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社会支持与中风和冠心病:日本公共卫生中心前瞻性队列研究II

Social support and stroke and coronary heart disease: the JPHC study cohorts II.

作者信息

Ikeda Ai, Iso Hiroyasu, Kawachi Ichiro, Yamagishi Kazumasa, Inoue Manami, Tsugane Shoichiro

机构信息

Public Health, Department of Social and Environmental Medicine, Graduate School of Medicine, Osaka University. Suita-shi, Osaka 565-0871, Japan.

出版信息

Stroke. 2008 Mar;39(3):768-75. doi: 10.1161/STROKEAHA.107.496695. Epub 2008 Jan 31.

Abstract

BACKGROUND AND PURPOSE

Studies conducted in Western countries have found a robust association between social support and cardiovascular outcomes (eg, prognosis after myocardial infarction and functional recovery after stroke). However, less is known about the influence of social support on the same outcomes among Asian populations. In this prospective cohort study, we sought to examine the impact of social support on the incidence and mortality of coronary heart disease and stroke among the Japanese.

METHODS

We examined prospectively the association between social support and risk of coronary heart disease and stroke incidence and mortality within a cohort of 44,152 Japanese men and women aged 40 to 69 years, free of previous diagnosis of cancer and cardiovascular disease. A total of 301 cases of newly diagnosed coronary heart disease, 1057 strokes, 191 coronary heart disease deaths, and 327 stroke deaths occurred between the baseline questionnaire (1993-1994) and the end of follow-up in January 2004.

RESULTS

The multivariate hazard ratios and 95% CI for stroke mortality in the highest social support versus lowest social support group was 1.45 (1.00 to 2.10) overall, 1.59 (1.01 to 2.51) for men, and 1.25 (0.63 to 2.46) for women. Social support was not associated with stroke incidence or coronary heart disease incidence and mortality.

CONCLUSIONS

Low social support was associated with higher risk of stroke mortality in men. However, social support was not associated with stroke incidence, suggesting social support may be more important in stroke prognosis than preventing incidence.

摘要

背景与目的

在西方国家进行的研究发现,社会支持与心血管疾病结局(如心肌梗死后的预后和中风后的功能恢复)之间存在密切关联。然而,关于社会支持对亚洲人群相同结局的影响,我们了解得较少。在这项前瞻性队列研究中,我们试图探讨社会支持对日本人冠心病和中风发病率及死亡率的影响。

方法

我们前瞻性地研究了44152名年龄在40至69岁之间、既往未被诊断患有癌症和心血管疾病的日本男性和女性队列中,社会支持与冠心病、中风发病率及死亡率风险之间的关联。在基线调查问卷(1993 - 1994年)至2004年1月随访结束期间,共发生了301例新诊断的冠心病、1057例中风、191例冠心病死亡和327例中风死亡。

结果

社会支持最高组与最低组相比,中风死亡率的多变量风险比及95%置信区间总体为1.45(1.00至2.10),男性为1.59(1.01至2.51),女性为1.25(0.63至2.46)。社会支持与中风发病率、冠心病发病率及死亡率无关。

结论

社会支持低与男性中风死亡率较高相关。然而,社会支持与中风发病率无关,这表明社会支持在中风预后方面可能比预防发病更为重要。

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