Taylor-Clift April, Holmgreen Lucie, Hobfoll Stevan E, Gerhart James I, Richardson DeJuran, Calvin James E, Powell Lynda H
Rush University Medical Center, United States.
Rush University Medical Center, United States.
J Affect Disord. 2016 Jan 15;190:227-234. doi: 10.1016/j.jad.2015.09.023. Epub 2015 Oct 22.
Traumatic events and posttraumatic stress disorder (PTSD) are associated with increased risk for cardiopulmonary disease (CPD) in veterans, men, and primarily White populations. Less is known about trauma, PTSD, and CPD burden among low-income, racial minority residents who are at elevated risk for trauma and PTSD. It was hypothesized that traumatic events and PTSD would be significantly associated with CPD burden among low-income, racial minority residents.
We evaluated cross-sectional relationships between traumatic events, PTSD, depression, and CPD burden in 251 low-income, urban, primarily Black adults diagnosed with heart failure. Data were analyzed using bivariate analyses, logistic and linear regression.
Forty-three percent endorsed at least one traumatic event. Twenty-one percent endorsed two or more traumatic events. In logistic regression analyses, traumatic events were associated with increased prevalence of coronary artery disease (adjusted odds=1.33, p<.05), hypertension (adjusted odds=1.28, p<.05), chronic obstructive pulmonary disease (adjusted odds=1.52, p<.01), and cardiac arrest (adjusted odds=1.27, p<.05). PTSD was also related to increased risk for chronic obstructive pulmonary disease (adjusted odds=1.22, p<.05) and was associated with earlier onset of heart failure (β=-.13, p<.05).
The study utilizes cross-sectional, self-report data.
Findings support the link between traumatic events, PTSD, and CPD burden in low-income, primarily Black patients with heart failure. Depression appears to be less closely linked to CPD burden, despite receiving significant attention in the literature. The accumulation of traumatic events may exacerbate CPD burden among urban, low-income, racial minority residents with heart failure; findings highlight the importance of PTSD screening.
创伤性事件和创伤后应激障碍（PTSD）与退伍军人、男性以及主要为白人的人群患心肺疾病（CPD）的风险增加有关。对于低收入、创伤和PTSD风险较高的少数族裔居民中的创伤、PTSD和CPD负担，人们了解较少。研究假设，创伤性事件和PTSD与低收入少数族裔居民的CPD负担显著相关。
我们评估了251名被诊断为心力衰竭的低收入、城市、主要为黑人的成年人中创伤性事件、PTSD、抑郁与CPD负担之间的横断面关系。使用双变量分析、逻辑回归和线性回归对数据进行分析。
43%的人认可至少发生过一次创伤性事件。21%的人认可发生过两次或更多次创伤性事件。在逻辑回归分析中，创伤性事件与冠状动脉疾病患病率增加相关（调整比值=1.33，p<0.05）、高血压（调整比值=1.28，p<0.05）、慢性阻塞性肺疾病（调整比值=1.52，p<0.01）以及心脏骤停（调整比值=1.27，p<0.05）。PTSD也与慢性阻塞性肺疾病风险增加相关（调整比值=1.22，p<0.05），并与心力衰竭的较早发病相关（β=-0.13，p<0.05）。
该研究使用的是横断面自我报告数据。
研究结果支持了创伤性事件、PTSD与低收入、主要为黑人的心力衰竭患者的CPD负担之间的联系。尽管在文献中受到了大量关注，但抑郁似乎与CPD负担的联系不那么紧密。创伤性事件的累积可能会加重城市低收入少数族裔心力衰竭患者的CPD负担；研究结果凸显了PTSD筛查的重要性。
