马夫 易人北 微盘:研究称，抑郁有增加中风的风险

People with depression are more likely to have a stroke than their mentally healthy peers, and their strokes are more likely to be fatal, according to a new analysis published this week in the Journal of the American Medical Association.

  本周美国医学会期刊的一篇新的分析文章称，与那些心理健康的同伴相比，沮丧的人更容易得中风病，而且所得中风具有很可能是致命性的。

Depression is a relatively minor risk factor for stroke compared to high blood pressure (hypertension) and other health conditions and behaviors that damage blood vessels, the researchers say. Still, their analysis suggests that as many as 4% of the estimated 795,000 strokes that occur in the United States each year can be attributed to depression.

      研究者称，与损害血管的高血压和其他健康状况相比，沮丧只是中风的一个次要风险因素。尽管如此，他们的分析结果显示：美国每年预计有795,000中风患者，其中的4%是由沮丧情绪引起的。

"If you have depression but no other health issues, you probably don't have to pay too much attention to stroke risk," says An Pan, Ph.D., the lead author of the analysis and a research fellow at the Harvard School of Public Health, in Boston. "But if you are depressed and are also obese, or have hypertension or...unhealthy lifestyle factors, your risk is going to increase dramatically."

     ”如果你心情沮丧而没有其他健康问题，那你就没有必要太在意中风的事“，分析报告的第一作者兼哈佛公共卫生学院研究人员An Pan博士如是说。”但是，如果你不但沮丧同时还患有肥胖症，或者高血压或其他不健康的生活习惯的话，你患中风的几率就大大增加了“。

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Pan and his colleagues combined data from 28 studies dating back to the mid-1990s that included about 318,000 people overall. Roughly 2.7% of the participants had a stroke during the studies, which ranged in length from two to 29 years.

      Pan和他的同事们收集了自上世纪90年代中期以来共涵盖318,00人的28项研究。粗略统计，这28项研究时常从2年到29年不等。据粗略统计，参与这些研究的人中有2.7%得了中风。

Compared to those who showed no signs of depression, people who received a depression diagnosis from a doctor or who reported feeling depressed were 45% more likely to have a stroke and 55% more likely to die from a stroke, the researchers found.

     研究者们发现，与那些没有沮丧情绪的人相比，那些从医生那得到沮丧诊断书的人患中风的几率为45%，而那些自己感到沮丧的人死于中风的几率为55%。

Depression increased the risk of ischemic stroke, in which a blood vessel becomes blocked and cannot send blood to the brain. But it did not measurably raise the risk of the other major type, hemorrhagic stroke, in which a blood vessel leaks or bursts open.

     沮丧会导致缺血性中风，由于血管堵塞导致血液不能输送到大脑。但沮丧不会导致出血性中风即血管泄露或血管爆裂。

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The new study is the latest in a long line of research linking depression to chronic disease and serious physical health problems.

"We knew that depression raises a person's risk of developing diabetes, obesity, hypertension, and cardiovascular disease," Pan says. "We also knew that depression can occur after patients suffer a stroke. We just didn't have strong enough evidence to know if the reverse was true, or what really comes first."

    Pan说，”我们都知道抑郁回增加人患糖尿病，肥胖症，高血压和心血管疾病的风险，我们也知道病人中风后会抑郁。我们现在还没有明显的证据来证明中风和抑郁的先后关系。

Researchers have already established that depression increases the risk of heart attacks (and especially fatal ones), so it makes sense that depression would have a similar association with stroke, says Norman Rosenthal, M.D., a clinical professor of psychiatry at the Georgetown University School of Medicine, in Washington, D.C.

    研究者们已经证明抑郁会导致心脏病，这说明沮丧可能与中风有些关系。华盛顿乔治城大学医学院临床精神病学教授Norman Rosenthal如是说。

"Strokes and heart attacks both represent blood vessels becoming blocked and blood being withheld from a vital organ, whether it's the heart or the brain," says Rosenthal, who was not involved in the new study. "They're essentially the same disease."

    没有参与该项新研究的Rosenthal称，“中风和心脏病都表示血管开始堵塞，某个重要的器官血管堵塞可能是心脏可能是大脑。从本质上说，它们是同一类疾病。”

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Depression could contribute to strokes in many ways, Pan says. For starters, people who are depressed are more likely to smoke or drink heavily, to follow an unhealthy diet, and to neglect their personal health. Most of the studies included in the analysis controlled for these and other risk factors, but the data suggests that at least some of the stroke risk in depressed people can be explained by an unhealthy lifestyle.

     Pan说，沮丧会从许多方面导致中风的发生。开始阶段，沮丧的人可能会猛抽烟严重酗酒，饮食规律紊乱，对个人健康毫不在意。数据显示至少有些因抑郁而中风的人可归因于不健康的生活方式。

There are other possibilities, as well, that aren't as easily measured. Depression can increase the production of stress hormones in the body, for instance, and can trigger dangerous inflammation in the blood vessels. "Little things, like keeping up good dental hygiene or socializing with friends, all affect inflammation levels -- and these are things that a depressed person is less likely to do," says Rosenthal.

     当然也有其他的可能性，只是它们不容易判断。沮丧能增加应激激素，比如它能引发血管里的危险炎症。Rosenthal说“即使一件很小的事情，比如保持良好的个人卫生或与朋友们社交，都会影响炎症的水平——但这些事情抑郁的人就很少去做”。

Depression may also cause people to slack on taking medications needed to control other stroke-related conditions, such as diabetes or high blood pressure. On the other hand, some medications prescribed for depression -- most notably the class of drugs known as atypical antipsychotics -- have been shown to cause weight gain and obesity, a known risk factor for stroke.

     抑郁还可能引起人们通过减少摄药量来控制其他中风相关的情况比如糖尿病或者高血压。另一方面，有些药物是专门用来治疗抑郁的——抗精神病药物就是典型的药物——它们会导致体重增加和肥胖症，这是导致中风的危险因素。

More research is needed to determine whether depression drugs contribute to stroke risk. Doctors should monitor weight gain and blood pressure levels in patients taking these drugs, but there's no reason for patients to stop taking them, Pan says. "For now, physicians should prescribe medication if they think it is necessary, or if non-drug treatments haven't worked."

    抑郁类药物是否回导致中风还需要更多的研究。Pan说，医生们在病人服药时应该注意体重水平和血压水平，但病人没有理由停止服药。”目前，内科医生应该在自己认为需要开药或非药物治疗不起效果是再开药“。

Although depression isn't the most important risk factor for stroke, the researchers say it likely has a noticeable impact on the stroke rate. They estimate that depression is responsible for an additional 106 strokes per 100,000 people in the United States each year.

    尽管沮丧情绪不是中风的最重要的风险因素，但它也是导致中风的一个值得关注的因素。他们估计在美国每年10万人中会有106人因为沮丧还得中风。