Bunker Stephen J, Colquhoun David M, Esler Murray D, Hickie Ian B, Hunt David, Jelinek V Michael, Oldenburg Brian F, Peach Hedley G, Ruth Denise, Tennant Christopher C, Tonkin Andrew M
National Heart Foundation, 411 King Street, West Melbourne, VIC 3003, Australia.
Med J Aust. 2003 Mar 17;178(6):272-6. doi: 10.5694/j.1326-5377.2003.tb05193.x.
An Expert Working Group of the National Heart Foundation of Australia undertook a review of systematic reviews of the evidence relating to major psychosocial risk factors to assess whether there are independent associations between any of the factors and the development and progression of coronary heart disease (CHD), or the occurrence of acute cardiac events. The expert group concluded that (i) there is strong and consistent evidence of an independent causal association between depression, social isolation and lack of quality social support and the causes and prognosis of CHD; and (ii) there is no strong or consistent evidence for a causal association between chronic life events, work-related stressors (job control, demands and strain), Type A behaviour patterns, hostility, anxiety disorders or panic disorders and CHD. The increased risk contributed by these psychosocial factors is of similar order to the more conventional CHD risk factors such as smoking, dyslipidaemia and hypertension. The identified psychosocial risk factors should be taken into account during individual CHD risk assessment and management, and have implications for public health policy and research.
澳大利亚国家心脏基金会的一个专家工作组对与主要心理社会风险因素相关的证据的系统评价进行了审查，以评估这些因素中是否有任何因素与冠心病（CHD）的发生、发展及急性心脏事件的发生存在独立关联。专家组得出结论：（i）有强有力且一致的证据表明，抑郁、社会孤立和缺乏优质社会支持与冠心病的病因及预后之间存在独立的因果关联；（ii）没有强有力或一致的证据表明，慢性生活事件、与工作相关的压力源（工作控制、需求和压力）、A型行为模式、敌意、焦虑症或恐慌症与冠心病之间存在因果关联。这些心理社会因素所导致的风险增加与吸烟、血脂异常和高血压等更传统的冠心病风险因素的风险增加程度相似。在个体冠心病风险评估和管理过程中，应考虑已确定的心理社会风险因素，这对公共卫生政策和研究也具有重要意义。
