Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden.
Department of Clinical Medicine-Department of Clinical Epidemiology, Aarhus University, Aarhus, Denmark.
JAMA Netw Open. 2022 Jun 1;5(6):e2218178. doi: 10.1001/jamanetworkopen.2022.18178.
Increasing evidence suggests that parental death is associated with unhealthy behaviors and mental ill-health. Knowledge regarding the link between parental death and the risk of ischemic heart disease (IHD) and stroke remains limited.
To investigate whether parental death is associated with an increased risk of IHD and stroke and whether these associations differ by the characteristics of the loss.
DESIGN, SETTING, AND PARTICIPANTS: This population-based cohort study, involving linkages between several nationwide registers, included 3 766 918 individuals born between 1973 and 1998 in Denmark and between 1973 and 1996 in Sweden. Participants were followed up until 2016 in Denmark and 2014 in Sweden. Data were analyzed from December 2019 to May 2021.
Death of a parent.
Diagnosis with or death due to IHD or stroke. Poisson regression was used to analyze the associations between parental death and IHD and stroke risk.
Altogether, 48.8% of the participants were women, and 42.7% were from Denmark. A total of 523 496 individuals lost a parent during the study period (median age at loss, 25 years; IQR, 17-32 years). Parental death was associated with a 41% increased risk of IHD (incidence rate ratio [IRR], 1.41; 95% CI, 1.33-1.51) and a 30% increased risk of stroke [IRR, 1.30; 95% CI, 1.21-1.38). The associations were observed not only if the parent died because of cardiovascular or other natural causes but also in cases of unnatural deaths. The associations were stronger when both parents had died (IHD: IRR, 1.87; 95% CI, 1.59-2.21; stroke: IRR, 1.64; 95% CI, 1.35-1.98) than when 1 parent had died (IHD: IRR, 1.37; 95% CI, 1.28-1.47; stroke: IRR, 1.27; 95% CI, 1.19-1.36) but did not differ substantially by the offspring's age at loss or the deceased parents' sex. The risk of acute myocardial infarction was highest in the first 3 months after loss.
In this cohort study, parental death in the first decades of life was associated with an increased risk of IHD and stroke. The associations were observed not only in cases of parental cardiovascular and other natural deaths but also in cases of unnatural deaths. Family members and health professionals may need to pay attention to the cardiovascular disease risk among parentally bereaved individuals.
越来越多的证据表明，父母的死亡与不健康的行为和心理健康问题有关。关于父母死亡与缺血性心脏病（IHD）和中风风险之间的联系的知识仍然有限。
研究父母死亡是否与 IHD 和中风风险增加有关，以及这些关联是否因丧失的特征而异。
设计、地点和参与者：这项基于人群的队列研究，涉及几个全国性登记处之间的联系，包括 1973 年至 1998 年期间在丹麦和 1973 年至 1996 年期间在瑞典出生的 3766918 人。参与者在丹麦的随访时间截至 2016 年，在瑞典的随访时间截至 2014 年。数据分析于 2019 年 12 月至 2021 年 5 月进行。
父母死亡。
IHD 或中风的诊断或死亡。使用泊松回归分析父母死亡与 IHD 和中风风险之间的关联。
共有 48.8%的参与者为女性，42.7%来自丹麦。在研究期间，共有 523496 人失去了父母（丧失时的中位年龄为 25 岁；IQR，17-32 岁）。父母死亡与 IHD 风险增加 41%相关（发病率比 [IRR]，1.41；95%CI，1.33-1.51），中风风险增加 30%相关（IRR，1.30；95%CI，1.21-1.38）。这种关联不仅存在于父母因心血管疾病或其他自然原因死亡的情况下，也存在于非自然死亡的情况下。当父母双方都去世时，这种关联更强（IHD：IRR，1.87；95%CI，1.59-2.21；中风：IRR，1.64；95%CI，1.35-1.98），而当只有 1 位父母去世时，这种关联较弱（IHD：IRR，1.37；95%CI，1.28-1.47；中风：IRR，1.27；95%CI，1.19-1.36），但与子女丧失父母时的年龄或已故父母的性别无显著差异。心肌梗死的风险在丧失后的头 3 个月内最高。
在这项队列研究中，生命早期父母的死亡与 IHD 和中风风险增加有关。这种关联不仅存在于父母心血管疾病和其他自然死亡的情况下，也存在于非自然死亡的情况下。家庭成员和卫生专业人员可能需要关注丧亲父母的个体的心血管疾病风险。
