探讨非理性信念、生活方式行为和教育状况在 10 年心血管疾病风险中的作用：ATTICA 流行病学研究。
Exploring the Role of Irrational Beliefs, Lifestyle Behaviors, and Educational Status in 10-Year Cardiovascular Disease Risk: the ATTICA Epidemiological Study.
机构信息
Department of Nutrition and Dietetics, School of Health Sciences and Education, Harokopio University, 70 Eleftheriou Venizelou Ave, 176 76, Kallithea, Athens, Greece.
School of Medicine Sydney, University of Notre Dame, Sydney, Australia.
出版信息
Int J Behav Med. 2023 Apr;30(2):279-288. doi: 10.1007/s12529-022-10091-9. Epub 2022 Apr 26.
BACKGROUND
Irrational beliefs, maladaptive emotions, and unhealthy lifestyle behaviors can adversely affect health status. However, limited research has examined the association between irrational beliefs and cardiovascular disease (CVD). The aim of this study was to evaluate the association between irrational beliefs and the 10-year CVD incidence among apparently healthy adults, considering the potential moderating or mediating role of particular social and lifestyle factors.
METHODS
The ATTICA study is a population-based, prospective cohort (2002-2012), in which 853 participants without a history of CVD [453 men (aged 45 ± 13 years) and 400 women (aged 44 ± 18 years)] underwent psychological evaluations. Among other tools, participants completed the irrational beliefs inventory (IBI, range 0-88), a self-reported measure consistent with the Ellis model of psychological disturbance. Demographic characteristics, detailed medical history, dietary, and other lifestyle habits were also evaluated. Incidence of CVD (i.e., coronary heart disease, acute coronary syndromes, stroke, or other CVD) was defined according to the International Coding Diseases (ICD)-10 criteria.
RESULTS
Mean IBI score was 53 ± 2 in men and 53 ± 3 in women (p = 0.88). IBI score was positively associated with 10-year CVD risk (hazard ratio 1.07, 95%CI 1.04, 1.13), in both men and women, and more prominently among those with less healthy dietary habits and lower education status; specifically, higher educational status leads to lower IBI score, and in conjunction they lead to lower 10-year CVD risk (HR for interaction 0.98, 95%CI 0.97, 0.99).
CONCLUSIONS
The findings of this study underline the need to build new, holistic approaches in order to better understand the inter-relationships between irrational beliefs, lifestyle behaviors, social determinants, and CVD risk in individuals.
背景
非理性信念、适应不良的情绪和不健康的生活方式行为会对健康状况产生不利影响。然而，关于非理性信念与心血管疾病（CVD）之间的关联，相关研究有限。本研究旨在评估非理性信念与健康成年人 CVD 10 年发病率之间的关联，同时考虑特定社会和生活方式因素的潜在调节或中介作用。
方法
ATTICA 研究是一项基于人群的前瞻性队列研究（2002-2012 年），共纳入 853 名无 CVD 病史的参与者[453 名男性（年龄 45±13 岁）和 400 名女性（年龄 44±18 岁）]，并对其进行心理评估。参与者完成了非理性信念量表（IBI，范围 0-88），这是一种符合 Ellis 心理障碍模型的自我报告测量工具。同时还评估了参与者的人口统计学特征、详细的病史、饮食和其他生活方式习惯。CVD 发生率（即冠心病、急性冠状动脉综合征、中风或其他 CVD）根据国际疾病分类（ICD-10）标准定义。
结果
男性的平均 IBI 评分为 53±2，女性为 53±3（p=0.88）。IBI 评分与 10 年 CVD 风险呈正相关（男性 1.07，95%CI 1.04，1.13；女性 1.07，95%CI 1.04，1.13），在饮食习惯不健康和受教育程度较低的人群中更为明显；具体而言，较高的受教育程度会导致较低的 IBI 评分，同时也会导致较低的 10 年 CVD 风险（交互作用的 HR 为 0.98，95%CI 0.97，0.99）。
结论
本研究结果强调需要建立新的整体方法，以便更好地理解个体中心非理性信念、生活方式行为、社会决定因素和 CVD 风险之间的相互关系。
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