Psychosocial aspects and self-reporting of cardiovascular diseases in Brazilian adults.

The study aimed to evaluate the effect of psychosocial aspects on self-reporting of cardiovascular diseases (CVDs). The hypotheses were that psychosocial aspects have a direct or indirect effect on health behaviors, cardiovascular disease risk factors (CVDRFs) and CVDs. A cross-sectional population-based study was conducted with a representative sample of 1100 adults from the urban area of a medium-sized municipality in southern Brazil. Structured interviews were conducted using a standardized and pre-tested questionnaire. The psychosocial aspects included scales of resilience, quality of life, sense of coherence and social support. The outcomes were CVDs and CVDRFs measured by single items asking participants whether a physician had stated that they had heart disease, high blood pressure or high cholesterol/triglycerides or were overweight (BMI≥25 kg/m2). Data analysis was based on structural equation models. The final model exhibited good fit : (χ2[57] = 155, p < 0.001, root-mean-square error of approximation [RMSEA] = 0.042, confirmatory fit index [CFI] = 0.902 and standardized root-mean-square residual [SRMR] = 0.042). Consistent with our direct effect hypothesis, favorable psychosocial aspects were inversely associated with CVDRFS (β = -0.15, p = 0.011) and with CVDs (β = -0.10, p = 0.048). The indirect effect through health behaviors was not confirmed. The findings suggest that psychosocial aspects may influence the presence of self-reported CVDs or CVDRFS.