Josefina Robertson1, Linus Schiöler2, Kjell Torén2, Mia Söderberg2, Jesper Löve3, Margda Waern4, Annika Rosengren5, Maria Åberg6. 1. Department of Public Health and Community Medicine/Primary Health Care, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden. 2. Section of Occupational and Environmental Medicine, Department of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden. 3. Section of Social Medicine and Epidemiology, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden. 4. Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden. 5. Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden. 6. Department of Public Health and Community Medicine/Primary Health Care, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden. Electronic address: maria.aberg@gu.se.
Abstract
BACKGROUND: Recent research suggests that the prevalence of early heart failure may be on the rise. Compromised mental health in adolescence may help to explain this phenomenon. We aimed to investigate whether nonpsychotic mental disorder and low stress resilience in late adolescence were associated with increased risk of early heart failure. METHODS: A prospective cohort study of 18-year-old men (n=1,784,450) who enlisted 1968-2005. At the conscription examination, 74,522 individuals were diagnosed with nonpsychotic mental disorders. Stress resilience was rated by psychologists; values were trichotomized. The risk of heart failure during the 46-year follow-up was calculated with Cox proportional hazards models. Baseline comorbidities, BMI, blood pressure, fitness, IQ, and parental education were included in the models. RESULTS: Incident cases of heart failure (n=9962) were identified in the National Hospital Register. In fully adjusted models, increased risk of early heart failure was observed in males diagnosed with nonpsychotic mental disorders at conscription (hazard ratio (HR), 1.36; 95% confidence interval (CI), 1.25-1.47). The highest risk was seen among men with the risk factor alcohol/substance use (HR 1.90; 95% CI 1.59-2.28). Conscripts with the risk factor low stress resilience showed increased risk of heart failure compared to those with high scores (HR 1.41; 95% CI 1.30-1.53). CONCLUSION: Nonpsychotic mental disorder, as well as low stress resilience in late adolescence may be associated with increased risk of early heart failure. Adolescence is potentially an important time for mental health interventions that may reduce both short and long-term consequences.
BACKGROUND: Recent research suggests that the prevalence of early heart failure may be on the rise. Compromised mental health in adolescence may help to explain this phenomenon. We aimed to investigate whether nonpsychotic mental disorder and low stress resilience in late adolescence were associated with increased risk of early heart failure. METHODS: A prospective cohort study of 18-year-old men (n=1,784,450) who enlisted 1968-2005. At the conscription examination, 74,522 individuals were diagnosed with nonpsychotic mental disorders. Stress resilience was rated by psychologists; values were trichotomized. The risk of heart failure during the 46-year follow-up was calculated with Cox proportional hazards models. Baseline comorbidities, BMI, blood pressure, fitness, IQ, and parental education were included in the models. RESULTS: Incident cases of heart failure (n=9962) were identified in the National Hospital Register. In fully adjusted models, increased risk of early heart failure was observed in males diagnosed with nonpsychotic mental disorders at conscription (hazard ratio (HR), 1.36; 95% confidence interval (CI), 1.25-1.47). The highest risk was seen among men with the risk factor alcohol/substance use (HR 1.90; 95% CI 1.59-2.28). Conscripts with the risk factor low stress resilience showed increased risk of heart failure compared to those with high scores (HR 1.41; 95% CI 1.30-1.53). CONCLUSION:Nonpsychotic mental disorder, as well as low stress resilience in late adolescence may be associated with increased risk of early heart failure. Adolescence is potentially an important time for mental health interventions that may reduce both short and long-term consequences.
Authors: Martin Lindgren; Josefina Robertson; Martin Adiels; Maria Schaufelberger; Maria Åberg; Kjell Torén; Margda Waern; N David Åberg; Annika Rosengren Journal: ESC Heart Fail Date: 2020-04-28
Authors: Anwal Ghulam; Marialaura Bonaccio; Simona Costanzo; Alessandro Gialluisi; Federica Santonastaso; Augusto Di Castelnuovo; Chiara Cerletti; Maria Benedetta Donati; Giovanni de Gaetano; Francesco Gianfagna; Licia Iacoviello Journal: Int J Environ Res Public Health Date: 2021-12-25 Impact factor: 3.390