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. 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

Thomas Svensson  1   2   3 , Manami Inoue  1   2 , Norie Sawada  2 , Kazumasa Yamagishi  4 , Hadrien Charvat  2 , Isao Saito  5 , Yoshihiro Kokubo  6 , Hiroyasu Iso  7 , Noriyuki Kawamura  8 , Kenji Shibuya  1 , Masaru Mimura  3 , Shoichiro Tsugane  2 ; JPHC Study Group; S Tsugane, S Tsugane, N Sawada, M Iwasaki, S Sasazuki, T Shimazu, T Yamaji, T Hanaoka, J Ogata, S Baba, T Mannami, A Okayama, Y Kokubo, K Miyakawa, F Saito, A Koizumi, Y Sano, I Hashimoto, T Ikuta, Y Tanaba, H Sato, Y Roppongi, T Takashima, Y Miyajima, N Suzuki, S Nagasawa, Y Furusugi, N Nagai, Y Ito, S Komatsu, T Minamizono, H Sanada, Y Hatayama, F Kobayashi, H Uchino, Y Shirai, T Kondo, R Sasaki, Y Watanabe, Y Miyagawa, Y Kobayashi, M Machida, K Kobayashi, M Tsukada, Y Kishimoto, E Takara, T Fukuyama, M Kinjo, M Irei, H Sakiyama, K Imoto, H Yazawa, T Seo, A Seiko, F Ito, F Shoji, R Saito, A Murata, K Minato, K Motegi, T Fujieda, S Yamato, K Matsui, T Abe, M Katagiri, M Suzuki, K Matsui, M Doi, A Terao, Y Ishikawa, T Tagami, H Sueta, H Doi, M Urata, N Okamoto, F Ide, H Goto, H Sakiyama, N Onga, H Takaesu, M Uehara, T Nakasone, M Yamakawa, F Horii, I Asano, H Yamaguchi, K Aoki, S Maruyama, M Ichii, M Takano, Y Tsubono, K Suzuki, Y Honda, K Yamagishi, S Sakurai, N Tsuchiya, M Kabuto, M Yamaguchi, Y Matsumura, S Sasaki, S Watanabe, M Akabane, T Kadowaki, M Inoue, M Noda, T Mizoue, Y Kawaguchi, Y Takashima, Y Yoshida, K Nakamura, R Takachi, J Ishihara, S Matsushima, S Natsukawa, H Shimizu, H Sugimura, S Tominaga, N Hamajima, H Iso, T Sobue, M Iida, W Ajiki, A Ioka, S Sato, E Maruyama, M Konishi, K Okada, I Saito, N Yasuda, S Kono, S Akiba
Affiliations

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

Thomas Svensson et al. Eur Heart J. .

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.

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