Social Support and Stroke and Coronary Heart Disease: The JPHC Study Cohorts II

Abstract

Background and Purpose - Studies conducted in Western countries have found a robust association between social support and cardiovascular outcomes ( eg, prognosis after myocardial infarction and functional recovery after stroke). However, less is known about the influence of social support on the same outcomes among Asian populations. In this prospective cohort study, we sought to examine the impact of social support on the incidence and mortality of coronary heart disease and stroke among the Japanese.Methods - We examined prospectively the association between social support and risk of coronary heart disease and stroke incidence and mortality within a cohort of 44 152 Japanese men and women aged 40 to 69 years, free of previous diagnosis of cancer and cardiovascular disease. A total of 301 cases of newly diagnosed coronary heart disease, 1057 strokes, 191 coronary heart disease deaths, and 327 stroke deaths occurred between the baseline questionnaire ( 1993 - 1994) and the end of follow-up in January 2004.Results - The multivariate hazard ratios and 95% CI for stroke mortality in the highest social support versus lowest social support group was 1.45 ( 1.00 to 2.10) overall, 1.59 ( 1.01 to 2.51) for men, and 1.25 ( 0.63 to 2.46) for women. Social support was not associated with stroke incidence or coronary heart disease incidence and mortality.Conclusions - Low social support was associated with higher risk of stroke mortality in men. However, social support was not associated with stroke incidence, suggesting social support may be more important in stroke prognosis than preventing incidence.