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【文摘发布】恐怖活动、急性应激和心血管健康
A 3-Year National Study Following the September 11th Attacks
E. Alison Holman, FNP, PhD; Roxane Cohen Silver, PhD; Michael Poulin, PhD; Judith Andersen, PhD; Virginia Gil-Rivas, PhD; Daniel N. McIntosh, PhD
Arch Gen Psychiatry. 2008;65(1):73-80.
Context The terrorist attacks of 9/11 (September 11, 2001) present an unusual opportunity to examine prospectively the physical health impact of extreme stress in a national sample.
Objective To examine the degree to which acute stress reactions to the 9/11 terrorist attacks predict cardiovascular outcomes in a national probability sample over the subsequent 3 years.
Design, Setting, and Participants A national probability sample of 2729 adults (78.1% participation rate), 95.0% of whom had completed a health survey before 9/11 (final health sample, 2592), completed a Web-based assessment of acute stress responses approximately 9 to 14 days after the terrorist attacks. Follow-up health surveys reassessed physician-diagnosed cardiovascular ailments 1 (n = 1923, 84.3% participation rate), 2 (n = 1576, 74.2% participation rate), and 3 (n = 1950, 78.9% participation rate) years following the attacks.
Main Outcome Measures Reports of physician-diagnosed cardiovascular ailments over the 3 years following the attacks.
Results Acute stress responses to the 9/11 attacks were associated with a 53% increased incidence of cardiovascular ailments over the 3 subsequent years, even after adjusting for pre-9/11 cardiovascular and mental health status, degree of exposure to the attacks, cardiovascular risk factors (ie, smoking, body mass index, and number of endocrine ailments), total number of physical health ailments, somatization, and demographics. Individuals reporting high levels of acute stress immediately following the attacks reported an increased incidence of physician-diagnosed hypertension (rate ratios, 2.15 at 1 year and 1.75 at 2 years) and heart problems (rate ratios, 2.98 at 1 year and 3.12 at 2 years) over 2 years. Among individuals reporting ongoing worry about terrorism post-9/11, high 9/11-related acute stress symptoms predicted increased risk of physician-diagnosed heart problems 2 to 3 years following the attacks (rate ratios, 4.67 at 2 years and 3.22 at 3 years).
Conclusion Using health data collected before 9/11 as a baseline, acute stress response to the terrorist attacks predicted increased reports of physician-diagnosed cardiovascular ailments over 3 years following the attacks.
Author Affiliations: Program in Nursing Science (Dr Holman) and Departments of Psychology and Social Behavior and Medicine (Dr Silver), University of California, Irvine; Center for Behavioral and Decision Sciences in Medicine, University of Michigan, Ann Arbor (Dr Poulin); Department of Veterans Affairs Medical Center, Syracuse, New York (Dr Andersen); and Departments of Psychology, University of North Carolina, Charlotte (Dr Gil-Rivas), and University of Denver, Denver, Colorado (Dr McIntosh).
http://archpsyc.ama-assn.org/cgi/content/short/65/1/73 本人已认领该文编译，48小时后若未提交译文，请其他战友自由认领。
Terrorism, Acute Stress, and Cardiovascular Health
恐怖活动、急性应激和心血管健康
A 3-Year National Study Following the September 11th Attacks
——9/11 3年后的一项全国性研究
Context The terrorist attacks of 9/11 (September 11, 2001) present an unusual opportunity to examine prospectively the physical health impact of extreme stress in a national sample.
背景：9/11（2001年9月11日）的恐怖袭击为针对全国性样本前瞻性的研究极度应激对身体健康的影响提供了一个特殊的机会。
Objective To examine the degree to which acute stress reactions to the 9/11 terrorist attacks predict cardiovascular outcomes in a national probability sample over the subsequent 3 years.
目的 通过全国范围的随机样本探讨9/11恐怖袭击中的急性应激反应程度对随后3年心血管事件的预测。
Design, Setting, and Participants A national probability sample of 2729 adults (78.1% participation rate), 95.0% of whom had completed a health survey before 9/11 (final health sample, 2592), completed a Web-based assessment of acute stress responses approximately 9 to 14 days after the terrorist attacks. Follow-up health surveys reassessed physician-diagnosed cardiovascular ailments 1 (n = 1923, 84.3% participation rate), 2 (n = 1576, 74.2% participation rate), and 3 (n = 1950, 78.9% participation rate) years following the attacks.
设计、环境和参与者 全国范围内随机抽取2729个成年人（78.1％的参与率），其中95.0％在9/11之前完成过健康调查（最终完整样本，2592），他们在大约9-14天后完成了一项基于网页的急性应激反应评价。患者在恐怖袭击后1年（n = 1923, 参与率84.3%）、2年(n = 1576, 参与率74.2%)、3年(n = 1950, 参与率78.9%)接受健康调查重新评估医师诊断的心血管疾病。
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作者:admin@医学,生命科学 2011-07-31 17:14
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