STRESS AND CORONARY HEART DISEASES THREE SPECIFC PROBLEMS IN RESEARCH 蒋捷宇11307120074
Glossary ← Coronary heart disease(CHD)慢性心脏病 e Follow-up 随访 e Hazard ratio 风险率 ∈Meta- analysis 荟萃分析 e Antecedents 前因
Glossary Coronary heart disease (CHD) 慢性心脏病 Follow-up 随访 Hazard ratio 风险率 Meta-analysis 荟萃分析 Antecedents 前因
Identify the stress Child Adult Abuse ∈ Work stress ∈ Parental disease Sick spouse Poor socioeconomic < Death of kids cIrcumstance
Child Abuse Parental disease Poor socioeconomic circumstance Adult Work stress Sick spouse Death of kids
Study Exposure Relative risk(95%Ci) %Weight Patterson 2010, men and women Loneliness 1.22069216) 10.1 Thurston 2009. men Loneliness 098(050.1.92) 8.0 Thurston 2009, women Loneliness 2.11(143,3.11) 158 Olsen 1991, men Loneliness 1.70(103,281) 11.9 Olsen 1991, women Loneliness 1.09(0.79150 186 Heffner 2011, men and women Isolation 240(1.03.559) 5.6 Eng 2002, men Isolation 182(102325) 99 Orth-Gomer 1993. men Isolation 380(1.1013.13) 2.9 Kaplan 1988, men Isolation 134(094,191) 17.2 Overall (I-squared =38.9%6, p=0. 109) 1.51(121,188) 0.5 1.5235 Relative risk(95% Cl)
Pre-clinical CHD sufferers <Who get CHD soon after stress assessment Reduce working hours Low stress level Get CHD
Reduce working hours Low stress level Who get CHD soon after stress assessment
Solution Events total 间)间 Events(n) Total (n) Follow-up Whitehall IF 382 10250 Fist)yeas exduded(3) -4)1824 19699 13154 Still Working 729 9129 First 5 years excluded (9 studies) "94 0 1411 80247 130(1150 WOLF-S2 106 5653 m148(087-252) IPAW-7 35 2022 158(072-349) WOLF-N 4678 125(074-211) 1724 188(089-395) 11237 122(086-173) POLS 24473 106(073-153) SSup 67 16345 104(053-204) DWECS 3 5463 127(068-2:36) 47373 090(051-159) NWCS 44900 119(073-193) Overall (<0-1%, p=o-895 123(110-137
Solution
Common soil " hypothesis Common ommon antecedents soil e Pathophysiological e Behavioral K Environmental Stress CHD
”Common soil” hypothesis Common antecedents Pathophysiological Behavioral Environmental Common soil Stress CHD
Solution e Cause of chd e Trigger for heart attacks < Poor prognostic indicator
Solution Cause of CHD Trigger for heart attacks Poor prognostic indicator
Take home message ∈ Identify the stress e Specific start point e Troublemakers e Confounders ∈" Common soil" hypothesis∈ Logic tricks
Take home message Identify the stress Troublemakers ”Common soil” hypothesis Specific start point Confounders Logic tricks
Reference e Kivimaki, M, et al, Job strain as a risk factor for coronary heart disease: a collaborative meta-analysis of individual participant data. Lancet, 2012. 380(9852): p 1491-7 Virtanen, M, et al., Overtime work and incident coronary heart disease: the Whitehall l prospective cohort study. Eur Heart), 2010. 31(14): p 1737-44 Steptoe, A. and M. Kivimaki, Stress and cardiovascular disease. Nat Rev cardiol, 2012 9(6:p.360-70 Steptoe, A and M. Kivimaki, Stress and cardiovascular disease: an update on current knowledge. Annu Rev Public Health, 2013. 34: p. 337-54 nfarction in Japan: case-control study. BM) 1998. 317(7/161): p. 775-o0 te myocardial Sokejima, S and S. Kagamimori, Working hours as a risk factor for acu
Reference Kivimaki, M., et al., Job strain as a risk factor for coronary heart disease: a collaborative meta-analysis of individual participant data. Lancet, 2012. 380(9852): p. 1491-7. Virtanen, M., et al., Overtime work and incident coronary heart disease: the Whitehall II prospective cohort study. Eur Heart J, 2010. 31(14): p. 1737-44. Steptoe, A. and M. Kivimaki, Stress and cardiovascular disease. Nat Rev Cardiol, 2012. 9(6): p. 360-70. Steptoe, A. and M. Kivimaki, Stress and cardiovascular disease: an update on current knowledge. Annu Rev Public Health, 2013. 34: p. 337-54. Sokejima, S. and S. Kagamimori, Working hours as a risk factor for acute myocardial infarction in Japan: case-control study. BMJ, 1998. 317(7161): p. 775-80