School of Public Health, Tianjin Medical University, 22 Qixiangtai Road, Heping District, Tianjin 300070, China.
School of Public Health, Zhejiang University, Zhejiang, China.
J Affect Disord. 2022 Feb 1;298(Pt A):388-395. doi: 10.1016/j.jad.2021.11.008. Epub 2021 Nov 6.
Evidence is limited regarding the impact of comprehensive mental health on the risk of subsequent cardiovascular events.
To investigate the association of mental health status with cardiovascular disease (CVD) in the UK Biobank.
This prospective study included 339,616 participants aged 40 to 69 years who were enrolled between 2006 and 2010 and were followed up to 2020, without CVD at baseline. A mental health score was created using information about depressive symptoms, anxiety, loneliness, and neuroticism. Cardiovascular disease events ascertained through hospital inpatient. Cox models were used to estimate hazard ratios and 95% confidence intervals across mental health score.
During a median follow-up of 11.3 years (3.7 million person-years), we documented 22,688 CVD cases including 18,460 CHD cases and 5,070 stroke cases (some individuals were diagnosed as having both CHD and stroke). A statistically significantly increased risk of incident CVD was observed for the four mental factors individually, with adjusted hazard ratios ranging from 1.03 to 1.44. The composite score of such four mental factors was also positively associated with CVD risk in a dose-response manner, with the highest scores associated with a 1.56-fold (95% confidence interval 1.47 to 1.65), 1.61-fold (1.51 to 1.72), and 1.44-fold (1.25 to 1.67) higher CVD, CHD, and stroke risk, respectively.
In this large prospective study, poor mental health status was associated with an increased risk of CVD. Our results highlight the importance to jointly investigate the mental health factors in relation to the risk of CVD.
关于综合心理健康对随后心血管事件风险的影响，证据有限。
在英国生物库中调查心理健康状况与心血管疾病 (CVD) 的关系。
这项前瞻性研究纳入了 339616 名年龄在 40 至 69 岁之间的参与者，他们于 2006 年至 2010 年期间入组，随访至 2020 年，基线时无 CVD。使用关于抑郁症状、焦虑、孤独和神经质的信息创建心理健康评分。通过医院住院患者确定心血管疾病事件。使用 Cox 模型估计 across mental health score 的风险比和 95%置信区间。
在中位数为 11.3 年（370 万人年）的随访期间，我们记录了 22688 例 CVD 病例，包括 18460 例 CHD 病例和 5070 例中风病例（一些人被诊断出同时患有 CHD 和中风）。单独来看，四个心理健康因素都与首发 CVD 的风险呈统计学显著增加相关，调整后的风险比范围为 1.03 至 1.44。这四个心理因素的综合评分也与 CVD 风险呈剂量反应关系呈正相关，最高评分与 CVD、CHD 和中风风险分别增加 1.56 倍（95%置信区间 1.47 至 1.65）、1.61 倍（1.51 至 1.72）和 1.44 倍（1.25 至 1.67）。
在这项大型前瞻性研究中，较差的心理健康状况与 CVD 风险增加相关。我们的结果强调了联合调查与 CVD 风险相关的心理健康因素的重要性。
