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Eur Heart J. 2016 Mar 14;37(11):890-899. doi: 10.1093/eurheartj/ehv724. Epub 2016 Jan 7.

Coping strategies and risk of cardiovascular disease incidence and mortality: the Japan Public Health Center-based prospective Study.

Svensson T1,2,3, Inoue M1,2, Sawada N2, Yamagishi K4, Charvat H2, Saito I5, Kokubo Y6, Iso H7, Kawamura N8, Shibuya K1, Mimura M3, Tsugane S2; JPHC Study Group, Tsugane S, Tsugane S, Sawada N, Iwasaki M, Sasazuki S, Shimazu T, Yamaji T, Hanaoka T, Ogata J, Baba S, Mannami T, Okayama A, Kokubo Y, Miyakawa K, Saito F, Koizumi A, Sano Y, Hashimoto I, Ikuta T, Tanaba Y, Sato H, Roppongi Y, Takashima T, Miyajima Y, Suzuki N, Nagasawa S, Furusugi Y, Nagai N, Ito Y, Komatsu S, Minamizono T, Sanada H, Hatayama Y, Kobayashi F, Uchino H, Shirai Y, Kondo T, Sasaki R, Watanabe Y, Miyagawa Y, Kobayashi Y, Machida M, Kobayashi K, Tsukada M, Kishimoto Y, Takara E, Fukuyama T, Kinjo M, Irei M, Sakiyama H, Imoto K, Yazawa H, Seo T, Seiko A, Ito F, Shoji F, Saito R, Murata A, Minato K, Motegi K, Fujieda T, Yamato S, Matsui K, Abe T, Katagiri M, Suzuki M, Matsui K, Doi M, Terao A, Ishikawa Y, Tagami T, Sueta H, Doi H, Urata M, Okamoto N, Ide F, Goto H, Sakiyama H, Onga N, Takaesu H, Uehara M, Nakasone T, Yamakawa M, Horii F, Asano I, Yamaguchi H, Aoki K, Maruyama S, Ichii M, Takano M, Tsubono Y, Suzuki K, Honda Y, Yamagishi K, Sakurai S, Tsuchiya N, Kabuto M, Yamaguchi M, Matsumura Y, Sasaki S, Watanabe S, Akabane M, Kadowaki T, Inoue M, Noda M, Mizoue T, Kawaguchi Y, Takashima Y, Yoshida Y, Nakamura K, Takachi R, Ishihara J, Matsushima S, Natsukawa S, Shimizu H, Sugimura H, Tominaga S, Hamajima N, Iso H, Sobue T, Iida M, Ajiki W, Ioka A, Sato S, Maruyama E, Konishi M, Okada K, Saito I, Yasuda N, Kono S, Akiba S.

Author information

1
Department of Global Health Policy, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan.
2
Epidemiology and Prevention Group, Research Center for Cancer Prevention and Screening, National Cancer Center, 5-1-1 Tsukiji, Chuo-ku, Tokyo 104-0045, Japan.
3
Department of Neuropsychiatry, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan.
4
Department of Public Health Medicine, Faculty of Medicine, University of Tsukuba, Tsukuba, 1-1-1 Tendodai, Tsukuba-shi, Ibaraki 305-8577, Japan.
5
Department of Community Health Systems Nursing, Ehime University Graduate School of Medicine, 454 Shitsukawa, Toon, Ehime 791-0295, Japan.
6
Department of Preventive Cardiology, National Cerebral and Cardiovascular Center, 5-7-1 Fujishiro-dai, Suita, Osaka 565-8565, Japan.
7
Public Health, Department of Social and Environmental Medicine, Graduate School of Medicine, Osaka University, 2-2 Yamadaoka, Suita-shi, Osaka 565-0871, Japan.
8
Gyokikai Medical Corporation, Aoyama KK Building 7F, 2-26-35 Minami-Aoyama, Minato-ku, Tokyo 107-0062, Japan.

Abstract

AIMS:

Coping strategies may be significantly associated with health outcomes. This is the first study to investigate the association between baseline coping strategies and cardiovascular disease (CVD) incidence and mortality in a general population cohort.

METHODS AND RESULTS:

The Japan Public Health Center-based prospective Study asked questions on coping in its third follow-up survey (2000-04). Analyses on CVD incidence and mortality included 57 017 subjects aged 50-79 without a history of CVD and who provided complete answers on approach- and avoidance-oriented coping behaviours and strategies. Cox regression models, adjusted for confounders, were used to determine hazard ratios (HRs) according to coping style. Mean follow-up time was 7.9 years for incidence and 8.0 years for mortality.The premorbid use of an approach-oriented coping strategy was inversely associated with incidence of stroke (HR = 0.85; 95% CI, 0.73-1.00) and CVD mortality (HR = 0.74; 95% CI, 0.55-0.99). Stroke subtype analyses revealed an inverse association between the approach-oriented coping strategy and incidence of ischaemic stroke (HR = 0.79; 95% CI, 0.64-0.98) and a positive association between the combined coping strategy and incidence of intra-parenchymal haemorrhage (HR = 2.03; 95% CI, 1.01-4.10). Utilizing an avoidance coping strategy was associated with increased mortality from ischaemic heart disease (IHD) only in hypertensive individuals (HR = 3.46; 95% CI, 1.07-11.18). The coping behaviours fantasizing and positive reappraisal were associated with increased risk of CVD incidence (HR = 1.24; 95% CI, 1.03-1.50) and reduced risk of IHD mortality (HR = 0.63; 95% CI, 0.40-0.99), respectively.

CONCLUSION:

An approach-oriented coping strategy, i.e. proactively dealing with sources of stress, may be associated with significantly reduced stroke incidence and CVD mortality in a Japanese population-based cohort.

KEYWORDS:

Cohort; Coping; Incidence; Mortality; Myocardial infarction; Stroke

PMID:
26746633
DOI:
10.1093/eurheartj/ehv724
[Indexed for MEDLINE]

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