Stress, Resilience, and Cardiovascular Disease Risk Among Black Women.
Black or African American
/ psychology
Age Factors
Aged
Cardiovascular Diseases
/ diagnosis
Female
Humans
Incidence
Life Change Events
Middle Aged
Prognosis
Prospective Studies
Resilience, Psychological
Risk Assessment
Risk Management
Sex Factors
Social Behavior
Stress, Psychological
/ diagnosis
Time Factors
United States
/ epidemiology
Women's Health
/ ethnology
atherosclerosis
cardiovascular diseases
diabetes mellitus
hypertension
risk
Journal
Circulation. Cardiovascular quality and outcomes
ISSN: 1941-7705
Titre abrégé: Circ Cardiovasc Qual Outcomes
Pays: United States
ID NLM: 101489148
Informations de publication
Date de publication:
04 2019
04 2019
Historique:
entrez:
27
3
2019
pubmed:
27
3
2019
medline:
12
5
2020
Statut:
ppublish
Résumé
Empirical data on the link between stress and cardiovascular disease (CVD) risk among black women is limited. We examined associations of stressful life events and social strain with incident CVD among black women and tested for effect modification by resilience. Our analysis included 10 785 black women enrolled in the Women's Health Initiative Observational Study and Clinical Trials cohort. Participants were followed for CVD for up to 23 years (mean, 12.5). Multivariable Cox regression was used to estimate hazard ratios and 95% CIs for associations between stress-related exposures and incident CVD. We included interactions between follow-up time (age) and stressful life events because of evidence of nonproportional hazards. Effect modification by resilience was examined in the sub-cohort of 2765 women with resilience and stressful life events measures. Higher stressful life events were associated with incident CVD at ages 55 (hazard ratio for highest versus lowest quartile=1.80; 95% CI, 1.27-2.54) and 65 (hazard ratio for highest versus lowest quartile=1.40; 95% CI, 1.16-1.68), but not at older ages. Adjustment for CVD risk factors attenuated these associations. Similar associations were observed for social strain. In the sub-cohort of women with updated stressful life events and resilience measures, higher stressful life events were associated with incident CVD in multivariable-adjusted models (hazard ratio=1.61; 95% CI, 1.04-2.51). Resilience did not modify this association nor was resilience independently associated with incident CVD. In this cohort of older black women, recent reports of stressful life events were related to incident CVD. Resilience was unrelated to incident CVD. URL: https://www.clinicaltrials.gov . Unique identifier: NCT00000611.
Sections du résumé
BACKGROUND
Empirical data on the link between stress and cardiovascular disease (CVD) risk among black women is limited. We examined associations of stressful life events and social strain with incident CVD among black women and tested for effect modification by resilience.
METHODS AND RESULTS
Our analysis included 10 785 black women enrolled in the Women's Health Initiative Observational Study and Clinical Trials cohort. Participants were followed for CVD for up to 23 years (mean, 12.5). Multivariable Cox regression was used to estimate hazard ratios and 95% CIs for associations between stress-related exposures and incident CVD. We included interactions between follow-up time (age) and stressful life events because of evidence of nonproportional hazards. Effect modification by resilience was examined in the sub-cohort of 2765 women with resilience and stressful life events measures. Higher stressful life events were associated with incident CVD at ages 55 (hazard ratio for highest versus lowest quartile=1.80; 95% CI, 1.27-2.54) and 65 (hazard ratio for highest versus lowest quartile=1.40; 95% CI, 1.16-1.68), but not at older ages. Adjustment for CVD risk factors attenuated these associations. Similar associations were observed for social strain. In the sub-cohort of women with updated stressful life events and resilience measures, higher stressful life events were associated with incident CVD in multivariable-adjusted models (hazard ratio=1.61; 95% CI, 1.04-2.51). Resilience did not modify this association nor was resilience independently associated with incident CVD.
CONCLUSIONS
In this cohort of older black women, recent reports of stressful life events were related to incident CVD. Resilience was unrelated to incident CVD.
CLINICAL TRIALS REGISTRATION
URL: https://www.clinicaltrials.gov . Unique identifier: NCT00000611.
Identifiants
pubmed: 30909729
doi: 10.1161/CIRCOUTCOMES.118.005284
pmc: PMC6508630
mid: NIHMS1522703
doi:
Banques de données
ClinicalTrials.gov
['NCT00000611']
Types de publication
Journal Article
Observational Study
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't
Research Support, U.S. Gov't, Non-P.H.S.
Langues
eng
Sous-ensembles de citation
IM
Pagination
e005284Subventions
Organisme : NHLBI NIH HHS
ID : HHSN268201600002C
Pays : United States
Organisme : NCI NIH HHS
ID : K01 CA218457
Pays : United States
Organisme : NHLBI NIH HHS
ID : HHSN268201600003C
Pays : United States
Organisme : NHLBI NIH HHS
ID : HHSN268201600004C
Pays : United States
Organisme : NHLBI NIH HHS
ID : K01 HL142848
Pays : United States
Organisme : NHLBI NIH HHS
ID : HHSN268201600018C
Pays : United States
Organisme : NCI NIH HHS
ID : K12 CA133250
Pays : United States
Organisme : NHLBI NIH HHS
ID : HHSN268201600001C
Pays : United States
Commentaires et corrections
Type : CommentIn
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