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JAHA：缺血性心脏病心理因素的性别分层风险

2019-04-30 xing.T 网络

缺血性心脏病心理因素性别分层风险
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由此可见，心理因素与女性和男性的IHD事件有关，但女性和男性之间没有显著差异。IHD主要为阻塞性冠状动脉疾病，其在男性中更普遍。心理预测因子和IHD的其他表现需要额外的数据证明，如冠状动脉微血管疾病，这在女性中更为常见。

心理因素与发生缺血性心脏病（IHD）的风险增加有关。在IHD的女性中更多地报告了心理因素和性别差异。近日，心血管疾病领域权威杂志JAHA上发表了一篇研究文章，在这项荟萃分析中，研究人员分析了女性和男性IHD发病的心理因素风险。研究人员假设大量的心理因素与发生IHD的风险较高有关，对于女性风险更高。

研究人员检索了PubMed、EMBASE和PsycINFO等数据库，以评估心理因素和IHD之间的关系。心理因素包括抑郁、焦虑或恐慌症、社会支持、敌意、愤怒、性格（D型）、A型行为模式、创伤后应激障碍和心理困扰。

在初步分析中，研究人员纳入了62项研究（77份单独报告），其中包含2145679名妇女和3119879名男子，并报告了混杂因素调整后的风险比或相对风险。随机效应模型的混合效应混杂因素调整后的估计显示，女性（风险比：1.22; 95％CI为1.14-1.30）和男性（风险比：1.25; 95％CI为1.19-1.31）心理因素（所有组合）与IHD有关。这些汇总效应估计没有发现性别差异（P=0.547）。

由此可见，心理因素与女性和男性的IHD事件有关，但女性和男性之间没有显著差异。IHD主要为阻塞性冠状动脉疾病，其在男性中更普遍。心理预测因子和IHD的其他表现需要额外的数据证明，如冠状动脉微血管疾病，这在女性中更为常见。

原始出处：

Veerle R. Smaardijk.et al.Sex‐ and Gender‐Stratified Risks of Psychological Factors for Incident Ischemic Heart Disease: Systematic Review and Meta‐Analysis.JAHA.2019.https://www.ahajournals.org/doi/full/10.1161/JAHA.118.010859

本文系梅斯医学（MedSci）原创编译整理，转载需授权！

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    2019-11-25 guihongzh

    #缺血性#

    0

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    2019-05-06 zwjnj2

    学习学习努力学习

    0

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    2019-05-04 小豁牙

    哈哈

    0

  4. 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level=null, likeNumber=100, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/vi_32/iaAVWEsIJUkA1ITy3uL0lhHUhyaJibWgFtH4KbJuaLbY2WUK33jgCFyoZ8Eqx7eE7hCuZhytc1C5GRrfjVXN8lYg/0, createdBy=fcb82149579, createdName=183****7028, createdTime=Thu May 02 07:26:38 CST 2019, time=2019-05-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=365593, encodeId=dfd336559353, content=谢谢了，学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=57, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=30331616752, createdName=txqjm, createdTime=Thu May 02 05:05:58 CST 2019, time=2019-05-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=365575, encodeId=21963655e589, content=不错值得学习推荐, beContent=null, objectType=article, channel=null, level=null, likeNumber=58, 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    2019-05-04 小豁牙

    好文章，学习了

    0

  5. 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level=null, likeNumber=100, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/vi_32/iaAVWEsIJUkA1ITy3uL0lhHUhyaJibWgFtH4KbJuaLbY2WUK33jgCFyoZ8Eqx7eE7hCuZhytc1C5GRrfjVXN8lYg/0, createdBy=fcb82149579, createdName=183****7028, createdTime=Thu May 02 07:26:38 CST 2019, time=2019-05-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=365593, encodeId=dfd336559353, content=谢谢了，学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=57, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=30331616752, createdName=txqjm, createdTime=Thu May 02 05:05:58 CST 2019, time=2019-05-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=365575, encodeId=21963655e589, content=不错值得学习推荐, beContent=null, objectType=article, channel=null, level=null, likeNumber=58, 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    2019-05-02 天地飞扬

    了解一下，谢谢分享！

    0

  6. 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level=null, likeNumber=100, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/vi_32/iaAVWEsIJUkA1ITy3uL0lhHUhyaJibWgFtH4KbJuaLbY2WUK33jgCFyoZ8Eqx7eE7hCuZhytc1C5GRrfjVXN8lYg/0, createdBy=fcb82149579, createdName=183****7028, createdTime=Thu May 02 07:26:38 CST 2019, time=2019-05-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=365593, encodeId=dfd336559353, content=谢谢了，学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=57, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=30331616752, createdName=txqjm, createdTime=Thu May 02 05:05:58 CST 2019, time=2019-05-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=365575, encodeId=21963655e589, content=不错值得学习推荐, beContent=null, objectType=article, channel=null, level=null, likeNumber=58, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=650f104372, createdName=gcwu82, createdTime=Wed May 01 17:34:49 CST 2019, time=2019-05-01, status=1, ipAttribution=)]
    2019-05-02 仁心济世

    #AHA#

    0

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level=null, likeNumber=100, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/vi_32/iaAVWEsIJUkA1ITy3uL0lhHUhyaJibWgFtH4KbJuaLbY2WUK33jgCFyoZ8Eqx7eE7hCuZhytc1C5GRrfjVXN8lYg/0, createdBy=fcb82149579, createdName=183****7028, createdTime=Thu May 02 07:26:38 CST 2019, time=2019-05-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=365593, encodeId=dfd336559353, content=谢谢了，学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=57, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=30331616752, createdName=txqjm, createdTime=Thu May 02 05:05:58 CST 2019, time=2019-05-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=365575, encodeId=21963655e589, content=不错值得学习推荐, beContent=null, objectType=article, channel=null, level=null, likeNumber=58, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=650f104372, createdName=gcwu82, createdTime=Wed May 01 17:34:49 CST 2019, time=2019-05-01, status=1, ipAttribution=)]
    2019-05-02 ylz8403

    #缺血性心脏病#

    0

  8. 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level=null, likeNumber=100, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/vi_32/iaAVWEsIJUkA1ITy3uL0lhHUhyaJibWgFtH4KbJuaLbY2WUK33jgCFyoZ8Eqx7eE7hCuZhytc1C5GRrfjVXN8lYg/0, createdBy=fcb82149579, createdName=183****7028, createdTime=Thu May 02 07:26:38 CST 2019, time=2019-05-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=365593, encodeId=dfd336559353, content=谢谢了，学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=57, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=30331616752, createdName=txqjm, createdTime=Thu May 02 05:05:58 CST 2019, time=2019-05-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=365575, encodeId=21963655e589, content=不错值得学习推荐, beContent=null, objectType=article, channel=null, level=null, likeNumber=58, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=650f104372, createdName=gcwu82, createdTime=Wed May 01 17:34:49 CST 2019, time=2019-05-01, status=1, ipAttribution=)]
    2019-05-02 183****7028

    学习

    0

  9. 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replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=650f104372, createdName=gcwu82, createdTime=Wed May 01 17:34:49 CST 2019, time=2019-05-01, status=1, ipAttribution=)]
    2019-05-02 txqjm

    谢谢了，学习

    0

  10. 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level=null, likeNumber=100, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/vi_32/iaAVWEsIJUkA1ITy3uL0lhHUhyaJibWgFtH4KbJuaLbY2WUK33jgCFyoZ8Eqx7eE7hCuZhytc1C5GRrfjVXN8lYg/0, createdBy=fcb82149579, createdName=183****7028, createdTime=Thu May 02 07:26:38 CST 2019, time=2019-05-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=365593, encodeId=dfd336559353, content=谢谢了，学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=57, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=30331616752, createdName=txqjm, createdTime=Thu May 02 05:05:58 CST 2019, time=2019-05-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=365575, encodeId=21963655e589, content=不错值得学习推荐, beContent=null, objectType=article, channel=null, level=null, likeNumber=58, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=650f104372, createdName=gcwu82, createdTime=Wed May 01 17:34:49 CST 2019, time=2019-05-01, status=1, ipAttribution=)]
    2019-05-01 gcwu82

    不错值得学习推荐

    0

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由此可见，这些结果表明他汀类药物，特别是使用高剂量的他汀类药物，对缺血性心脏病的心衰患者具有良好的预后影响，无论低密度脂蛋白胆固醇水平如何。

Circulation：动物性食物与缺血性心脏病风险

由此可见，IHD风险与红肉和加工肉类的摄入呈正相关，与酸奶、奶酪和鸡蛋的摄入呈负相关，尽管与酸奶和鸡蛋的关联可能受到反向因果关系偏差的影响。目前尚不清楚与红肉和加工肉类以及奶酪的关联是否反映了因果关系，但这些食物与血浆非高密度脂蛋白胆固醇的关联与红肉和加工肉类与收缩压的关联相一致，其可以调节这种效应。

Int J Cardiol：他汀类药物对无缺血性心脏病的射血分数正常的心衰患者的疗效分析！

由此可见，他汀治疗与HFpEF患者，特别是那些没有IHD的患者的预后相关。

JCO：儿童癌症幸存者缺血性心脏病和卒中的预测

近日在JCO上发表的一篇文章研究预测了5年的儿童癌症幸存者发生缺血性心脏病和卒中的风险。

Heart：新西兰首次和复发性缺血性心脏病事件持续下降！

由此可见，在2005年至2015年期间，无论既往有无IHD，新西兰人IHD的住院率和死亡率均有大幅度下降，这些观察结果表明一级和二级预防的努力已在有效地减少IHD事件的发生。