Psychosocial factors and Risk of hard cardiovascular disease: The Multi-Ethnic Study of Atherosclerosis (MESA)

Background and Aim: Cardiovascular diseases (CVDs) are a group of abnormalities or disorders that involve the blood vessels and heart. The aim of this study is to investigate the role of various psychosocial factors such as depressive symptoms (CES-D), chronic stress burden (Chrbur), anxiety, and emotional social support (ESS) on the incidence of hard CVD (HCVD). Materials and Methods: We examined the relationship between psychological factors and incident of HCVD among 6,779 participants from the Multi-Ethnic Study of Atherosclerosis (MESA). CES-D, anxiety, Chrbur, ESS were measured using validated scales and physician reviewers adjudicated incident CVD events. We applied Cox proportional Hazards (PH) models to adjust for relevant demographic, behavioral, and other covariates. In the analyses, we included psychological factors in several following approaches: 1) Continuous; 2) categorical; and 3) spline approach. No violation of the PH was found. The preferred model was the one with the minimum AIC value. Results: During a median follow up of 8.46 years, 370 participants developed HCVD. There was not a statistical significant association between anxiety and HCVD hazard ratios (95%CI) for the highest versus the lowest category [HR=1.51 (0.80-2.86)]. Each 1point higher score for Chrbur (HR, 1.18; 95% CI, 1.08–1.29) and CES-D (HR, 1.02; 95% CI, 1.01–1.03) was associated with an increased risk of HCVD in separate models. In contrast, ESS (HR, 0.98; 95% CI, 0.96–0.99) was associated with a decreased risk of HCVD. Conclusion: higher levels of Chrbur and CES-D and lower levels of ESS are associated with significantly increased risk of incident CVD.

کلیدواژه ها:

Depressive Symptoms ، Anxiety ، Chronic Stress Burden ، Emotional Social Support ، Cardiovascular Disease