Department of Psychology, Chapman University, Orange, California.
Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, Massachusetts.
Am J Prev Med. 2017 Dec;53(6):791-798. doi: 10.1016/j.amepre.2017.06.028. Epub 2017 Aug 22.
Favorable cardiovascular health (FCH) is associated with healthy longevity and reduced cardiovascular mortality risk. However, limited work has investigated the distribution of FCH in older age or considered the antecedents of FCH. Based on prior work linking psychological well-being with cardiovascular endpoints, higher psychological well-being was hypothesized to be associated with increased likelihood of maintaining FCH over time.
Data were from the English Longitudinal Study of Ageing. The first study wave (2002-2003) included men and women aged ≥50 years. The analytic sample (N=4,925) was restricted to individuals without baseline cardiovascular disease and with clinical data from three follow-ups through 2013. Psychological well-being was assessed with 17 items from the Control, Autonomy, Satisfaction, and Pleasure scale. FCH was defined as being a non-smoker, diabetes-free, and having healthy levels of blood pressure, cholesterol, and BMI (FCH scores ranged from 0-5). Statistical analyses conducted in 2016-2017 used linear mixed models to examine associations between psychological well-being and FCH scores over time. Secondary analyses examined cardiovascular-related mortality.
Only 1% of participants had achieved complete FCH at study baseline. Adjusting for sociodemographic factors and depression, greater psychological well-being was associated with higher FCH scores across time (β=0.05, 95% CI=0.02, 0.08), but not rate of change in FCH. Psychological well-being was also associated with a 29% reduced risk of cardiovascular-related mortality in multivariable-adjusted models.
Findings suggest that psychological well-being is associated with having FCH at older ages, and add to knowledge of assets that may increase likelihood of healthy aging.
良好的心血管健康（FCH）与健康长寿和降低心血管死亡率风险相关。然而，有限的工作调查了老年人中 FCH 的分布情况，或者考虑了 FCH 的前因。基于先前将心理幸福感与心血管终点联系起来的工作，假设较高的心理幸福感与随着时间的推移保持 FCH 的可能性增加有关。
数据来自英国老龄化纵向研究。第一波研究（2002-2003 年）包括 50 岁及以上的男性和女性。分析样本（N=4925）仅限于没有基线心血管疾病且在 2013 年之前有三次随访临床数据的个体。心理幸福感使用控制、自主、满意和愉悦量表中的 17 个项目进行评估。FCH 定义为不吸烟、无糖尿病且血压、胆固醇和 BMI 水平健康（FCH 评分范围为 0-5）。2016-2017 年进行的统计分析使用线性混合模型来检查心理幸福感与 FCH 评分随时间的关联。次要分析检查了心血管相关死亡率。
只有 1%的参与者在研究基线时就达到了完全的 FCH。调整社会人口因素和抑郁因素后，较高的心理幸福感与随时间推移的 FCH 评分较高相关（β=0.05，95%CI=0.02，0.08），但与 FCH 变化率无关。在多变量调整模型中，心理幸福感也与心血管相关死亡率降低 29%相关。
研究结果表明，心理幸福感与老年人中具有 FCH 有关，并增加了可能增加健康老龄化可能性的资产知识。
