A modest protective association between pet ownership and cardiovascular diseases: A systematic review and meta-analysis

Purpose
Investigate the relationship between pet ownership and cardiovascular (CV) outcomes.
Methods
We searched the PubMed, Ovid EMBASE, Cumulative Index to Nursing and Allied Health Literature, Cochrane Database of Systematic Reviews, and Cochrane Central Register of Controlled Trials databases up to August 2018. Eligible publications examining the association between pet ownership and all-cause and CV mortality (primary outcomes) and risks of cardiovascular disease (CVD), myocardial infarction (MI), and stroke (secondary outcomes) were included. We used the Newcastle–Ottawa Scale to assess the quality of the articles.
Results
We included 12 studies, involving 488,986 participants (52.3% female, mean age 56.1 years), in our systematic review. The mean follow-up duration was 8.7 ± 6.3 years. Pet ownership had no association with adjusted all-cause mortality (odds ratio, OR = 1.01, 95% confidence interval, CI [0.94, 1.08], I2 = 76%), adjusted CV mortality (OR = 0.87, 95% CI [0.75, 1.00], I2 = 72%), or risk of cardiovascular disease (CVD) (OR = 0.87, 95% CI [0.72, 1.05], I2 = 73%), myocardial infarction (MI) (OR = 0.99, 95% CI [0.97, 1.01], I2 = 0%), or stroke (OR = 0.99, 95% CI [0.98, 1.01], I2 = 0%). However, subgroup analysis showed that pet ownership was associated with a lower adjusted CV mortality in the general population (OR = 0.93, 95% CI [0.86, 0.99], I2 = 27%) than in CVD patients. In patients with established CVD, pet ownership was associated with a lower adjusted CVD risk (OR = 0.71, 95% CI [0.60, 0.84], I2 = 0%).
Conclusion
Pet ownership is not associated with adjusted all-cause or CV mortality, or risk of CVD, MI, or stroke, but it is associated with a lower adjusted CV mortality in the general population and a lower CVD risk in patients with established CVD.

研究目的
探讨宠物饲养与心血管（cardiovascular, CV）结局之间的关联。

研究方法
我们检索了截至2018年8月的PubMed、Ovid EMBASE、护理及相关健康文献累积索引（Cumulative Index to Nursing and Allied Health Literature）、Cochrane系统评价数据库（Cochrane Database of Systematic Reviews）以及Cochrane对照试验中心注册库（Cochrane Central Register of Controlled Trials）。纳入符合条件的、探讨宠物饲养与全因死亡率及心血管死亡率（主要结局），以及心血管疾病（cardiovascular disease, CVD）、心肌梗死（myocardial infarction, MI）和卒中风险（次要结局）之间关联的文献。我们采用纽卡斯尔-渥太华量表（Newcastle–Ottawa Scale）评估文献质量。

研究结果
本系统评价共纳入12项研究，涉及488988名参与者（女性占52.3%，平均年龄56.1岁），平均随访时长为8.7±6.3年。宠物饲养与校正后全因死亡率无显著关联（比值比（odds ratio, OR）=1.01，95%置信区间（confidence interval, CI）[0.94, 1.08]，I²=76%）、校正后心血管死亡率（OR=0.87，95%CI [0.75, 1.00]，I²=72%），亦与心血管疾病（CVD）风险（OR=0.87，95%CI [0.72, 1.05]，I²=73%）、心肌梗死（MI）风险（OR=0.99，95%CI [0.97, 1.01]，I²=0%）及卒中风险（OR=0.99，95%CI [0.98, 1.01]，I²=0%）无显著关联。不过亚组分析显示，与心血管疾病患者相比，普通人群中宠物饲养与更低的校正后心血管死亡率相关（OR=0.93，95%CI [0.86, 0.99]，I²=27%）。在确诊心血管疾病的患者中，宠物饲养与更低的校正后CVD风险相关（OR=0.71，95%CI [0.60, 0.84]，I²=0%）。

研究结论
宠物饲养与校正后全因死亡率、心血管死亡率及CVD、MI、卒中风险均无显著关联，但在普通人群中与更低的校正后心血管死亡率相关，且在确诊心血管疾病的患者中与更低的CVD风险相关。