From the The Miriam Hospital (Salmoirago-Blotcher); Brown University School of Medicine (Salmoirago-Blotcher, Eaton), Providence, Rhode Island; University at Buffalo (Hovey), Buffalo, New York; University of Michigan (Andrews), Ann Arbor, Michigan; UC San Diego (Allison), La Jolla, California; University of Nevada (Brunner), Reno, Nevada; University of Iowa (Denburg), Iowa City, Iowa; Brown University School of Medicine and School of Public Health (Eaton), Providence, Rhode Island; UC Davis (Garcia), Davis, California; Ohio State University (Sealy-Jefferson), Columbus, Ohio; University of Washington (Zaslavsky), Seattle, Washington; Northwestern University (former affiliation), Evanston, Illinois; US Centers for Disease Control and Prevention (Kang), Atlanta, Georgia; UC San Francisco (López), San Francisco, California; Stony Brook University (Post), Stony Brook, New York; Vanderbilt University (Tindle), Nashville, Tennessee; and Albert Einstein College of Medicine (Wassertheil-Smoller), New York, New York.
Psychosom Med. 2019 Apr;81(3):256-264. doi: 10.1097/PSY.0000000000000672.
Psychological traits such as optimism and hostility affect coronary heart disease (CHD) risk, but mechanisms for this association are unclear. We hypothesized that optimism and hostility may affect CHD risk via changes in heart rate variability (HRV).
We conducted a longitudinal analysis using data from the Women's Health Initiative Myocardial Ischemia and Migraine Study. Participants underwent 24-hour ambulatory electrocardiogram monitoring 3 years after enrollment. Optimism (Life Orientation Test-Revised), cynical hostility (Cook-Medley), demographics, and coronary risk factors were assessed at baseline. HRV measures included standard deviation of average N-N intervals (SDNN); standard deviation of average N-N intervals for 5 minutes (SDANN); and average heart rate (HR). CHD was defined as the first occurrence of myocardial infarction, angina, coronary angioplasty, and bypass grafting. Linear and Cox regression models adjusted for CHD risk factors were used to examine, respectively, associations between optimism, hostility, and HRV and between HRV and CHD risk.
Final analyses included 2655 women. Although optimism was not associated with HRV, hostility was inversely associated with HRV 3 years later (SDANN: adjusted β = -0.54; 95% CI = -0.97 to -0.11; SDNN: -0.49; 95% CI = -0.93 to -0.05). HRV was inversely associated with CHD risk; for each 10-millisecond increase in SDNN or SDANN, there was a decrease in CHD risk of 9% (p = .023) and 12% (p = .006), respectively.
HRV did not play a major role in explaining why more optimistic women seem to be somewhat protected from CHD risk. Although hostility was inversely associated with HRV, its role in explaining the association between hostility and CHD risk remains to be established.
乐观和敌意等心理特征会影响冠心病（CHD）风险，但这种关联的机制尚不清楚。我们假设乐观和敌意可能通过心率变异性（HRV）的变化来影响 CHD 风险。
我们使用妇女健康倡议心肌缺血和偏头痛研究的数据进行了纵向分析。参与者在入组后 3 年接受了 24 小时动态心电图监测。在基线时评估了乐观（生活取向测试修订版）、犬儒敌意（库克-梅德利）、人口统计学和冠状动脉危险因素。HRV 测量包括平均 N-N 间隔标准差（SDNN）；5 分钟平均 N-N 间隔标准差（SDANN）；平均心率（HR）。CHD 定义为首次发生心肌梗死、心绞痛、冠状动脉成形术和旁路移植术。使用线性和 Cox 回归模型分别调整 CHD 危险因素，以检查乐观、敌意和 HRV 之间的关联，以及 HRV 和 CHD 风险之间的关联。
最终分析包括 2655 名女性。尽管乐观与 HRV 无关，但敌意与 3 年后的 HRV 呈负相关（SDANN：调整后的β=-0.54；95%CI=-0.97 至-0.11；SDNN：-0.49；95%CI=-0.93 至-0.05）。HRV 与 CHD 风险呈负相关；SDNN 或 SDANN 每增加 10 毫秒，CHD 风险降低 9%（p=0.023）和 12%（p=0.006）。
HRV 并没有在解释为什么更乐观的女性似乎在某种程度上免受 CHD 风险方面发挥主要作用。尽管敌意与 HRV 呈负相关，但它在解释敌意与 CHD 风险之间的关联中的作用仍有待确定。
