Public Health, Department of Social Medicine, Graduate School of Medicine, Osaka University, Suita, Osaka, Japan.
Department of Public Health, Hokkaido University, Sapporo, Hokkaido, Japan.
BMJ Open. 2022 Oct 10;12(10):e059725. doi: 10.1136/bmjopen-2021-059725.
To investigate whether having a purpose in life () is associated with risk of cardiovascular disease (CVD) mortality and whether the association varies by employment status.
Prospective cohort study.
Residents in 45 municipalities, Japan.
29 517 men and 41 984 women aged 40-79 years, free of CVD and cancer at baseline from 1988 to 1990.
CVD mortality.
During the median follow-up of 19.1 years, 4680 deaths (2393 men and 2287 women) from total CVD were observed. Greater was associated with a lower risk of CVD mortality, and the result was stronger for men than for women. Stratified by employment status, the inverse association was confined to unemployed persons. Among unemployed persons, the multivariable HRs of total CVD were higher for moderate and high versus low levels of . Multivariable HRs (95% CIs) were 0.74 (0.57 to 0.97) and 0.69 (0.52 to 0.93), P for trend <0.044, respectively in men, and 0.78 (0.64 to 0.95) and 0.77 (0.61 to 0.97), P for trend=0.039 in women. No association was observed among the employed, including part-time workers, self-employed and homemakers for both men and women. Such an inverse association remained even after excluding early deaths within 5 years from the baseline survey.
Higher levels of were associated with a lower risk of CVD mortality, especially for unemployed men and women.
探讨生活目标与心血管疾病（CVD）死亡率的相关性，以及这种相关性是否因就业状况而异。
前瞻性队列研究。
日本 45 个市町村的居民。
年龄在 40-79 岁、基线时无 CVD 和癌症的 29517 名男性和 41984 名女性，随访时间为 1988 年至 1990 年。
CVD 死亡率。
在平均 19.1 年的随访期间，共观察到 4680 例 CVD 死亡（2393 名男性和 2287 名女性）。生活目标越高，CVD 死亡率越低，且男性的结果强于女性。按就业状况分层，这种负相关仅限于失业者。在失业者中，与低水平的生活目标相比，中高水平的生活目标与总 CVD 的多变量 HR 更高。多变量 HR（95%CI）分别为男性 0.74（0.57 至 0.97）和 0.69（0.52 至 0.93），趋势 P 值<0.044；女性 0.78（0.64 至 0.95）和 0.77（0.61 至 0.97），趋势 P 值=0.039。对于男性和女性的在职人群，包括兼职工作者、个体经营者和家庭主妇，均未观察到这种关联。即使在排除基线调查后 5 年内的早期死亡后，这种负相关仍然存在。
较高的生活目标水平与较低的 CVD 死亡率相关，尤其是对失业的男性和女性而言。
