September 11, 2011Open Access
View Full PaperCardiovascular disease risk factors in relation to suicide mortality in Asia: prospective cohort study of over one million Korean men and women
Key Result
In a 14-year cohort of over 1.2 million Korean adults, CVD risk factors including current smoking (HR 1.69; 95% CI 1.27-2.24) and underweight BMI were associated with increased suicide mortality.
Study Design
Type
Cohort (n=1,234,927)
Structured PICO
Are cardiovascular disease risk factors associated with future mortality from suicide in Korean adults?
P
Population
1,234,927 Korean men and women aged 30-95 years with baseline CVD risk factor measurements, followed for 14 years for suicide mortality.
E
Exposure
Cardiovascular disease risk factors (smoking, alcohol intake, blood cholesterol, BMI, stature, socioeconomic status, marital status, exercise, blood pressure)
C
Comparator
Lower risk categories or absence of risk factors (e.g., never smoking, normal weight, higher cholesterol)
O
Outcome
Mortality from suicidehard clinical
Established cardiovascular risk factors, including smoking, low BMI, and low cholesterol, are associated with an elevated risk of future suicide mortality in a large Korean cohort.
Main Result
Hazard Ratio: 1.69 (95% CI 1.27–2.24)
Abstract
AIMS: A potential role for cardiovascular disease (CVD) risk factors in the aetiology of suicide has not been comprehensively examined. In addition to being small in scale and poorly characterized, existing studies very rarely sample Asian populations in whom risk factor-suicide relationships may plausibly differ to Caucasian groups. We examined the association between a series of CVD risk factors and future mortality from suicide. METHODS AND RESULTS: The Korean Cancer Prevention Study is a prospective cohort study comprising 1 234 927 individuals (445 022 women) aged 30-95 years with extensive measurement of established CVD risk factors at baseline and subsequent mortality surveillance. Fourteen years of follow-up gave rise to 472 deaths (389 in men and 83 in women) from suicide. After adjustment for a range of covariates, in men, smoking hazard ratio; 95% CI: (current vs. never: 1.69; 1.27, 2.24), alcohol intake (1-24 g/day vs. none: 1.29; 1.00, 1.66), blood cholesterol (≥ 240 vs. <200 mg/dL: 0.54; 0.36, 0.80), body mass index (underweight vs. normal weight: 2.08; 1.26, 3.45), stature quartile 1(lowest) vs. 4: 1.68; 1.23, 2.30, socioeconomic status quartile 1(lowest) vs. 4: 1.65; 1.21, 2.24, and martial status (unmarried vs. other: 1.60; 0.83, 3.06) were related to suicide mortality risk. These associations were generally apparent in women, although of lower magnitude. Exercise and blood pressure were not associated with completed suicide. CONCLUSION: In this cohort of Korean men and women, a series of CVD risk factors were associated with an elevated risk of future suicide mortality.