慢性应激负担、感知压力和创伤后应激与西班牙裔社区健康研究/拉丁裔社会文化辅助研究中心血管疾病患病率和危险因素的关联。
Associations of chronic stress burden, perceived stress, and traumatic stress with cardiovascular disease prevalence and risk factors in the Hispanic Community Health Study/Study of Latinos Sociocultural Ancillary Study.
机构信息
From the Department of Psychology (L.C.G., S.C.R., A.L.F.) and Graduate School of Public Health (S.F.C., G.A.T.), San Diego State University, San Diego, California; Departments of Preventive Medicine (M.R.C.) and Medical Social Sciences (F.J.P.), Feinberg School of Medicine, Northwestern University, Chicago, Illinois; Departments of Public Policy (K.P.) and Biostatistics (D.S.-A.), Gillings School of Global Public Health, University of North Carolina at Chapel Hill, North Carolina; Department of Psychology (O.B.W., N.S.), University of Miami, Miami, Florida; Department of Epidemiology and Population Health (S.W.-S., C.R.I), Albert Einstein College of Medicine; and Department of Medicine (M.L.D.), University of Illinois at Chicago, Illinois.
出版信息
Psychosom Med. 2014 Jul-Aug;76(6):468-75. doi: 10.1097/PSY.0000000000000069.
OBJECTIVE
The current study examined multiple stress indicators (chronic, perceived, traumatic) in relation to prevalent coronary heart disease, stroke, and major cardiovascular disease (CVD) risk factors (i.e., diabetes, dyslipidemia, hypertension, and current smoking) in the multisite Hispanic Community Health Study/Study of Latinos Sociocultural Ancillary Study (2010-2011).
METHODS
Participants were 5313 men and women 18 to 74 years old, representing diverse Hispanic/Latino ethnic backgrounds, who underwent a comprehensive baseline clinical examination and sociocultural examination with measures of stress.
RESULTS
Chronic stress burden was related to a higher prevalence of coronary heart disease after adjusting for sociodemographic, behavioral, and biological risk factors (odds ratio [OR; 95% confidence interval], 1.22 [1.10-1.36]) and related to stroke prevalence in the model adjusted for demographic and behavioral factors (OR [95% confidence interval], 1.26 [1.03-1.55]). Chronic stress was also related to a higher prevalence of diabetes (OR = 1.20 [1.11-1.31]) and hypertension (OR = 1.10 [1.02-1.19]) in individuals free from CVD (n = 4926). Perceived stress (OR = 1.03 [1.01-1.05]) and traumatic stress (OR = 1.15 [1.05-1.26]) were associated with a higher prevalence of smoking. Participants who reported a greater number of lifetime traumatic events also unexpectedly showed a lower prevalence of diabetes (OR = 0.89 [0.83-0.97]) and hypertension (OR = 0.88 [0.82-0.93]). Effects were largely consistent across age and sex groups.
CONCLUSIONS
The study underscores the advantages of examining multiple indicators of stress in relation to health because the direction and consistency of associations may vary across distinct stress conceptualizations. In addition, the study suggests that chronic stress is related to higher CVD risk and prevalence in Hispanics/Latinos, the largest US ethnic minority group.
目的
本研究调查了多种压力指标（慢性、感知、创伤性）与多站点西班牙裔社区健康研究/拉丁裔社会文化辅助研究（2010-2011 年）中普遍存在的冠心病、中风和主要心血管疾病（CVD）危险因素（即糖尿病、血脂异常、高血压和当前吸烟）之间的关系。
方法
参与者为 5313 名年龄在 18 至 74 岁之间的男性和女性，代表了不同的西班牙裔/拉丁裔族裔背景，他们接受了全面的基线临床检查和社会文化检查，并进行了压力测量。
结果
在调整了社会人口统计学、行为和生物学危险因素后，慢性压力负担与冠心病的患病率较高相关（优势比[OR；95%置信区间]，1.22 [1.10-1.36]），并且与调整了人口统计学和行为因素后的中风患病率相关（OR [95%置信区间]，1.26 [1.03-1.55]）。在没有 CVD（n = 4926）的个体中，慢性压力也与糖尿病（OR = 1.20 [1.11-1.31]）和高血压（OR = 1.10 [1.02-1.19]）的患病率较高相关。感知压力（OR = 1.03 [1.01-1.05]）和创伤性压力（OR = 1.15 [1.05-1.26]）与吸烟率较高相关。报告有更多生活创伤事件的参与者出人意料地显示出较低的糖尿病（OR = 0.89 [0.83-0.97]）和高血压（OR = 0.88 [0.82-0.93]）患病率。这些影响在不同年龄和性别组中基本一致。
结论
该研究强调了检查多种压力指标与健康之间关系的优势，因为不同的压力概念之间的关联方向和一致性可能不同。此外，该研究表明，慢性压力与西班牙裔/拉丁裔美国人（美国最大的少数民族群体）的 CVD 风险和患病率较高有关。
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