Caregiving Strain and Estimated Risk for Stroke and Coronary Heart Disease Among Spouse Caregivers Differential Effects by Race and Sex
Caregiving Strain and Estimated Risk for Stroke and Coronary Heart Disease Among Spouse Caregivers Differential Effects by Race and Sex
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DOI：
10.1161/strokeaha.109.568279
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发表时间：
2010-02-01
期刊：
影响因子：
8.3
通讯作者：
Safford, Monika M.
中科院分区：
文献类型：
--
作者：
Haley, William E.;Roth, David L.;Safford, Monika M.
背景和目的：社会心理压力作为卒中和冠心病（CHD）的危险因素已被广泛研究，但对不同种族和性别的压力对卒中和冠心病风险的差异影响知之甚少。照顾残疾配偶与死亡率和冠心病风险增加有关，但照顾压力与中风和冠心病风险的关系跨种族和性别尚不清楚。方法：在REGARDS研究中，为残疾配偶提供家庭护理的参与者报告了照顾压力（高、部分或无）、抑郁症状、社会关系、教育程度和年龄。比较护理组的Framingham卒中风险评分（N = 716）和Framingham冠心病风险评分（N = 607），分别估计10年卒中和缺血性心脏病的预计风险。结果：高护理压力与23%的协变量调整后卒中估计风险相关（无压力护理人员为11.06%，高压力护理人员为13.62%）。这种关联在男性中更强，尤其是照顾压力大的非裔美国男性（估计10年中风风险为26.95%）。照顾压力与冠心病风险评分无关。结论：照顾妻子的压力与较高的中风风险显著相关，对照顾妻子的男性影响最大，尤其是非洲裔美国男性。男性配偶照顾者可能需要特殊的照顾支持。前瞻性纵向研究应该检查性别和种族如何调节压力对中风和冠心病风险的影响。(中风。2010;41:331 - 336)。
Background and Purpose-Psychosocial stress has been widely studied as a risk factor for stroke and coronary heart disease (CHD) but little is known about the differential effects of stress on stroke and CHD risk by race and sex. Caregiving for a disabled spouse has been associated with increased mortality and CHD risk, but the association of caregiving strain with stroke and CHD risk across race and sex is unknown.Methods-Participants in the REasons for Geographic and Racial Differences in Stroke (REGARDS) study who were providing in-home caregiving to a disabled spouse reported on caregiving strain (high, some, or none), depressive symptoms, social network, education, and age. Caregiving strain groups were compared on the Framingham Stroke Risk Score (N = 716) and Framingham CHD Risk Score (N = 607), which estimate the projected 10-year risk of incident stroke and ischemic heart disease, respectively.Results-High caregiving strain was associated with a 23% higher covariate-adjusted estimated stroke risk (11.06% for caregivers with no strain versus 13.62% risk for high-strain caregivers). This association was stronger in men, particularly African American men with high caregiving strain (26.95% estimated 10-year stroke risk). Caregiving strain was not associated with CHD risk scores.Conclusions-Caregiving strain is significantly associated with higher estimated stroke risk with greatest effects for men, particularly African American men, providing caregiving to their wives. Male spouse caregivers may need special caregiving support. Prospective longitudinal studies should examine how sex and race may moderate the impact of stress on stroke and CHD risk. (Stroke. 2010;41:331-336.)