Isfahan Cardiovascular Research Center, Cardiovascular Research Institute, University of Medical Sciences, Isfahan 8166173414, Iran.
Interventional Cardiology Research Center, Cardiovascular Research Institute, University of Medical Sciences, Isfahan 8166173414, Iran.
Eur J Cardiovasc Nurs. 2022 Jun 30;21(5):483-490. doi: 10.1093/eurjcn/zvab110.
Psychological factors are among the most suspected indicators which may cause atherosclerosis. Coping strategies modifying psychological stress may be significantly associated with health outcomes. However, little is known about the influence of adaptive and maladaptive coping strategies on major adverse cardiovascular disease (CVD) events. The purpose of this study is to examine this idea among a sample of adults. Design: cohort study.
The Isfahan cohort study (ICS) is a longitudinal population-based, prospective study. Participants (N=6323 individuals aged 35 years or greater at baseline) were selected by multistage random sampling with 6-year intervals (i.e. 2001: 6323 individuals, 2007: 3296 individuals, and 2013: 1706 individuals). Adaptive and maladaptive coping strategies were evaluated by a multicomponent self-administered stress management paper-based questionnaire. All CVD events were confirmed by a blinded panel of experts and a marginal cox regression model was used to model the survival data. Adaptive coping strategies could be protective against CVD events with hazard ratios (95% confidence interval) [0.97 (0.95-0.99)] and maladaptive coping strategies seem to be a risk factor, 1.02 (1.01-1.04) in the whole population. Individuals younger than 60 showed similar results, with 0.96 (0.93-0.98) and 1.04 (1.01-1.07) for adaptive and maladaptive coping strategies, respectively. However, these findings were not replicated among seniors older than age 60.
Based on our results, coping strategies have an important role in cardiovascular events, particularly among young adults. According to the results, informing patients about adaptive stress management may promote primary prevention of CVD events.
心理因素是导致动脉粥样硬化的最可疑指标之一。改变心理压力的应对策略可能与健康结果有显著关联。然而，对于适应和不适应的应对策略对主要不良心血管疾病（CVD）事件的影响知之甚少。本研究的目的是在成年人样本中检验这一观点。
队列研究。
伊斯法罕队列研究（ICS）是一项基于人群的纵向前瞻性研究。参与者（N=6323 名，基线时年龄在 35 岁或以上）通过多阶段随机抽样，每 6 年间隔一次（即 2001 年：6323 人，2007 年：3296 人，2013 年：1706 人）。适应性和不适应性应对策略通过多成分自我管理应激管理纸质问卷进行评估。所有 CVD 事件均由盲法专家小组确认，并使用边缘 Cox 回归模型对生存数据进行建模。适应性应对策略可降低 CVD 事件的风险，风险比（95%置信区间）为[0.97（0.95-0.99)]，而不适应的应对策略似乎是一个风险因素，为 1.02（1.01-1.04）。年龄小于 60 岁的个体表现出类似的结果，适应性和不适应性应对策略的风险比分别为 0.96（0.93-0.98）和 1.04（1.01-1.07）。然而，这些结果在年龄大于 60 岁的老年人中没有得到复制。
根据我们的结果，应对策略在心血管事件中起着重要作用，特别是在年轻成年人中。根据研究结果，告知患者适应性应激管理可能会促进 CVD 事件的一级预防。
