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Associations of Stressful Life Events and Social Strain With Incident Cardiovascular Disease in the Women's Health Initiative

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,...

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Autores principales: Kershaw, Kiarri N., Brenes, Gretchen A., Charles, Luenda E., Coday, Mace, Daviglus, Martha L., Denburg, Natalie L., Kroenke, Candyce H., Safford, Monika M., Savla, Tina, Tindle, Hilary A., Tinker, Lesley F., Van Horn, Linda
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Blackwell Publishing Ltd 2014
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4309050/
https://www.ncbi.nlm.nih.gov/pubmed/24973226
http://dx.doi.org/10.1161/JAHA.113.000687
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author Kershaw, Kiarri N.
Brenes, Gretchen A.
Charles, Luenda E.
Coday, Mace
Daviglus, Martha L.
Denburg, Natalie L.
Kroenke, Candyce H.
Safford, Monika M.
Savla, Tina
Tindle, Hilary A.
Tinker, Lesley F.
Van Horn, Linda
author_facet Kershaw, Kiarri N.
Brenes, Gretchen A.
Charles, Luenda E.
Coday, Mace
Daviglus, Martha L.
Denburg, Natalie L.
Kroenke, Candyce H.
Safford, Monika M.
Savla, Tina
Tindle, Hilary A.
Tinker, Lesley F.
Van Horn, Linda
author_sort Kershaw, Kiarri N.
collection PubMed
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.
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spelling pubmed-43090502015-01-28 Associations of Stressful Life Events and Social Strain With Incident Cardiovascular Disease in the Women's Health Initiative Kershaw, Kiarri N. Brenes, Gretchen A. Charles, Luenda E. Coday, Mace Daviglus, Martha L. Denburg, Natalie L. Kroenke, Candyce H. Safford, Monika M. Savla, Tina Tindle, Hilary A. Tinker, Lesley F. Van Horn, Linda J Am Heart Assoc Original Research 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. Blackwell Publishing Ltd 2014-06-27 /pmc/articles/PMC4309050/ /pubmed/24973226 http://dx.doi.org/10.1161/JAHA.113.000687 Text en © 2014 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley Blackwell. This is an open access article under the terms of the Creative Commons Attribution‐NonCommercial (http://creativecommons.org/licenses/by-nc/3.0/) License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.
spellingShingle Original Research
Kershaw, Kiarri N.
Brenes, Gretchen A.
Charles, Luenda E.
Coday, Mace
Daviglus, Martha L.
Denburg, Natalie L.
Kroenke, Candyce H.
Safford, Monika M.
Savla, Tina
Tindle, Hilary A.
Tinker, Lesley F.
Van Horn, Linda
Associations of Stressful Life Events and Social Strain With Incident Cardiovascular Disease in the Women's Health Initiative
title Associations of Stressful Life Events and Social Strain With Incident Cardiovascular Disease in the Women's Health Initiative
title_full Associations of Stressful Life Events and Social Strain With Incident Cardiovascular Disease in the Women's Health Initiative
title_fullStr Associations of Stressful Life Events and Social Strain With Incident Cardiovascular Disease in the Women's Health Initiative
title_full_unstemmed Associations of Stressful Life Events and Social Strain With Incident Cardiovascular Disease in the Women's Health Initiative
title_short Associations of Stressful Life Events and Social Strain With Incident Cardiovascular Disease in the Women's Health Initiative
title_sort associations of stressful life events and social strain with incident cardiovascular disease in the women's health initiative
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4309050/
https://www.ncbi.nlm.nih.gov/pubmed/24973226
http://dx.doi.org/10.1161/JAHA.113.000687
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