Department of Epidemiology & Biostatistics, School of Public Health, Peking University, Beijing 100191, China.
Department of Epidemiology & Biostatistics, School of Public Health, Peking University, Beijing 100191, China; Peking University Center for Public Health and Epidemic Preparedness & Response, Beijing 100191, China.
J Affect Disord. 2022 Oct 15;315:291-296. doi: 10.1016/j.jad.2022.08.008. Epub 2022 Aug 5.
Anxiety might be a potentially modifiable risk factor of cardiovascular diseases (CVDs). Evidence relating anxiety symptoms and generalized anxiety disorder (GAD) to CVDs from prospective cohort study was still lacking in China.
Participants aged 30 to 79 years old from 10 areas across China were recruited during 2004-2008 and were followed up until 2017. 487,209 participants without CVDs at baseline remained for analyses. Anxiety symptoms (panic attacks and continuous anxiety) during the past 12 months were identified in a face-to-face interview. Participants with continuous anxiety were further assessed for GAD using Composite International Diagnostic Interview-Short Form. The primary outcomes were incident CVD, ischaemic heart disease (IHD), haemorrhagic stroke (HS), and ischaemic stroke (IS).
During 4.7 million person-years of follow-up, we documented 140,365 incident cases of CVD. For panic attacks, the multivariable-adjusted HRs (95 % CI) were 1.08 (1.04-1.13), 1.10 (1.02-1.19), 1.20 (1.05-1.38) and 1.20 (1.11-1.30) for CVD, IHD, HS and IS, respectively. Continuous anxiety was positively associated with incident CVD and IHD, and the corresponding HRs were 1.12 (1.04-1.20) and 1.21 (1.07-1.37).
Anxiety symptoms were examined according to self-reported questionnaires, which could constitute key study limitations.
Among the Chinese adults, those with anxiety symptoms or GAD might be important at-risk population of CVD.
焦虑可能是心血管疾病（CVD）的一个潜在可改变的危险因素。在中国，前瞻性队列研究中仍缺乏与 CVD 相关的焦虑症状和广泛性焦虑障碍（GAD）的证据。
2004-2008 年期间，在中国 10 个地区招募了年龄在 30 至 79 岁的参与者，并随访至 2017 年。在基线时没有 CVD 的 487,209 名参与者仍被纳入分析。在面对面访谈中确定了过去 12 个月的焦虑症状（惊恐发作和持续焦虑）。使用复合国际诊断访谈-短表对有持续焦虑的参与者进一步评估 GAD。主要结局是新发 CVD、缺血性心脏病（IHD）、出血性中风（HS）和缺血性中风（IS）。
在 470 万人年的随访期间，我们记录了 140,365 例 CVD 新发病例。对于惊恐发作，多变量调整后的 HR（95%CI）分别为 1.08（1.04-1.13）、1.10（1.02-1.19）、1.20（1.05-1.38）和 1.20（1.11-1.30）用于 CVD、IHD、HS 和 IS。持续焦虑与新发 CVD 和 IHD 呈正相关，相应的 HR 分别为 1.12（1.04-1.20）和 1.21（1.07-1.37）。
焦虑症状是根据自我报告的问卷进行检查的，这可能是研究的主要限制。
在中国成年人中，有焦虑症状或 GAD 的人可能是 CVD 的高危人群。
