加了25%。在人口层面上，5%的心血管疾病病例是由欺凌行为解释的，2.9%是由工作场所暴力引起的。这些关联显示了工作场所欺凌的剂量-反应模式，在较小程度上也显示了工作场所暴力的影响。他们在敏感性分析中保持稳定，例如，对随访时间、基线精神障碍或不健康的生活方式进行了额外的调整。这些影响的大小与以前对其他心理社会心血管疾病风险因素的影响相当。因此，职场欺凌和暴力可能是新的、潜在的可改变的心血管风险因素。然而，尽管近100万个研究对象年和3000例心血管疾病病例令人印象深刻，但这些发现需要谨慎的解释和独立的复制。
The relevance of psychosocial cardiovascular risk factors is increasingly recognized. Depression and other mental disorders, but also subclinical depressive symptoms, vital exhaustion, anger, and personality traits such as hostility, are independent predictors of incident cardiovascular disease (CVD). Social factors associated with increased CVD risk include low socio-economic status, social isolation, low social support, and stress at work or in family life. 1, 2 Psychological and social factors are strongly inter-related and tend to cluster in certain individuals.In this issue of the European Heart Journal, Xu et al. 3 provide evidence for another psychosocial factor that may be involved in CVD risk. Analysing data from four Scandinavian cohort studies with a total of 79 201 healthy men and women, they looked at workplace bullying and violence as predictors of incident CVD, defined as first hospitalization for coronary heart disease or stroke. Over a mean follow-up period of 12.4 years, the authors observed 3229 cases of new CVD. After adjustment for confounders, CVD incidence was increased by 59% in persons reporting workplace bullying at baseline and by 25% in those who reported physical violence or threat of violence at work. On the population level, 5% of CVD cases were explained by bullying and 2.9% by workplace violence. The associations showed a dose–response pattern for workplace bullying and to a lesser extent also for workplace violence. They remained stable in sensitivity analyses with, for example, additional adjustment for length of follow-up, baseline mental disorders, or unhealthy lifestyle. The magnitude of the effects is comparable with that previously shown for other psychosocial CVD risk factors. Workplace bullying and violence might therefore be new, potentially modifiable cardiovascular risk factors. However, despite the impressive number of almost 1 million subject-years and> 3000 cases of CVD, the findings need cautious interpretation and independent replication.