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Title: Psychological distress as a risk factor for death from cerebrovascular disease
Authors: Hamer, Mark
Kivimaki, Mika
Stamatakis, Emmanuel
Batty, G. David
Issue Date: 2012
Publisher: © Canadian Medical Association
Citation: HAMER, M. ...et al., 2012. Psychological distress as a risk factor for death from cerebrovascular disease. Canadian Medical Association Journal, 184(13), pp. 1461-1466.
Abstract: Background: Little is known about psychological risk factors in cerebrovascular disease. We examined the association between psychological distress and risk of death due to cerebrovascular disease. Methods: We obtained data from 68 652 adult participants of the Health Survey for England (mean age 54.9 [standard deviation 13.9] yr, 45.0% male sex) with no known history of cardiovascular diseases at baseline. We used the 12-item General Health Questionnaire (GHQ-12) to assess the presence of psychological distress. We followed participants for eight years for cause-specific death using linkage to national registers. Results: There were 2367 deaths due to cardiovascular disease during follow-up. Relative to participants with no symptoms of psychological distress (GHQ-12 score 0) at baseline, people with psychological disress (GHQ-12 score ≥ 4, 14.7% of participants) had an increased risk of death from cerebrovascular disease (adjusted hazard ratio [HR] 1.66, 95% confidence interval [CI] 1.32–2.08) and ischemic heart disease (adjusted HR 1.59, 95% CI 1.34–1.88). There was also evidence of a dose–response effect with increasing GHQ-12 score (p for trend < 0.001 in all analyses). Associations were only marginally attenuated after we adjusted for possible confounders, including socioeconomic status, smoking and use of antihypertensive medications. Interpretation: Psychological distress was associated with increased risk of death due to cerebrovascular disease in a large population representative cohort. These data suggest that the cardiovascular effects of psychological distress are not limited to coronary artery disease.
Description: This paper is posted with the permission of the publisher and it is not to be reproduced.
Version: Published
DOI: 10.1503/cmaj.111719
URI: https://dspace.lboro.ac.uk/2134/19203
Publisher Link: http://dx.doi.org/10.1503/cmaj.111719
ISSN: 0008-4409
Appears in Collections:Published Articles (Sport, Exercise and Health Sciences)

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