Everson S A, Kaplan G A, Goldberg D E, Salonen J T
Department of Epidemiology, University of Michigan, Ann Arbor, MI 48109-2029, USA.
Hypertension. 2000 Feb;35(2):561-7. doi: 10.1161/01.hyp.35.2.561.
Recent studies have reported that hopelessness is an important factor in cardiovascular morbidity and mortality, including ischemic heart disease, acute myocardial infarction, and atherosclerotic progression. This study examined the relationship between hopelessness and incident hypertension in a population-based sample of 616 initially normotensive, middle-aged men from eastern Finland, an area with high rates of cardiovascular disease. Participants completed a medical examination and a series of psychological questionnaires at baseline and at the 4-year follow-up. Hopelessness was measured by 2 items assessing negative expectancy about the future and one's goals. A logistic regression model with adjustments for age, body mass index, baseline resting blood pressure, physical activity, smoking, alcohol consumption, education, parental history of hypertension, and self-reported depressive symptoms revealed that men reporting high levels of hopelessness at baseline were 3 times more likely to become hypertensive (systolic blood pressure > or =165 mm Hg and/or a diastolic blood pressure > or =95 mm Hg or confirmed use of antihypertensive medication) in the intervening 4 years than men who were not hopeless (odds ratio, 3.22; 95% confidence interval, 1. 56, 6.67). Men reporting moderate levels of hopelessness were not at a significantly increased risk of hypertension (odds ratio, 1.27; 95% confidence interval, 0.79, 2.07). This is the first study to identify a significant relationship between hopelessness and incident hypertension. Research is needed to explore the neuroendocrine and central nervous system mechanisms underlying this association.
最近的研究报告称，绝望是心血管疾病发病和死亡的一个重要因素，包括缺血性心脏病、急性心肌梗死和动脉粥样硬化进展。本研究在芬兰东部一个心血管疾病高发地区，对616名初始血压正常的中年男性进行了基于人群的抽样调查，以研究绝望与新发高血压之间的关系。参与者在基线时和4年随访时完成了医学检查和一系列心理问卷。绝望程度通过2个评估对未来和个人目标的消极预期的项目来衡量。一个经过年龄、体重指数、基线静息血压、身体活动、吸烟、饮酒、教育程度、高血压家族史和自我报告的抑郁症状调整的逻辑回归模型显示，在基线时报告绝望程度高的男性在随后4年中患高血压（收缩压≥165毫米汞柱和/或舒张压≥95毫米汞柱或确认使用抗高血压药物）的可能性是不绝望男性的3倍（比值比，3.22；95%置信区间，1.56，6.67）。报告中度绝望程度的男性患高血压的风险没有显著增加（比值比，1.27；95%置信区间，0.79，2.07）。这是第一项确定绝望与新发高血压之间存在显著关系的研究。需要开展研究来探索这种关联背后的神经内分泌和中枢神经系统机制。
