title: Acute myocardial infarction: a comparison of the risk between physicians and the general population.
abstract: Physicians in Taiwan have a heavy workload and a stressful workplace, both of which may contribute to cardiovascular disease. However, the risk of acute myocardial infarction (AMI) in physicians is not clear. This population-based cohort study used Taiwan's National Health Insurance Research Database. We identified 28,062 physicians as the case group and randomly selected 84,186 nonmedical staff patients as the control group. We used a conditional logistic regression to compare the AMI risk between physicians and controls. Subgroup analyses of physician specialty, age, gender, comorbidities, area, and hospital level were also done. Physicians have a higher prevalence of HTN (23.59% versus 19.06%, P < 0.0001) and hyperlipidemia (21.36% versus 12.93%, P < 0.0001) but a lower risk of AMI than did the controls (adjusted odds ratio (AOR): 0.57; 95% confidence interval (CI): 0.46-0.72) after adjusting for DM, HTN, hyperlipidemia, and area. Between medical specialty, age, and area subgroups, differences in the risk for having an AMI were nonsignificant. Medical center physicians had a lower risk (AOR: 0.42; 95% CI: 0.20-0.85) than did local clinic physicians. Taiwan's physicians had higher prevalences of HTN and hyperlipidemia, but a lower risk of AMI than did the general population. Medical center physicians had a lower risk than did local clinic physicians. Physicians are not necessary healthier than the general public, but physicians, especially in medical centers, have a greater awareness of disease and greater access to medical care, which permits timely treatment and may prevent critical conditions such as AMI induced by delayed treatment.
authors: Department of Emergency Medicine, Chi-Mei Medical Center, Tainan, Taiwan.
authors: Yen-ting
authors: YT
authors: Chen
authors: Department of Emergency Medicine, Chi-Mei Medical Center, Tainan, Taiwan ; Department of Environmental and Occupational Health, College of Medicine, National Cheng Kung University, Tainan, Taiwan ; Department of Child Care and Education, Southern Taiwan University of Science and Technology, Tainan, Taiwan ; Department of Emergency Medicine, Kuo General Hospital, Tainan, Taiwan.
authors: Chien-Cheng
authors: CC
authors: Huang
authors: Department of Medical Research, Chi-Mei Medical Center, Tainan, Taiwan ; Department of Healthcare Administration and Medical Informatics, Kaohsiung Medical University, Kaohsiung, Taiwan.
authors: Shih-Feng
authors: SF
authors: Weng
authors: Department of Emergency Medicine, Chi-Mei Medical Center, Tainan, Taiwan ; Department of Biotechnology, Southern Taiwan University of Science and Technology, Tainan, Taiwan.
authors: Chien-Chin
authors: CC
authors: Hsu
authors: Department of Medical Research, Chi-Mei Medical Center, Tainan, Taiwan.
authors: Jhi-Joung
authors: JJ
authors: Wang
authors: Department of Emergency Medicine, Chi-Mei Medical Center, Tainan, Taiwan ; Department of Biotechnology, Southern Taiwan University of Science and Technology, Tainan, Taiwan ; Department of Emergency Medicine, Taipei Medical University, Taipei, Taiwan.
authors: Hung-Jung
authors: HJ
authors: Lin
authors: Department of Leisure, Recreation and Tourism Management, Southern Taiwan University of Science and Technology, Tainan, Taiwan ; Department of Occupational Medicine, Chi-Mei Medical Center, Tainan, Taiwan ; Department of Medical Research, Chi-Mei Medical Center, Liouying, Tainan, Taiwan.
authors: Shih-Bin
authors: SB
authors: Su
authors: Department of Environmental and Occupational Health, College of Medicine, National Cheng Kung University, Tainan, Taiwan ; Department of Occupational and Environmental Medicine, National Cheng Kung University Hospital, Tainan, Taiwan.
authors: How-Ran
authors: HR
authors: Guo
authors: Department of Emergency Medicine, Kuang-Tien General Hospital, Taichung, Taiwan ; Department of Nursing, Hungkuang University, Taichung, Taiwan.
authors: Chi-Wen
authors: CW
authors: Juan
mesh_terms: D000328:Adult; D015897:Comorbidity; D003710:Demography; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000453:epidemiology*; D010820:Physicians; D012307:Risk Factors; D013624:Taiwan / Q000453:epidemiology