Knox S S, Siegmund K D, Weidner G, Ellison R C, Adelman A, Paton C
National Heart, Lung, and Blood Institute, Bethesda, Maryland 20892-7936, USA.
Am J Cardiol. 1998 Nov 15;82(10):1192-6. doi: 10.1016/s0002-9149(98)00599-2.
This cross-sectional study investigated the association of hostility and social support to coronary heart disease (CHD) in 2 groups of men and women: those with a familial predisposition for CHD (high-risk sample) and a randomly selected group. The hypothesis was that hostility and low social support would be associated with CHD, and would have a greater effect in the high-risk group. The random sample contained 2,447 individuals (47.1% male) from 576 families, and the high-risk sample consisted of 2,300 people (45.5% male) from 542 families. Odds ratios (OR) and their 95% confidence intervals were calculated using generalized estimating equations (GEE) for logistic regression. Family was specified as the clustering variable, and robust SEEs were obtained to account for dependence of the data within families. After controlling for age, education, body mass index, exercise, smoking history, drinking history, and drinking >5 drinks a day, hostility was associated with a history of coronary bypass surgery or coronary angioplasty in high-risk men (OR 1.21) and a history of myocardial infarction in high-risk women (OR 1.39). High-risk women with high social support had reduced odds of a previous myocardial infarction (OR 0.76), whereas women with high network adequacy in the random sample had reduced risk of myocardial infarction (OR 0.41) and angina (OR 0.49). A ratio of high hostility to low social support was associated with past myocardial infarction in high-risk women (OR 2.47) and a history of angina (OR 2.02) in the random sample men. These results suggest that high hostility and low social support are associated with some manifestations of CHD after controlling for adverse health behaviors.
这项横断面研究调查了两组男性和女性中敌意和社会支持与冠心病（CHD）之间的关联：有冠心病家族易感性的人群（高危样本）和随机选择的一组人群。研究假设是，敌意和低社会支持与冠心病相关，并且在高危组中影响更大。随机样本包括来自576个家庭的2447人（47.1%为男性），高危样本包括来自542个家庭的2300人（45.5%为男性）。使用广义估计方程（GEE）进行逻辑回归计算比值比（OR）及其95%置信区间。将家庭指定为聚类变量，并获得稳健的标准误以考虑家庭内部数据的依赖性。在控制了年龄、教育程度、体重指数、运动、吸烟史、饮酒史和每日饮酒超过5杯后，敌意与高危男性的冠状动脉搭桥手术或冠状动脉成形术史相关（OR 1.21），与高危女性的心肌梗死史相关（OR 1.39）。社会支持高的高危女性发生既往心肌梗死的几率降低（OR 0.76），而随机样本中网络充足性高的女性发生心肌梗死（OR 0.41）和心绞痛（OR 0.49）的风险降低。高敌意与低社会支持之比与高危女性过去的心肌梗死相关（OR 2.47），与随机样本男性的心绞痛史相关（OR 2.02）。这些结果表明，在控制了不良健康行为后，高敌意和低社会支持与冠心病的某些表现相关。
