Gradus Jaimie L, Farkas Dóra Körmendiné, Svensson Elisabeth, Ehrenstein Vera, Lash Timothy L, Milstein Arnold, Adler Nancy, Sørensen Henrik Toft
National Center for PTSD, VA Boston Healthcare System, Boston, Massachusetts, USA Departments of Psychiatry and Epidemiology, Boston University, Boston, Massachusetts, USA Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark.
Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark.
BMJ Open. 2015 Dec 14;5(12):e009334. doi: 10.1136/bmjopen-2015-009334.
Post-traumatic stress disorder (PTSD) is a well-documented risk factor for cardiovascular disease (CVD). However, it is unknown whether another common stress disorder-adjustment disorder--is also associated with an increased risk of CVD and whether gender modifies these associations. The aim of this study was to examine the overall and gender-stratified associations between PTSD and adjustment disorder and 4 CVD events.
Prospective cohort study utilising Danish national registry data.
The general population of Denmark.
PTSD (n=4724) and adjustment disorder (n=64,855) cohorts compared with the general population of Denmark from 1995 to 2011.
CVD events including myocardial infarction (MI), stroke, ischaemic stroke and venous thromboembolism (VTE). Standardised incidence rates and 95% CIs were calculated.
Associations were found between PTSD and all 4 CVD events ranging from 1.5 (95% CI 1.1 to 1.9) for MI to 2.1 (95% CI 1.7 to 2.7) for VTE. Associations that were similar in magnitude were also found for adjustment disorder and all 4 CVD events: 1.5 (95% CI 1.4 to 1.6) for MI to 1.9 (95% CI 1.8 to 2.0) for VTE. No gender differences were noted.
By expanding beyond PTSD and examining a second stress disorder-adjustment disorder-this study provides evidence that stress-related psychopathology is associated with CVD events. Further, limited evidence of gender differences in associations for either of the stress disorders and CVD was found.
创伤后应激障碍（PTSD）是心血管疾病（CVD）一个有充分文献记载的风险因素。然而，另一种常见的应激障碍——适应障碍——是否也与CVD风险增加相关，以及性别是否会改变这些关联尚不清楚。本研究的目的是检验PTSD和适应障碍与4种CVD事件之间的总体关联以及按性别分层的关联。
利用丹麦国家登记数据进行的前瞻性队列研究。
丹麦普通人群。
1995年至2011年期间，将PTSD队列（n = 4724）和适应障碍队列（n = 64855）与丹麦普通人群进行比较。
CVD事件，包括心肌梗死（MI）、中风、缺血性中风和静脉血栓栓塞（VTE）。计算标准化发病率和95%置信区间。
发现PTSD与所有4种CVD事件之间存在关联，MI的关联度为1.5（95%置信区间1.1至1.9），VTE的关联度为2.1（95%置信区间1.7至2.7）。适应障碍与所有4种CVD事件之间也发现了相似程度的关联：MI为1.5（95%置信区间1.4至1.6），VTE为1.9（95%置信区间1.8至2.0）。未发现性别差异。
通过扩展到PTSD之外并研究第二种应激障碍——适应障碍——本研究提供了证据表明与应激相关的精神病理学与CVD事件有关。此外，发现两种应激障碍与CVD关联的性别差异证据有限。
