Division of Occupational Medicine, Karolinska institutet, Institute of Environmental Medicine, Stockholm, Sweden.
Occup Environ Med. 2014 Mar;71(3):183-8. doi: 10.1136/oemed-2013-101721. Epub 2014 Jan 8.
Although unemployment may be a stressful life event, its association with coronary heart disease (CHD) remains unclear. This study examines the association between unemployment and later hospitalisation due to CHD.
The study was based on a Swedish military conscription cohort of 18 to 20-year-old men from 1969/1970 (n=49 321) with information provided on health status and health behaviours. Information on unemployment in middle age was obtained from national registers. CHD information was obtained from hospital registers and the cause of death register. Cox proportional hazard analyses were run on the 39 243 individuals who were in paid employment in 1996 and 1997.
It was found that ≥90 days of unemployment was associated with subsequent CHD during 8 years follow-up (crude HR=1.47, 95% CI 1.23 to 1.75). Controlling for known risk factors for CHD reduced the association but a significant association remained (HR=1.24, 95% CI 1.04 to 1.48); ≥90 days of unemployment was significantly associated with CHD during the first 4 years (HR adjusted for known risk factors=1.31, 95% CI 1.01 to 1.71).
Unemployment was associated with increased risk of CHD after adjustment for confounders. We interpret the increased risk of CHD associated with unemployment as potentially the somatic result of a process started by stress.
尽管失业可能是一种压力生活事件，但它与冠心病（CHD）的关系尚不清楚。本研究探讨了失业与随后因 CHD 住院的关系。
该研究基于瑞典 1969/1970 年 18 至 20 岁男性的兵役队列（n=49321），提供了健康状况和健康行为的信息。中年失业信息从国家登记处获得。CHD 信息从医院登记处和死因登记处获得。对 1996 年和 1997 年有报酬就业的 39243 人进行了 Cox 比例风险分析。
发现在 8 年的随访中，失业≥90 天与随后的 CHD 相关（粗 HR=1.47，95%CI 1.23 至 1.75）。控制 CHD 的已知危险因素后，该关联有所减弱，但仍存在显著关联（HR=1.24，95%CI 1.04 至 1.48）；失业与 CHD 显著相关，尤其是在随访的前 4 年（调整已知危险因素的 HR=1.31，95%CI 1.01 至 1.71）。
调整混杂因素后，失业与 CHD 风险增加相关。我们将失业与 CHD 相关的风险增加解释为压力引起的潜在躯体结果。
