Zhang Xue Yidan, Wang Yu, Lee Jun Soo, Pollack Lisa M, Luo Feijun
Division for Heart Disease and Stroke Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
ASRT Inc, Atlanta, Georgia, USA.
BMJ Open. 2025 Sep 5;15(9):e091096. doi: 10.1136/bmjopen-2024-091096.
This study uses nationally representative survey data from the USA to estimate the relationship between a history of heart attack or stroke with the prevalence of mental health symptoms.
Cross-sectional.
Data from the 2019 and the 2018 National Health Interview Survey (NHIS) sample adult interview.
30 872 adults from the 2019 NHIS and 24 593 adults from the 2018 NHIS were analysed separately; a history of heart attack or stroke was determined based on participants' recollection of previous communications with health professionals.
Poisson log-linear regressions with robust SEs were employed to estimate the relative prevalence of mental health symptoms associated with a history of heart attack or stroke. Mental health outcomes included moderate-to-severe depression symptoms according to the Patient Health Questionnaire, moderate-to-severe anxiety symptoms according to the General Anxiety Disorder scale and serious psychological distress according to the Kessler Psychological Distress scale.
The prevalence of moderate-to-severe symptoms of depression, anxiety and serious psychological distress was more than two times as high among individuals with a history of heart attack or stroke compared with those without such a history. After adjusting for potentially confounding socio-demographic and health variables, survivors of heart attack were 33% and 40% more likely and survivors of stroke were 59% and 52% more likely to experience depression and anxiety symptoms, compared with adults without these conditions. Additionally, survivors of stroke were 76% more likely to have serious psychological distress than those without a stroke history.
Findings from this study highlight the increased mental health problems experienced by heart attack or stroke survivors relative to adults without these conditions. They underscore the importance of addressing mental health concerns among adults who have experienced a heart attack or stroke.
本研究使用来自美国的具有全国代表性的调查数据，以估计心脏病发作或中风病史与心理健康症状患病率之间的关系。
横断面研究。
2019年和2018年全国健康访谈调查（NHIS）样本成人访谈数据。
分别分析了2019年NHIS的30872名成年人和2018年NHIS的24593名成年人；根据参与者对先前与医疗专业人员沟通情况的回忆来确定心脏病发作或中风病史。
采用具有稳健标准误的泊松对数线性回归来估计与心脏病发作或中风病史相关的心理健康症状的相对患病率。心理健康结局包括根据患者健康问卷得出的中度至重度抑郁症状、根据广泛性焦虑障碍量表得出的中度至重度焦虑症状以及根据凯斯勒心理困扰量表得出的严重心理困扰。
与没有心脏病发作或中风病史的个体相比，有此类病史的个体中，中度至重度抑郁、焦虑和严重心理困扰症状的患病率高出两倍多。在对潜在的混杂社会人口学和健康变量进行调整后，与没有这些疾病的成年人相比，心脏病发作幸存者出现抑郁和焦虑症状的可能性分别高出33%和40%，中风幸存者出现这些症状的可能性分别高出59%和52%。此外，与没有中风病史的人相比，中风幸存者出现严重心理困扰的可能性高出76%。
本研究结果凸显了心脏病发作或中风幸存者相对于没有这些疾病的成年人所经历的心理健康问题增加。它们强调了在经历过心脏病发作或中风的成年人中解决心理健康问题的重要性。
