Allostatic load in the association of depressive symptoms with incident coronary heart disease: The Jackson Heart Study.
African American
Allostatic load
Coronary heart disease
Depression
Metabolic
Women
Journal
Psychoneuroendocrinology
ISSN: 1873-3360
Titre abrégé: Psychoneuroendocrinology
Pays: England
ID NLM: 7612148
Informations de publication
Date de publication:
11 2019
11 2019
Historique:
received:
08
03
2019
revised:
24
06
2019
accepted:
28
06
2019
pubmed:
16
7
2019
medline:
24
6
2020
entrez:
16
7
2019
Statut:
ppublish
Résumé
African Americans are at heightened risk for coronary heart disease (CHD), with biologic pathways poorly understood. We examined the role of allostatic load (AL) in the association of depressive symptoms with incident CHD among 2,670 African American men and women in the prospective Jackson Heart Study. Depressive symptoms were quantified using the Center for Epidemiologic Studies Depression Scale (CES-D). Incident CHD was ascertained by self-report, death certificate survey, and adjudicated medical record surveillance. Baseline AL was quantified using biologic parameters of metabolic, cardiovascular, immune, and neuroendocrine subsystems and as a combined meta-factor. Sequential models adjusted for demographic, socioeconomic, and behavioral covariates, stratified to examine differences by sex. Greater depressive symptomatology was associated with greater metabolic, cardiovascular, and immune AL (p-values≤0.036) and AL meta-factor z-scores (p = 0.007), with findings driven by observations among females. Each 1-point increase in baseline depressive symptomatology, and 1-SD increase in metabolic AL, neuroendocrine AL, and AL meta-factor z-scores was associated with 3.3%, 88%, 39%, and 130% increases in CHD risk, respectively (p-values <0.001). Neuroendocrine AL and AL meta-factor scores predicted incident CHD among males but not females in stratified analyses. Metabolic AL partially mediated the association of depressive symptoms with incident CHD (5.79% mediation, p = 0.044), a finding present among females (p = 0.016) but not males (p = 0.840). Among African American adults, we present novel findings of an association between depressive symptomatology and incident CHD, partially mediated by metabolic AL. These findings appear to be unique to females, an important consideration in the design of targeted interventions for CHD prevention.
Identifiants
pubmed: 31307010
pii: S0306-4530(19)30195-7
doi: 10.1016/j.psyneuen.2019.06.020
pmc: PMC7232849
mid: NIHMS1584927
pii:
doi:
Types de publication
Journal Article
Research Support, N.I.H., Extramural
Langues
eng
Sous-ensembles de citation
IM
Pagination
104369Subventions
Organisme : NHLBI NIH HHS
ID : HHSN268201800012C
Pays : United States
Organisme : NIDDK NIH HHS
ID : K23 DK117041
Pays : United States
Organisme : NINR NIH HHS
ID : K23 NR017902
Pays : United States
Organisme : NIMHD NIH HHS
ID : HHSN268201800013I
Pays : United States
Organisme : NHLBI NIH HHS
ID : HHSN268201800011C
Pays : United States
Organisme : NHLBI NIH HHS
ID : HHSN268201800015I
Pays : United States
Organisme : NHLBI NIH HHS
ID : HHSN268201800014C
Pays : United States
Organisme : NCATS NIH HHS
ID : UL1 TR002733
Pays : United States
Informations de copyright
Copyright © 2019 Elsevier Ltd. All rights reserved.
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