Department of Global Public Health, Karolinska Institutet, Tomtebodavägen 18A, 171 77, Stockholm, Sweden.
Department of Public Health and Nursing, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway.
BMC Med. 2023 Jan 5;21(1):8. doi: 10.1186/s12916-022-02707-4.
Adverse childhood life events are associated with increased risks of hypertension, ischemic heart disease, and stroke later in life. Limited evidence also suggests that stress in adulthood may increase the risk of atrial fibrillation (AF). Whether childhood adversity may lead to the development of AF is unknown. We investigated whether the loss of a parent or sibling in childhood is associated with an increased risk of AF and compared this effect to that of similar losses in young adulthood.
We studied 6,394,975 live-born individuals included in the Danish (1973-2018) and Swedish Medical Birth Registers (1973-2014). We linked data from several national registers to obtain information on the death of parents and siblings and on personal and familial sociodemographic and health-related factors. We analyzed the association between bereavement and AF using Poisson regression.
Loss of a parent or sibling was associated with an increased AF risk both when the loss occurred in childhood and in adulthood; the adjusted incident rate ratios and 95% confidence intervals were 1.24 (1.14-1.35) and 1.24 (1.16-1.33), respectively. Bereavement in childhood was associated with AF only if losses were due to cardiovascular diseases or other natural causes, while loss in adulthood was associated with AF not only in case of natural deaths, but also unnatural deaths. The associations did not differ substantially according to age at loss and whether the deceased was a parent or a sibling.
Bereavement both in childhood and in adulthood was associated with an increased AF risk.
儿童时期的不良生活事件与成年后患高血压、缺血性心脏病和中风的风险增加有关。有限的证据还表明,成年期的压力可能会增加心房颤动(AF)的风险。尚不清楚儿童时期的逆境是否会导致 AF 的发生。我们调查了儿童时期失去父母或兄弟姐妹是否与 AF 风险增加有关,并将这种影响与成年早期类似的丧失进行了比较。
我们研究了丹麦(1973-2018 年)和瑞典医学出生登记处(1973-2014 年)中纳入的 6394975 名活产儿。我们从多个国家登记处链接数据,以获取父母和兄弟姐妹死亡以及个人和家庭社会人口统计学和与健康相关的因素信息。我们使用泊松回归分析了丧亲与 AF 之间的关联。
父母或兄弟姐妹的丧失与 AF 风险增加有关,无论是在儿童时期还是成年时期发生丧失;调整后的发病率比和 95%置信区间分别为 1.24(1.14-1.35)和 1.24(1.16-1.33)。只有当丧失是由于心血管疾病或其他自然原因时,儿童时期的丧亲才与 AF 有关,而成年时期的丧失不仅与自然死亡有关,而且与非自然死亡有关。根据丧失年龄以及死者是父母还是兄弟姐妹,这些关联没有明显差异。
儿童期和成年期的丧亲都与 AF 风险增加有关。