受抑郁症影响的患者更有可能停止服用心脏病药物

1// Living near green spaces linked to lower mortality risk from non-communicable diseases

Lancet | 绿地与非传染性疾病的低死亡率有关

Scientists derived the association between greenspace measures and mortality by linking 2011 United Kingdom Census data of London-dwelling adults 18 years and older to data from the U.K. death registry and the Greenspace Information for Greater London resource.

科学家们通过将2011年英国18岁及以上居住在伦敦的成年人人口普查数据与英国死亡登记处和绿色伦敦空间信息的数据联系起来，得出了绿地和死亡率之间的联系。

A greenspace was defined as any freely accessible park or garden. The greenspace quantity was determined by measuring the percentage area of residential neighborhoods covered by parks or gardens. A total of 4,648,087 individuals who responded to the 2011 Census were included in the final analysis. The average age of the study cohort was about 48 years old, with 53.4% of the study cohort female. In terms of demographics, almost 67% of the participants were White, 12% South Asian, 9.7% Black, 1.3% Chinese, and 2.4% mixed.

绿地即任何可自由进入的公园或花园。绿地数量是通过测量公园或花园覆盖的居民区面积百分比来确定的。人口普查最终纳入数据为4648087名。研究队列的平均年龄约为48岁，其中53.4%为女性。就人口统计数据而言，几乎67%的参与者是白人，12%是南亚人，9.7%是黑人，1.3%是中国人，2.4%是混血儿。

During the mean follow-up period of 8.4 years, 8% of respondents had died. More specifically, 1.5% of the study cohort died due to cardiovascular disease, 2.1% because of cancer, 0.6% from respiratory disease, and less than 0.1% from type 2 diabetes.

在平均8.4年的随访期内，死亡人数占8%。具体而言，研究队列中有1.5%死于心血管疾病，2.1%死于癌症，0.6%死于呼吸系统疾病，不到0.1%死于二型糖尿病。

An induction in all-cause and cancer-related mortality risk was observed with every ten additional greenspace access points per km2 in residential neighborhoods. However, no association of greenspace access point density was observed with cardiovascular disease-, respiratory disease-, and diabetes-related mortality risks. Regarding park-specific greenspaces, a reduction in respiratory mortality risk was observed with every ten additional access points per km2 for pocket parks. In contrast, an induction in all-cause, cardiovascular, and cancer mortality risk was observed with every ten additional access points per km2 for small open spaces. 

在住宅区，每平方公里增加10个绿地接入点，全因死亡率和癌症风险降低。然而，没有观察到绿地接入点密度与心血管疾病、呼吸系统疾病和糖尿病的死亡风险相关。关于公园专用绿地，袖珍公园每平方公里增加10个接入点，呼吸系统相关死亡风险就会下降。相比之下，在小的开放空间，每平方公里每增加10个接入点，全因死亡率、心血管疾病和癌症相关死亡率均下降。

Both positive and negative associations between greenspace quantity and access to mortality risks were observed in the current study. Notably, the study findings indicate that a reduction in mortality risk may be achieved by increasing the quantity and access of pocket parks in urban areas.

当前的研究观察到绿地数量和死亡风险之间的积极和消极联系。值得注意的是，研究结果表明，可以通过增加城市地区袖珍公园的数量和入口来降低死亡风险。

2// Patients affected by depression more likely to stop taking their heart medications

ESC | 受抑郁症影响的患者更有可能停止服用心脏病药物

Patients who feel low when having a cardiac device implanted are more likely to stop taking their heart medications than those without depression, according to research presented today at ACNAP 2023, a scientific congress of the European Society of Cardiology (ESC).

2023欧洲心脏病学会（ESC）科学大会上公布的研究显示，针对植入心脏除颤器（ICD）的患者，情绪低落的患者比无抑郁的患者停止服用心脏药物的可能性更大。

This study examined whether anxiety and depression at the time of ICD implantation are associated with medication adherence one year after receiving the device. The study was a secondary analysis of the ACQUIRE-ICD randomized controlled trial of an eHealth intervention, which enrolled patients from all six implantation centers in Denmark. Of 478 patients in the trial with an ICD or an ICD with cardiac resynchronization therapy (CRT-D), 433 (91%) were taking at least one heart medication when their device was implanted. These included beta-blockers, ACE inhibitors, statins and diuretics. Of the 433 patients, 322 patients (74%) completed assessments of medication adherence at both baseline (implantation) and 12 months after implantation and were included in the current analyses. Depression scores at baseline were negatively associated with medication adherence at 12 months (p=0.02). The association with anxiety was not statistically significant.

这项研究调查了ICD植入时的焦虑和抑郁是否与接受该装置一年后的药物依从性有关。这项研究是对一项电子健康干预的ACQUIRE-ICD随机对照试验的二次分析，该试验招募了来自丹麦所有六个植入中心的患者。在接受心脏再同步化治疗的ICD或ICD试验的478名患者中，433名（91%）在植入ICD后至少需服用一种心脏病药物。这些药物包括β受体阻滞剂、ACE抑制剂、他汀类药物和利尿剂。在433名患者中，322名患者(74%)完成了基线和植入后12个月的药物依从性评估，并被纳入当前的分析。研究发现，基线时的抑郁评分与12个月时的药物依从性呈负相关（p=0.02），而焦虑与药物依从性的关联没有统计学意义。

These results highlight the importance of considering the psychological status of people receiving an ICD. Those with symptoms of depression at the time of implantation could be at risk of discontinuing their heart medications, even if they are taking them initially, and may need extra support.

这些研究结果强调了关注ICD患者心理状态的重要性。患者即使最初会服用心脏病药物，但仍可能会面临停药的风险，他们需要获得额外支持。

3// Is consuming ultra-processed foods associated with an increased risk of venous thromboembolisms?

食用过度加工食品是否会增加静脉血栓栓塞的风险？

In a recent study published in the Clinical Nutrition Journal, scientists examined the association between the consumption of ultra-processed foods and the risk of venous thromboembolisms using a prospective cohort from the United Kingdom (U.K.) Biobank.

在最近发表在《临床营养杂志》上的一项研究中，研究人员利用英国生物银行的一项前瞻性队列研究了过度加工食品的消费与静脉血栓栓塞风险之间的关系。

Large-scale industrial food processing has resulted in the surplus availability of ultra-processed foods that often have a high energy content in the form of added sugars and trans and saturated fatty acids, high sodium content, and relatively low nutritional or dietary fiber content.

大规模的工业食品加工带来的过度加工食品，通常添加了许多糖和反式/饱和脂肪酸，具有高能量、高钠、低的营养/膳食纤维的特点。

Many studies have reported the association between consuming ultra-processed foods and a host of diseases, including inflammatory bowel disease, cardiovascular disease, mental health disorders, and all-cause mortality.

许多研究报告了食用过度加工食品与许多疾病之间的联系，包括炎症性肠病、心血管疾病、精神健康障碍和全因死亡。

The increased consumption of ultra-processed foods has also directly been linked to abdominal obesity, impaired kidney function, and inflammation, which increase the risk of venous thromboembolism. Venous thromboembolism is a circulatory system disorder that results in blood clots in the veins and has a high economic burden and mortality risk.

过度加工食品消费的增加也与腹部肥胖、肾功能受损和炎症直接相关，这些都会增加静脉血栓栓塞的风险。静脉血栓栓塞是一种循环系统疾病，导致静脉凝血，并具有高经济负担和死亡风险。

*本文来源于双心视界