Medalie J H, Goldbourt U
Am J Med. 1976 May 31;60(6):910-21. doi: 10.1016/0002-9343(76)90921-9.
The major independent role played by anxiety and severe psychosocial problems (especially family ones) is demonstrated by this multivariate analysis of a five year prospective study of the development of new angina pectoris among almost 10,000 adult men (average annual incidence = 5.7/1,000). The independent effect of these two variables is considerably augmented by the other significant risk factors of age, total serum cholesterol, systolic or diastolic blood pressure, certain electrocardiographic abnormalities and diabetes mellitus. The presence of all seven risk factors (at a high level) increases the probability of angina pectoris developing within five years to 289/1,000 from 14/1,000, when these factors are low or absent. The wife's love and support is an important balancing factor, which apparently reduces the risk of angina pectoris even in the presence of high risk factors. The implications of these findings to the pathophysiology and prevention of angina are stressed.
对近10000名成年男性进行的为期五年的新发心绞痛发展前瞻性研究的多变量分析表明，焦虑和严重的社会心理问题（尤其是家庭问题）发挥了主要的独立作用（年均发病率=5.7/1000）。这两个变量的独立作用因年龄、总血清胆固醇、收缩压或舒张压、某些心电图异常和糖尿病等其他重要危险因素而显著增强。当所有七个危险因素（处于高水平）存在时，心绞痛在五年内发生的概率从这些因素水平低或不存在时的14/1000增至289/1000。妻子的关爱和支持是一个重要的平衡因素，即使在存在高风险因素的情况下，这一因素显然也能降低患心绞痛的风险。强调了这些发现对心绞痛病理生理学和预防的意义。
