Kubzansky L D, Kawachi I, Spiro A, Weiss S T, Vokonas P S, Sparrow D
Department of Health and Social Behavior, Harvard School of Public Health, Boston, MA 02120, USA.
Circulation. 1997 Feb 18;95(4):818-24. doi: 10.1161/01.cir.95.4.818.
Worry is an important component of anxiety, which recent work suggests is related to increased incidence of coronary heart disease (CHD). Chronic worry has also been associated with decreased heart rate variability. We hypothesized that high levels of worry may increase CHD risk.
We examined prospectively the relationship of worry with CHD incidence in the Normative Aging Study, an ongoing cohort of older men. In 1975, 1759 men free of diagnosed CHD completed a Worries Scale, indicating the extent to which they worried about each of five worry domains: social conditions, health, financial, self-definition, and aging. During 20 years of follow-up, 323 cases of incident CHD occurred: 113 cases of nonfatal myocardial infarction (MI); 86 cases of fatal CHD; and 124 cases of angina pectoris. Worry about social conditions was the domain most strongly associated with incident CHD. Compared with men reporting the lowest levels of social conditions worry, men reporting the highest levels had multivariate adjusted relative risks of 2.41 (95% CI, 1.40 to 4.13) for nonfatal MI and 1.48 (95% CI, 0.99 to 2.20) for total CHD (nonfatal MI and fatal CHD). A dose-response relation was found between level of worry and both nonfatal MI (P for trend, .002) and total CHD (P for trend, .04).
These results suggest that high levels of worry in specific domains may increase the risk of CHD in older men.
担忧是焦虑的一个重要组成部分，近期研究表明它与冠心病（CHD）发病率增加有关。慢性担忧还与心率变异性降低有关。我们假设高水平的担忧可能会增加患冠心病的风险。
在规范性衰老研究中，我们前瞻性地研究了担忧与冠心病发病率之间的关系，该研究是一个正在进行的老年男性队列研究。1975年，1759名未被诊断患有冠心病的男性完成了一份担忧量表，该量表表明了他们对五个担忧领域（社会状况、健康、财务、自我定义和衰老）中每一个领域的担忧程度。在20年的随访期间，发生了323例冠心病事件：113例非致命性心肌梗死（MI）；86例致命性冠心病；124例心绞痛。对社会状况的担忧是与冠心病事件最密切相关的领域。与报告社会状况担忧水平最低的男性相比，报告最高水平的男性发生非致命性心肌梗死的多变量调整相对风险为2.41（95%CI，1.40至4.13），发生总冠心病（非致命性心肌梗死和致命性冠心病）的多变量调整相对风险为1.48（95%CI，0.99至2.20）。在担忧水平与非致命性心肌梗死（趋势P值，.002）和总冠心病（趋势P值，.04）之间均发现了剂量反应关系。
这些结果表明，特定领域的高水平担忧可能会增加老年男性患冠心病的风险。
