Gallo William T, Bradley Elizabeth H, Falba Tracy A, Dubin Joel A, Cramer Laura D, Bogardus Sidney T, Kasl Stanislav V
Department of Epidemiology and Public Health, Yale University School of Medicine, New Haven, Connecticut 06510, USA.
Am J Ind Med. 2004 May;45(5):408-16. doi: 10.1002/ajim.20004.
The role of stress in the development of cardiovascular disease is well established. Previous research has demonstrated that involuntary job loss in the years immediately preceding retirement can be a stressful life event shown to produce adverse changes in physical and affective health. The objective of this study was to estimate the risk of myocardial infarction (MI) and stroke associated with involuntary job loss among workers nearing retirement in the United States.
We used multivariable survival analysis to analyze data from the first four waves of the Health and Retirement Survey (HRS), a nationally representative sample of older individuals in the US. The analytic sample includes 457 workers who experienced job loss and a comparison group of 3,763 employed individuals.
The results indicate that involuntary job loss is not associated with subsequent risk of MI (adjusted HR = 1.89; 95% CI = 0.91, 3.93); the risk of subsequent stroke associated with involuntary job loss is more than double (adjusted HR = 2.64; 95% CI = 1.01, 6.94).
Our findings present new data to suggest that involuntary job loss should be considered as a plausible risk factor for subsequent cardiovascular and cerebrovascular illness among older workers.
压力在心血管疾病发展过程中的作用已得到充分证实。先前的研究表明，在临近退休前几年非自愿失业可能是一种应激性生活事件，已被证明会对身体健康和情感健康产生不利变化。本研究的目的是评估美国临近退休的工人中与非自愿失业相关的心肌梗死（MI）和中风风险。
我们使用多变量生存分析来分析来自健康与退休调查（HRS）前四波的数据，HRS是美国老年人具有全国代表性的样本。分析样本包括457名经历失业的工人和3763名在职人员的对照组。
结果表明，非自愿失业与随后的MI风险无关（调整后风险比[HR]=1.89；95%置信区间[CI]=0.91，3.93）；与非自愿失业相关的随后中风风险增加了一倍多（调整后HR=2.64；95%CI=1.01，6.94）。
我们的研究结果提供了新的数据，表明非自愿失业应被视为老年工人随后发生心血管和脑血管疾病的一个合理风险因素。
