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心血管风险的心理社会维度:探讨中年和老年人社会孤立和孤独感的影响。

Psycho-social dimensions of cardiovascular risk: exploring the impact of social isolation and loneliness in middle-aged and older adults.

机构信息

Department of Epidemiology and Health Statistics, School of Public Health, Hangzhou Medical College, 481 Binwen Road, Hangzhou, 310053, China.

Department of Big Data in Health Science, Zhejiang University School of Public Health and Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China.

出版信息

BMC Public Health. 2024 Aug 29;24(1):2355. doi: 10.1186/s12889-024-19885-w.

Abstract

BACKGROUND

Cardiovascular disease (CVD) is a major health concern for middle-aged and older adults, with lifestyle and metabolic risk factors well-studied. However, the role of psychosocial factors in CVD remains underexplored.

OBJECTIVE

This study aims to delve into the connection between psychosocial factors and the occurrence of CVD.

METHODS

We utilized data from the UK Biobank, a large-scale study covering adults aged 38 to 73 recruited from various centers across the UK between 2006 and 2010. We employed Cox proportional hazards models to analyze the relationship between social isolation, loneliness, and incident CVD. CVD diagnoses were confirmed through hospital records and death-register data. Additionally, we conducted mediation analyses to assess the impact of low-grade inflammation.

RESULTS

The study encompassed 427,942 participants free from CVD, 55.8% of whom are women. High levels of social isolation and loneliness were linked to a higher risk of CVD (HRs 1.11, 95% CI 1.06-1.16; HRs 1.17, 95% CI 1.11-1.23). Depression also emerged as a predictor of CVD onset (HRs 1.25, 95% CI 1.19-1.31), with each psychosocial factor independently contributing to increased CVD risk. Mediation analyses pinpointed inflammation as a crucial mediator, especially for loneliness (indirect effect proportion: 4.7%).

CONCLUSIONS

This study underscores the significance of psychosocial factors in relation to CVD. Integrating assessments for social isolation, loneliness, and depression into routine healthcare could potentially aid in CVD prevention among middle-aged and elderly individuals. This study underscores the significance of psychosocial factors in relation to CVD, emphasizing the association between social isolation or loneliness and the heightened risk of CVD.

摘要

背景

心血管疾病(CVD)是中老年人群的主要健康关注点,生活方式和代谢风险因素已得到充分研究。然而,心理社会因素在 CVD 中的作用仍未得到充分探索。

目的

本研究旨在深入探讨心理社会因素与 CVD 发生之间的关系。

方法

我们利用了英国生物库(UK Biobank)的数据,该研究是一项大型研究,涵盖了 2006 年至 2010 年期间在英国各地的多个中心招募的 38 至 73 岁的成年人。我们使用 Cox 比例风险模型分析了社会隔离、孤独感与 CVD 发病之间的关系。CVD 诊断通过医院记录和死亡登记数据进行确认。此外,我们还进行了中介分析,以评估低度炎症的影响。

结果

该研究共纳入了 427942 名无 CVD 的参与者,其中 55.8%为女性。高水平的社会隔离和孤独感与 CVD 风险增加相关(HRs 1.11,95%CI 1.06-1.16;HRs 1.17,95%CI 1.11-1.23)。抑郁也被发现是 CVD 发病的预测因素(HRs 1.25,95%CI 1.19-1.31),每个心理社会因素都独立地导致 CVD 风险增加。中介分析指出炎症是一个关键的中介因素,特别是对孤独感而言(间接效应比例:4.7%)。

结论

本研究强调了心理社会因素与 CVD 之间的关系。将社会隔离、孤独感和抑郁评估纳入常规医疗保健中,可能有助于预防中老年人群的 CVD。

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