Everson S A, Kauhanen J, Kaplan G A, Goldberg D E, Julkunen J, Tuomilehto J, Salonen J T
Human Population Laboratory, Public Health Institute, Berkeley, CA 94704-1011, USA.
Am J Epidemiol. 1997 Jul 15;146(2):142-52. doi: 10.1093/oxfordjournals.aje.a009245.
Cynical hostility has been associated with increased cardiovascular morbidity and mortality; yet few studies have investigated this relation in population-based samples, and little is known about underlying mechanisms. This study examined the association between hostility, measured by the eight-item Cynical Distrust Scale, and risk for all-cause and cardiovascular mortality and incident myocardial infarction. Subjects were 2,125 men, ages 42-60 years, from the Kuopio Ischemic Heart Disease Risk Factor Study, a longitudinal study of unestablished and traditional risk factors for ischemic heart disease, mortality, and other outcomes. There were 177 deaths (73 cardiovascular) in 9 years of follow-up. Men with hostility scores in the top quartile were at more than twice the risk of all-cause mortality (relative hazards (RH) 2.30, 95% confidence interval (CI) 1.47-3.59) and cardiovascular mortality (RH 2.70, 95% CI 1.27-5.76), relative to men with scores in the lowest quartile. Among 1,599 men without previous myocardial infarction or angina, high scorers also had an increased risk of myocardial infarction (RH 2.18, 95% CI 1.01-4.70). Biologic and socioeconomic risk factors, social support, and prevalent diseases had minimal impact on these associations, whereas adjustments for the behavioral risk factors of smoking, alcohol consumption, physical activity, and body mass index substantially weakened the relations. Simultaneous risk factor adjustment eliminated the observed associations. Results show that high levels of hostility are associated with increased risk of all-cause and cause-specific mortality and incident myocardial infarction and that these effects are mediated primarily through behavioral risk factors.
愤世嫉俗的敌意与心血管疾病发病率和死亡率的增加有关；然而，很少有研究在基于人群的样本中调查这种关系，对其潜在机制也知之甚少。本研究通过八项愤世嫉俗不信任量表测量敌意，研究了敌意与全因死亡率、心血管死亡率及心肌梗死发病风险之间的关联。研究对象为2125名年龄在42至60岁之间的男性，来自库奥皮奥缺血性心脏病危险因素研究，这是一项对缺血性心脏病、死亡率及其他结局的未确定和传统危险因素进行的纵向研究。在9年的随访中，有177人死亡（73人死于心血管疾病）。与敌意得分处于最低四分位数的男性相比，得分处于最高四分位数的男性全因死亡率风险（相对风险（RH）2.30，95%置信区间（CI）1.47 - 3.59）和心血管死亡率风险（RH 2.70，95% CI 1.27 - 5.76）高出两倍多。在1599名既往无心肌梗死或心绞痛的男性中，高分者心肌梗死风险也增加（RH 2.18，95% CI 1.01 - 4.70）。生物和社会经济危险因素、社会支持及常见疾病对这些关联影响极小，而对吸烟、饮酒、体育活动和体重指数等行为危险因素进行调整后，这些关系显著减弱。同时对危险因素进行调整消除了观察到的关联。结果表明，高度敌意与全因死亡率、特定病因死亡率及心肌梗死发病风险增加有关，且这些影响主要通过行为危险因素介导。
