Marital status and ischemic heart disease incidence and mortality in women: a large prospective study.
Marital status and ischemic heart disease incidence and mortality in women: a large prospective study.
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DOI：
10.1186/1741-7015-12-42
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发表时间：
2014-03-12
期刊：
影响因子：
9.3
通讯作者：
Million Women Study Collaborators
中科院分区：
文献类型：
--
作者：
Floud S;Balkwill A;Canoy D;Wright FL;Reeves GK;Green J;Beral V;Cairns BJ;Million Women Study Collaborators
已婚与男性缺血性心脏病（IHD）的死亡率较低相关，但女性相关性的证据较少，目前尚不清楚已婚与IHD事件和致命性的相关性是否相似。我们在百万妇女研究中研究了婚姻状况与IHD发病率和死亡率之间的关系。共有734，626名女性（平均年龄60岁）既往无心脏病，中风或癌症，前瞻性随访住院和死亡。采用考克斯回归法计算已婚或与伴侣同居妇女与非已婚或与伴侣同居妇女的IHD校正相对危险度（RR）。研究了14个社会经济、生活方式和其他潜在混杂因素的作用。81%的妇女报告已婚或与伴侣生活，她们不太可能生活在贫困地区，吸烟或不参加体育活动，但酒精摄入量高于未婚或与伴侣生活的妇女。在8.8年的随访中，30，747名妇女首次发生IHD事件（住院或死亡），2，148名死于IHD。已婚或与伴侣同居的女性发生首次IHD事件的风险与未婚女性相似（RR = 0.99，95%置信区间（CI）0.96至1.02），但IHD死亡风险显著降低（RR = 0.72，95% CI 0.66至0.80，P <0.0001）。IHD死亡风险较低的情况在既往接受过IHD住院治疗和未接受过IHD住院治疗的女性中均明显可见（分别为：RR = 0.72，95%CI 0.60至0.85，P <0.0001，n = 683;和0.70，95%CI 0.62至0.78，P <0.0001，n = 1，465）。这些调查结果在不同社会经济群体的妇女之间或在生活方式和其他因素之间没有明显差异。在调整社会经济，生活方式和其他因素后，已婚或与伴侣生活的女性患IHD的风险相似，但与未婚或与伴侣生活的女性相比，IHD死亡率显著降低。
Being married has been associated with a lower mortality from ischemic heart disease (IHD) in men, but there is less evidence of an association for women, and it is unclear whether the associations with being married are similar for incident and for fatal IHD. We examined the relation between marital status and IHD incidence and mortality in the Million Women Study. A total of 734,626 women (mean age 60 years) without previous heart disease, stroke or cancer, were followed prospectively for hospital admissions and deaths. Adjusted relative risks (RRs) for IHD were calculated using Cox regression in women who were married or living with a partner versus women who were not. The role of 14 socio-economic, lifestyle and other potential confounding factors was investigated. 81% of women reported being married or living with a partner and they were less likely to live in deprived areas, to smoke or be physically inactive, but had a higher alcohol intake than women who were not married or living with a partner. During 8.8 years of follow-up, 30,747 women had a first IHD event (hospital admission or death) and 2,148 died from IHD. Women who were married or living with a partner had a similar risk of a first IHD event as women who were not (RR = 0.99, 95% confidence interval (CI) 0.96 to 1.02), but a significantly lower risk of IHD mortality (RR = 0.72, 95% CI 0.66 to 0.80, P <0.0001). This lower risk of IHD death was evident both in women with and without a prior IHD hospital admission (respectively: RR = 0.72, 95% CI 0.60 to 0.85, P <0.0001, n = 683; and 0.70, 95% CI 0.62 to 0.78, P <0.0001, n = 1,465). These findings did not vary appreciably between women of different socio-economic groups or by lifestyle and other factors. After adjustment for socioeconomic, lifestyle and other factors, women who were married or living with a partner had a similar risk of developing IHD but a substantially lower IHD mortality compared to women who were not married or living with a partner.
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DOI：
10.1097/hjr.0b013e3283063929
发表时间：
2008-10-01
影响因子：
--
作者：
Molloy, Gerard J.;Hamer, Mark;Chida, Yoichi
通讯作者：
Chida, Yoichi
影响因子：
5
作者：
CHANDRA, V;SZKLO, M;TONASCIA, J
通讯作者：
TONASCIA, J
影响因子：
5
作者：
Idler, Ellen L.;Boulifard, David A.;Contrada, Richard J.
通讯作者：
Contrada, Richard J.
影响因子：
4.7
作者：
JONES, DR
通讯作者：
JONES, DR
DOI：
10.1097/hjr.0b013e3283083e04
发表时间：
2008-10-01
影响因子：
--
作者：
Empana, Jean-Philippe;Jouven, Xavier;Siscovick, David
通讯作者：
Siscovick, David