Effect of Positive Well-Being on Incidence of Symptomatic Coronary Artery Disease
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- 作者：Lisa R. Yanek ; Brian G. Kral ; Taryn F. Moy ; Dhananjay Vaidya ; Mariana Lazo ; Lewis C. Becker ; Diane M. Becker
- 刊名：The American Journal of Cardiology
- 出版年：2013
- 出版时间：15 October, 2013
- 年：2013
- 卷：112
- 期：8
- 页码：1120-1125
- 全文大小：193 K
文摘
Although negative emotions and psychiatric morbidity have often been found to increase incident coronary artery disease (CAD) risk, fewer studies have shown positive emotions to be protective against CAD; none have been performed in high-risk healthy populations, taking risk factors into account. Thus, we examined the effect of positive well-being on incident CAD in both a high-risk initially healthy population and a national probability sample. We screened healthy siblings of probands with documented early-onset CAD from 1985 to 2007 in the GeneSTAR (Genetic Study of Atherosclerosis Risk) population and examined sociodemographic data, risk factors, and positive well-being using the General Well-Being Schedule. We further classified siblings into high-, intermediate-, and low-risk strata according to the Framingham risk score and followed them for 5 to 25?years. Siblings (n?= 1,483) with greater baseline General Well-Being Schedule total scores were significantly less likely to develop CAD (hazard ratio 0.67, 95 % confidence interval 0.58 to 0.79), independent of age, gender, race, and traditional risk factors. Protection was strongest in the high Framingham risk score stratum (hazard ratio 0.52, 95 % confidence interval 0.30 to 0.90). The findings were replicated in the first National Health and Nutrition Examination Survey and Epidemiologic Follow-up Study (n?= 5,992; hazard ratio 0.87, 95 % confidence interval 0.83 to 0.93). In conclusion, positive well-being was associated with nearly a 1/3 reduction in CAD in a high-risk population with a positive family history, a nearly 50 % reduction in incident CAD in the highest risk stratum in those with a positive family history, and a 13 % reduction in incident CAD in a national probability sample, independent of the traditional CAD risk factors.