Sun Ying, Zhang Haojie, Wang Bin, Chen Chi, Chen Yingchao, Chen Yi, Xia Fangzhen, Tan Xiao, Zhang Jihui, Li Qing, Qi Lu, Lu Yingli, Wang Ningjian
Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, China.
Department of Neuroscience, Uppsala University, Uppsala, Sweden; Department of Clinical Neuroscience, Karolinska Institutet, Sweden.
Atherosclerosis. 2022 Oct;359:44-51. doi: 10.1016/j.atherosclerosis.2022.08.007. Epub 2022 Aug 13.
Psychologic wellbeing can impact cardiovascular health. We aimed to evaluate the joint association of multiple psychologic wellbeing factors with cardiovascular diseases (CVD) and examine whether this association was modified by genetic susceptibility.
In the UK Biobank, 126,255 participants free of CVD (coronary heart disease [CHD], stroke, and heart failure [HF]) at baseline, who completed a questionnaire on psychological factors, were included. The psychological wellbeing score was calculated by four factors: happiness, life satisfaction, broad depression, and neuroticism. Cox proportional hazard models were used to assess the association between the psychological wellbeing score and CVD risk.
During the median follow-up of 11.5 years, 10,815 participants had newly diagnosed CVDs. Low life satisfaction, the presence of depression, and neuroticism score ≥1 were significantly associated with an increased risk of CVD in the multivariable-adjusted model. Through decreasing the psychological wellbeing score, there were significant increasing linear trends in the risk of CVD, CHD, stroke, and HF (all p for trend < 0.001). Participants with the lowest psychological wellbeing score had the highest risk for CVD (HR 1.51, 95% CI 1.42-1.61). Women were more susceptible to worse psychological wellbeing status for CVD than men (p for interaction = 0.009). The associations of the psychological wellbeing score with CVD were consistent across genetic risk (p for interaction >0.05). When considered jointly, participants exposed to high-risk psychological wellbeing and genetic status had a 2.70-fold (95% CI 2.25-3.24) risk for CHD.
Joint exposure to multiple psychological wellbeing factors was associated with increased risks of incident CVD in an additive manner, regardless of genetic susceptibility.
心理健康会影响心血管健康。我们旨在评估多种心理健康因素与心血管疾病（CVD）的联合关联，并检验这种关联是否会因遗传易感性而改变。
在英国生物银行中，纳入了126,255名基线时无CVD（冠心病[CHD]、中风和心力衰竭[HF]）且完成了心理因素问卷的参与者。心理健康得分由四个因素计算得出：幸福感、生活满意度、广泛性抑郁和神经质。采用Cox比例风险模型评估心理健康得分与CVD风险之间的关联。
在中位随访11.5年期间，10,815名参与者新诊断出患有CVD。在多变量调整模型中，低生活满意度、存在抑郁以及神经质得分≥1与CVD风险增加显著相关。通过降低心理健康得分，CVD、CHD、中风和HF的风险存在显著的线性增加趋势（所有趋势p值<0.001）。心理健康得分最低的参与者患CVD的风险最高（HR 1.51，95%CI 1.42 - 1.61）。女性比男性更容易因心理健康状况较差而患CVD（交互作用p值 = 0.009）。心理健康得分与CVD的关联在不同遗传风险水平上是一致的（交互作用p值>0.05）。综合考虑时，暴露于高风险心理健康和遗传状态的参与者患CHD的风险是2.70倍（95%CI 2.25 - 3.24）。
无论遗传易感性如何，同时暴露于多种心理健康因素会以累加的方式增加发生CVD的风险。
