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روان شناسی و مشاوره::
بیماری عروق کرونر قلب، بیماری عروق کرونر قلب
In addition, fibrinogen is a blood coagulation factor that has been associated with coronary heart disease (CHD), and two studies have reported an
effects on incidence vs prognosis, Valtorta and colleagues performed a metaanalysis of studies on new CHD and/or stroke diagnosis as a function of
The meta-analysis included data from 11 CHD
No difference was found between the association of CHD incidence with loneliness or objective social isolation, so the
Results showed that poor social relationships were associated with a 29% increase in risk of incident CHD and a 32%،This personal disposition is assessed with the Spielberger Trait Anger Scale, which measures the frequency and intensity of angry affect.16 The cognitive dimension is hostility, which is conceptualized as cynical attitudes about others and most commonly assessed with the Cook-Medley Hostility (Ho), derived from the Minnesota Multiphasic Personality Inventory.17 Certain subscales of the Ho inventory, such as the Cynical distrust scale, have shown stronger associations for predicting CHD.18
Early results, based on subcomponent analyses,11,12,18,19 showed strong associations between anger/hostility and cardiac events or mortality in prospective studies, often of approximate magnitude to traditional risk factors, but the evidence has been more mixed since then.25 In a qualitative review,25 outcomes were assessed separately for samples without known CHD (coronary heart disease) and those with CHD (fatal or non fatal MI).
as did 1 of 3 studies for trait anger33 and 5 of 9 studies for anger expression.34,12,35-37 Another 2 of 9 studies were positive for subsamples: one for women only,38 and one for 48- to 59-year-olds only.39 In populations with known CHD (15 reports, of which 14 assessed fatal or nonfatal MI), only 1 of 6 had positive results for cynical hostility,40 2 of 3 (one of those marginal) for trait anger,41,42 and 2 of 6 for anger expression.43,44 Suls and Bunde25 concluded that the effects of hostility, trait anger, and anger expression were difficult to identify or might not apply in all populations, and that results in patient samples were "very weak and inconsistent with respect to anger, hostility, and anger expression" (p. 284).
A meta-analysis assessed the association between anger, hostility, and anger expression and CHD in prospective studies.45 Twenty-five studies reported CHD outcomes in initially healthy populations and 19 studies with CHD samples.45 The hazard ratio of 1.19 (95% CI: 1.05 to 1.35) indicated greater risk of CHD events associated with higher anger/hostility/expression in the healthy population studies.
A hazard ratio of 1.24 (95% CI: 1.08 to 1.42) for poorer prognosis (CHD mortality or events) was found in the patient sample studies.
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