Associations of stressful life events and social strain with incident cardiovascular disease in the Women's Health Initiative

Details

• Personal Author:
  Brenes GA ; Charles LE ; Coday M ; Daviglus ML ; Denburg NL ; Kershaw KN ; Kroenke CH ; Safford MM ; Savla T ; Tindle HA ; Tinker LF ; Van Horn L
• Description:
  Background - Epidemiologic studies have yielded mixed findings on the association of psychosocial stressors with cardiovascular disease (CVD) risk. In this study, we examined associations of stressful life events (SLE) and social strain with incident coronary heart disease (CHD) and stroke (overall, and for hemorrhagic and ischemic strokes) independent of sociodemographic characteristics, and we evaluated whether these relationships were explained by traditional behavioral and biological risk factors. Methods and Results - Data from approximately 82,000 Women's Health Initiative Observational Study participants were used for the SLE and social strain analyses, respectively. Participants were followed for events for up to 18.0 years (median, 14.0). Separate Cox proportional hazards models were generated to estimate associations of each stress measure with incident CVD. After adjusting for sociodemographic characteristics and depressive symptoms, higher SLE and social strain were associated with higher incident CHD and stroke (each P trend <0.05). Hazard ratios and 95% confidence intervals were 1.12 (1.01, 1.25) for incident CHD and 1.14 (1.01, 1.28) for incident stroke among participants reporting high versus low SLE. Findings were similar for social strain. Associations were attenuated with further adjustment for mediating behavioral and biological risk factors. Findings were similar for associations of SLE with ischemic stroke and hemorrhagic stroke, but social strain was only associated with ischemic stroke. Conclusions - Higher SLE and social strain were associated with higher incident CVD independent of sociodemographic factors and depressive symptoms, but not behavioral and biological risk factors. [Description provided by NIOSH]
• Subjects:
  Behavior Biological Factors Cardiovascular Diseases Cardiovascular System Demography Epidemiology Mental Disorders Mental Health Occupational Health Risk Assessment Safety Stress, Psychological Women

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• Keywords:
  Author Keywords: Cardiovascular Diseases Biological-factors Cardiovascular-system Cardiovascular-system-disease Cardiovascular-system-disorders Demographic-characteristics Heart Mathematical-models Mental-disorders Psychological-stress Risk-analysis Sociological-factors Stress

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• ISSN:
  2047-9980
• Document Type:
  Text
• Genre:
  Journal Article
• Place as Subject:
  Alabama ; California ; Illinois ; Iowa ; North Carolina ; OSHA Region 10 ; OSHA Region 3 ; OSHA Region 4 ; OSHA Region 5 ; OSHA Region 7 ; OSHA Region 9 ; Pennsylvania ; Tennessee ; Virginia ; Washington ; West Virginia
• CIO:
  National Institute for Occupational Safety and Health (NIOSH)
• Division:
  HELD - Health Effects Laboratory Division
• Topic:
  Workplace Safety & Health
• Location:
  North America
• Volume:
  3
• Issue:
  3
• NIOSHTIC Number:
  nn:20045302
• Citation:
  J Am Heart Assoc 2014 Jun; 3(3):e000687
• Contact Point Address:
  Kiarri Kershaw, PhD, MPH, Northwestern University, 680 N Lake Shore Drive, Suite 1400, Chicago, IL 60611
• Email:
  k-kershaw@northwestern.edu
• Federal Fiscal Year:
  2014
• Peer Reviewed:
  True
• Source Full Name:
  Journal of the American Heart Association
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:3ba1bb8bb0de3582c8c519e00c4299c8adf2ac3583474e61f49ba1d9b66c3e042ef2b7253b45622c6e65c08677b454fdd147cb4d59be1e861145da3b9f285c55
• Download URL:
  https://stacks.cdc.gov/view/cdc/200765/cdc_200765_DS1.pdf
• File Type:
  [PDF - 777.88 KB ]