Frank H. Netter MD School of Medicine at Quinnipiac University, United States.
Department of Psychiatry, University of California, San Diego, United States; Joint Doctoral Program in Clinical Psychology, San Diego State University/University of California, San Diego, United States.
J Psychosom Res. 2017 Dec;103:29-33. doi: 10.1016/j.jpsychores.2017.10.001. Epub 2017 Oct 5.
Caregiving stress is associated with increased risk of cardiovascular disease (CVD). Inability to adequately regulate blood pressure is a possible underlying mechanism explaining this risk. We examined the relationship between length of caregiving and cardiovagal baroreflex sensitivity (cBRS) to better understand the link between caregiving and CVD risk.
A total of 146 elderly individuals (≥55years) participated in this study, of whom 96 were providing in-home care to a spouse with dementia and 50 were healthy controls married to a non-demented spouse (i.e., non-caregivers). Among the caregivers, 56 were short-term caregivers (caring<4years) and 40 were long-term caregivers (caring≥4years). A multiple linear regression model, with contrast codes comparing short and long-term caregivers with non-caregivers was used to understand relationships between chronic caregiving and cBRS.
After controlling for relevant demographic and health characteristics, mean±SE log transformed cBRS for non-caregivers was 0.971±0.029. Relative to non-caregivers, the long-term caregivers had significantly impaired cBRS (0.860±0.033; p=0.013). However, mean cBRS for short-term caregivers did not significant differ from non-caregivers (0.911±0.028; p=0.144).
These results suggest that long-term caregiving stress is associated with an impaired cBRS. Accumulation of stress from years of caregiving could result in worse cBRS function, which could be a mechanistic explanation for the correlation between caregiving stress and the increased risk of CVD.
照顾压力与心血管疾病（CVD）风险增加有关。无法充分调节血压可能是解释这种风险的潜在机制。我们研究了照顾时间与心血管迷走神经反射敏感性（cBRS）之间的关系，以更好地理解照顾与 CVD 风险之间的联系。
共有 146 名老年人（≥55 岁）参与了这项研究，其中 96 名正在为患有痴呆症的配偶提供家庭护理，50 名健康对照者与非痴呆症配偶（即非照顾者）结婚。在照顾者中，56 名是短期照顾者（照顾<4 年），40 名是长期照顾者（照顾≥4 年）。使用多元线性回归模型，使用对比码比较短期和长期照顾者与非照顾者，以了解慢性照顾与 cBRS 之间的关系。
在控制相关人口统计学和健康特征后，非照顾者的平均±SE 对数转换 cBRS 为 0.971±0.029。与非照顾者相比，长期照顾者的 cBRS 明显受损（0.860±0.033；p=0.013）。然而，短期照顾者的平均 cBRS 与非照顾者无显著差异（0.911±0.028；p=0.144）。
这些结果表明，长期照顾压力与受损的 cBRS 有关。多年来的压力积累可能导致 cBRS 功能更差，这可能是照顾压力与 CVD 风险增加之间相关性的机制解释。
