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首页> 外文期刊>Psychosomatic Medicine: Journal of the American Psychosomatic Society >Psychological distress as a predictor of CHD events in men: the effect of persistence and components of risk.
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Psychological distress as a predictor of CHD events in men: the effect of persistence and components of risk.

机译：心理困扰是男性冠心病事件的预测因子：持久性的影响和风险的组成部分。

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OBJECTIVE: This paper examines the role of psychological distress in the etiology of coronary heart disease (CHD), with particular reference to the persistence of distress symptoms, the contribution that undetected CHD at baseline makes to the observed associations and to the effect of separate components of psychological distress. METHOD: 5449 men in an occupational cohort (79% of the total), with at least two prior measurements of the General Health Questionnaire (GHQ-30), were followed for CHD events (including CHD death, nonfatal myocardial infarction (MI), and angina) for (mean) 6.8 years. Psychological distress was measured using the GHQ-30, and general/anxiety, depression and sleep subscales were created based on a principal components analysis. RESULTS: Psychological distress increased the risk of CHD events, with the risk highest in men with recent onset of distress. Age-adjusted hazard ratios were 1.48 (1.03-2.13) for persistent and 1.77 (1.13-2.78) for new distress. Angina events accounted for much of the observed associations. This increased risk was independent of conventional CHD risk factors, markers of underlying CHD, or measures of reporting bias, and it was related to anxiety items and sleep disturbance rather than depressive symptoms. CONCLUSIONS: Psychological distress increases the risk of a future diagnosis of angina in men. This risk is not accounted for by the presence of underlying CHD. These results highlight the importance of identifying both the role of underlying atherosclerosis in the pathway linking distress to heart disease and the timing of action of the components of psychological distress.
机译：目的：本文探讨了心理困扰在冠心病（CHD）病因中的作用，特别是关于困扰症状的持续性，基线时未检测到的CHD对所观察到的联想和单独成分的影响的作用。心理困扰。方法：对职业队列中的5449名男性（占总数的79％）进行了至少两次先前的《一般健康状况调查表》（GHQ-30）测量，以进行冠心病事件（包括冠心病死亡，非致命性心肌梗塞（MI），和心绞痛）（平均）6.8年。使用GHQ-30测量了心理困扰，并基于主成分分析创建了一般/焦虑，抑郁和睡眠分量表。结果：心理困扰增加了冠心病事件的风险，在最近发生困扰的男性中风险最高。年龄调整后的持续性危险比为1.48（1.03-2.13），持久性危险为1.77（1.13-2.78）。心绞痛事件占观察到的关联的大部分。这种增加的风险与常规的冠心病危险因素，潜在冠心病的标志物或报告偏倚的措施无关，并且与焦虑症和睡眠障碍有关，而不是与抑郁症状有关。结论：心理困扰增加了男性心绞痛未来诊断的风险。潜在的CHD不能解释这种风险。这些结果凸显了确定潜在动脉粥样硬化在将困扰与心脏病联系的途径中的作用以及心理困扰各成分的作用时机的重要性。

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