Chair of Epidemiology and Population Studies, Faculty of Health Sciences, Jagiellonian University Medical College, Krakow, Poland.
National Institute of Public Health, Prague, Czech Republic.
J Epidemiol Community Health. 2017 Aug;71(8):771-778. doi: 10.1136/jech-2017-208992. Epub 2017 May 17.
Inverse associations between perceived control and cardiovascular disease (CVD) have been reported in studies from Western Europe and the USA. To assess this relationship across different populations, we investigated the association between perceived control and all-cause and CVD mortality in three population-based cohorts of Eastern European countries.
We analysed data from a prospective cohort study in random population samples in Krakow (Poland), Novosibirsk (Russia) and six Czech towns. Baseline survey included structured questionnaire and objective examination in a clinic. Perceived control was assessed using an 11-item scale developed by the MacArthur Foundation Programme on Successful Midlife. Information on vital status was obtained from death registers. Effect of perceived control on mortality was assessed using Cox proportional hazards models.
A total of 2377 deaths (1003 from CVD) occurred among 27 249 participants over a median 7-year follow-up. In the Czech and Polish cohorts, perceived control was inversely associated with mortality; the adjusted HRs for the lowest versus highest control quintiles were 1.71 (1.34 to 2.19) in men and 1.63 (1.14 to 2.35) in women for all-cause mortality and 2.31 (1.48 to 3.59) and 5.50 (2.14 to 14.13) for CVD deaths. There was no association between perceived control and mortality in Russia; the adjusted HRs for all-cause mortality were 1.03 (0.79 to 1.34) in men and 1.29 (0.82 to 2.02) in women.
Low perceived control was associated with increased risk of all-cause and CVD mortality in Czech and Polish cohorts but not in Russia. It is possible that this inconsistency may partly reflect a different sociocultural understanding of the concept of control in Russia.
在来自西欧和美国的研究中，报告了感知控制与心血管疾病（CVD）之间的负相关关系。为了评估这种关系在不同人群中的差异，我们研究了东欧三个国家的基于人群的队列研究中感知控制与全因和 CVD 死亡率之间的关系。
我们分析了来自克拉科夫（波兰）、新西伯利亚（俄罗斯）和六个捷克城镇的前瞻性队列研究的随机人群样本数据。基线调查包括结构化问卷和诊所的客观检查。感知控制使用麦克阿瑟基金会成功中年计划开发的 11 项量表进行评估。通过死亡登记获得生存状态信息。使用 Cox 比例风险模型评估感知控制对死亡率的影响。
在 27249 名参与者中，中位随访 7 年后共发生 2377 例死亡（1003 例死于 CVD）。在捷克和波兰队列中，感知控制与死亡率呈负相关；最低与最高控制五分位数相比，男性的调整 HR 为 1.71（1.34 至 2.19），女性为 1.63（1.14 至 2.35）；全因死亡率和 CVD 死亡率分别为 2.31（1.48 至 3.59）和 5.50（2.14 至 14.13）。在俄罗斯，感知控制与死亡率之间没有关联；男性全因死亡率的调整 HR 为 1.03（0.79 至 1.34），女性为 1.29（0.82 至 2.02）。
在捷克和波兰队列中，低感知控制与全因和 CVD 死亡率风险增加相关，但在俄罗斯队列中则没有关联。这种不一致可能部分反映了俄罗斯对控制概念的不同社会文化理解。
