The cumulative effect of unemployment on risks for acute myocardial infarction.

نویسندگان

  • Matthew E Dupre
  • Linda K George
  • Guangya Liu
  • Eric D Peterson
چکیده

BACKGROUND Employment instability is a major source of strain affecting an increasing number of adults in the United States. Little is known about the cumulative effect of multiple job losses and unemployment on the risks for acute myocardial infarction (AMI). METHODS We investigated the associations between different dimensions of unemployment and the risks for AMI in US adults in a prospective cohort study of adults (N = 13,451) aged 51 to 75 years in the Health and Retirement Study with biennial follow-up interviews from 1992 to 2010. Unadjusted rates of age-specific AMI were used to demonstrate observed differences by employment status, cumulative number of job losses, and cumulative time unemployed. Cox proportional hazards models were used to examine the multivariate effects of cumulative work histories on AMI while adjusting for sociodemographic background and confounding risk factors. RESULTS The median age of the study cohort was 62 years, and 1061 AMI events (7.9%) occurred during the 165,169 person-years of observation. Among the sample, 14.0% of subjects were unemployed at baseline, 69.7% had 1 or more cumulative job losses, and 35.1% had spent time unemployed. Unadjusted plots showed that age-specific rates of AMI differed significantly for each dimension of work history. Multivariate models showed that AMI risks were significantly higher among the unemployed (hazard ratio, 1.35 [95% CI, 1.10-1.66]) and that risks increased incrementally from 1 job loss (1.22 [1.04-1.42]) to 4 or more cumulative job losses (1.63 [1.29-2.07]) compared with no job loss. Risks for AMI were particularly elevated within the first year of unemployment (hazard ratio, 1.27 [95% CI, 1.01-1.60]) but not thereafter. Results were robust after adjustments for multiple clinical, socioeconomic, and behavioral risk factors. CONCLUSIONS Unemployment status, multiple job losses, and short periods without work are all significant risk factors for acute cardiovascular events.

برای دانلود متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید

ثبت نام

اگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید

منابع مشابه

Prediction of long-term cardiac events by 123I-MIBG imaging after acute myocardial infarction and reperfusion therapy

Objective(s): In heart failure, the heart-to-mediastinum (H/M) ratio of the delayed image and washout rate (WR) are well-known as a powerful cardiac event predictors. H/M ratio quantifies the accumulation rate of MIBG in the myocardium and WR quantifies reduction of meta-iodobenzylguanidine (MIBG) accumulation in the heart from the early planar image to the delayed pla...

متن کامل

Impact of Age on Risk Factors and Clinical Manifestations of Acute Coronary Syndrome: Observations From the Coronary Care Unit of Sulaimani, Iraq

Background: ST-segment elevation myocardial infarction (STEMI) and non-ST-segment elevation myocardial infarction (NSTEMI ) are common types of acute coronary syndrome which are associated with the risk factors of age, obesity, hypertension, and diabetes. Objective: The present study aimed to examine the effects of age on the risk factors and clinical sym...

متن کامل

Evaluation of the role of opium addiction in acute myocardial infarction as a risk factor

Background: More than half of myocardial infracted (MI) patients have no conventional risk factors. Regarding the belief that opium addiction has a protective effect on heart diseases, addiction prevalence has unfortunately increased in recent years. This study was conducted to investigate the effect of opium addiction on patients with acute myocardial infarction. Methods: This case-control stu...

متن کامل

Assessment of Periodontal Parameters and Serum Markers in Patients with Acute Myocardial Infarction

Background: Cardiovascular disease is the leading cause of death in developed countries and is a disease that has many contributing factors. Periodontal disease is one of the factors contributing to the progression of the disease. The aim of this study was to investigate the effect of periodontal disease on the incidence of acute myocardial infarction. Methods: In this case-control study, 60 su...

متن کامل

Evaluation of Effect of Family-centered Intervention by SMS on Quality of Life of Patients with Acute Myocardial Infarction

Background & Aim: Patients with acute myocardial infarction (MI) need care due to the complications of the disease. This study aimed to evaluate the effect of the family-centered intervention on the quality of life of patients with acute MI. Materials and Methods: A randomized clinical trial study was conducted on 80 patients with acute myocardial infarction, who were hospitalized in Hajar and ...

متن کامل

ذخیره در منابع من


  با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید

برای دانلود متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید

ثبت نام

اگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید

عنوان ژورنال:
  • Archives of internal medicine

دوره 172 22  شماره 

صفحات  -

تاریخ انتشار 2012