Mario Sims1, Lá Shauntá M Glover2, Samson Y Gebreab3, Tanya M Spruill4. 1. Department of Medicine, University of Mississippi Medical Center, 350 W. Woodrow Wilson Avenue, Jackson, MS, 39213,, USA. msims2@umc.edu. 2. Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA. 3. National Institutes of Health, Rockville, MD, USA. 4. Department of Population Health, NYU School of Medicine, New York, USA.
Abstract
BACKGROUND: Racial disparities in cardiovascular disease (CVD) have been attributed in part to negative psychosocial factors. Prior studies have demonstrated associations between individual psychosocial factors and CVD risk factors, but little is known about their cumulative effects. METHODS: Using the Jackson Heart Study, we examined the cross-sectional associations of cumulative psychosocial factors with CVD risk factors among 5306 African Americans. We utilized multivariable Poisson regression to estimate sex-stratified prevalence ratios (PR 95% confidence interval-CI) of obesity, hypertension and diabetes prevalence and hypertension and diabetes control with negative affect (cynicism, anger-in, anger-out, depressive symptoms and cumulative negative affect) and stress (global stress, weekly stress, major life events-MLEs and cumulative stress), adjusting for demographics, socioeconomic status, and behaviors. RESULTS: After full adjustment, high (vs. low) cumulative negative affect was associated with prevalent obesity among men (PR 1.36 95% CI 1.16-1.60), while high (vs. low) cumulative stress was similarly associated with obesity among men and women (PR 1.24 95% CI 1.01-1.52 and PR 1.13 95% CI 1.03-1.23, respectively). Psychosocial factors were more strongly associated with prevalent hypertension and diabetes among men than women. For example, men who reported high cynicism had a 12% increased prevalence of hypertension (PR 1.12, 95% CI 1.03-1.23). Psychosocial factors were more strongly associated with lower hypertension and diabetes control for women than men. Women who reported high (vs. low) cynicism had a 38% lower prevalence of hypertension control (PR 0.62, 95% CI 0.46-0.84). CONCLUSIONS: Cumulative psychosocial factors were associated with CVD risk factors and disease management among African Americans. The joint accumulation of psychosocial factors was more associated with risk factors for men than women.
BACKGROUND: Racial disparities in cardiovascular disease (CVD) have been attributed in part to negative psychosocial factors. Prior studies have demonstrated associations between individual psychosocial factors and CVD risk factors, but little is known about their cumulative effects. METHODS: Using the Jackson Heart Study, we examined the cross-sectional associations of cumulative psychosocial factors with CVD risk factors among 5306 African Americans. We utilized multivariable Poisson regression to estimate sex-stratified prevalence ratios (PR 95% confidence interval-CI) of obesity, hypertension and diabetes prevalence and hypertension and diabetes control with negative affect (cynicism, anger-in, anger-out, depressive symptoms and cumulative negative affect) and stress (global stress, weekly stress, major life events-MLEs and cumulative stress), adjusting for demographics, socioeconomic status, and behaviors. RESULTS: After full adjustment, high (vs. low) cumulative negative affect was associated with prevalent obesity among men (PR 1.36 95% CI 1.16-1.60), while high (vs. low) cumulative stress was similarly associated with obesity among men and women (PR 1.24 95% CI 1.01-1.52 and PR 1.13 95% CI 1.03-1.23, respectively). Psychosocial factors were more strongly associated with prevalent hypertension and diabetes among men than women. For example, men who reported high cynicism had a 12% increased prevalence of hypertension (PR 1.12, 95% CI 1.03-1.23). Psychosocial factors were more strongly associated with lower hypertension and diabetes control for women than men. Women who reported high (vs. low) cynicism had a 38% lower prevalence of hypertension control (PR 0.62, 95% CI 0.46-0.84). CONCLUSIONS: Cumulative psychosocial factors were associated with CVD risk factors and disease management among African Americans. The joint accumulation of psychosocial factors was more associated with risk factors for men than women.
Authors: Ashley S Felix; Timiya S Nolan; LáShauntá M Glover; Mario Sims; Daniel Addison; Sakima A Smith; Cindy M Anderson; Barbara J Warren; Cheryl Woods-Giscombe; Darryl B Hood; Karen Patricia Williams Journal: J Racial Ethn Health Disparities Date: 2022-09-22
Authors: Jessica R Fernandez; Francisco A Montiel Ishino; Faustine Williams; Natalie Slopen; Allana T Forde Journal: J Am Heart Assoc Date: 2022-06-14 Impact factor: 6.106
Authors: Jee Won Park; Akilah J Dulin; Belinda L Needham; Mario Sims; Eric B Loucks; Joseph L Fava; Laura A Dionne; Matthew M Scarpaci; Charles B Eaton; Chanelle J Howe Journal: Front Cardiovasc Med Date: 2021-12-15
Authors: Jissy Cyriac; Sarah Jenkins; Christi A Patten; Sharonne N Hayes; Clarence Jones; Lisa A Cooper; LaPrincess C Brewer Journal: JMIR Mhealth Uhealth Date: 2021-11-12 Impact factor: 4.773
Authors: LáShauntá M Glover; Crystal W Cené; Alexander Reiner; Samson Gebreab; David R Williams; Kari E North; Mario Sims Journal: Healthcare (Basel) Date: 2021-05-28
Authors: Carl G Streed; Lauren B Beach; Billy A Caceres; Nadia L Dowshen; Kerrie L Moreau; Monica Mukherjee; Tonia Poteat; Asa Radix; Sari L Reisner; Vineeta Singh Journal: Circulation Date: 2021-07-08 Impact factor: 39.918