Junmei Miao Jonasson1, Michael Hendryx2, Aladdin H Shadyab3, Erika Kelley4,5, Karen C Johnson6, Candyce H Kroenke7, Lorena Garcia8, Sofia Lawesson9, Ailiana Santosa10, Shawnita Sealy-Jefferson11, Xiaochen Lin12, Crystal W Cene13, Simin Liu12, Carolina Valdiviezo14, Juhua Luo15. 1. School of Public Health and Community Medicine at the Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden junmei.jonasson@gu.se. 2. Department of Environmental and Occupational Health, School of Public Health, Indiana University Bloomington, Bloomington, IN. 3. Department of Family Medicine and Public Health, School of Medicine, University of California San Diego, La Jolla, CA. 4. Department of Reproductive Biology, School of Medicine, Case Western Reserve University, Cleveland, OH. 5. Department of Obstetrics and Gynecology, University Hospitals MacDonald Women's Hospital, Cleveland, OH. 6. Department of Preventive Medicine, School of Medicine, University of Tennessee Health Science Center, Memphis, TN. 7. Division of Research, Kaiser Permanente Northern California, Oakland, CA. 8. Department of Public Health Sciences, School of Medicine, University of California Davis, Davis, CA. 9. Department of Health, Medicine and Caring Sciences, School of Medicine, Linköping University, Linköping, Sweden. 10. School of Public Health and Community Medicine at the Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden. 11. Department of Family Medicine and Population Health, Virginia Commonwealth University, Richmond, VA. 12. School of Public Health, Brown University, Providence, RI. 13. Department of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC. 14. MedStar Heart & Vascular Institute, MedStar Georgetown University Hospital, Washington, DC. 15. Department of Epidemiology and Biostatistics, School of Public Health, Indiana University Bloomington, Bloomington, IN.
Abstract
OBJECTIVE: We studied associations between social support, social network size, social strain, or stressful life events and risk of coronary heart disease (CHD) in postmenopausal women with type 2 diabetes. RESEARCH DESIGN AND METHODS: From the Women's Health Initiative, 5,262 postmenopausal women with type 2 diabetes at baseline were included. Cox proportional hazards regression models adjusted for demographics, depressive symptoms, anthropometric variables, and lifestyle factors were used to examine associations between social factors and CHD. RESULTS: A total of 672 case subjects with CHD were observed during an average 12.79 (SD 6.29) years of follow-up. There was a significant linear trend toward higher risk of CHD as the number of stressful life events increased (P for trend = 0.01; hazard ratio [HR] [95% CI] for the third and fourth quartiles compared with first quartile: 1.27 [1.03-1.56] and 1.30 [1.04-1.64]). Being married or in an intimate relationship was related to decreased risk of CHD (HR 0.82 [95% CI 0.69-0.97]). CONCLUSIONS: Among postmenopausal women with type 2 diabetes, higher levels of stressful life events were associated with higher risk of CHD. Experience of stressful life events might be considered as a risk factor for CHD among women with type 2 diabetes.
OBJECTIVE: We studied associations between social support, social network size, social strain, or stressful life events and risk of coronary heart disease (CHD) in postmenopausal women with type 2 diabetes. RESEARCH DESIGN AND METHODS: From the Women's Health Initiative, 5,262 postmenopausal women with type 2 diabetes at baseline were included. Cox proportional hazards regression models adjusted for demographics, depressive symptoms, anthropometric variables, and lifestyle factors were used to examine associations between social factors and CHD. RESULTS: A total of 672 case subjects with CHD were observed during an average 12.79 (SD 6.29) years of follow-up. There was a significant linear trend toward higher risk of CHD as the number of stressful life events increased (P for trend = 0.01; hazard ratio [HR] [95% CI] for the third and fourth quartiles compared with first quartile: 1.27 [1.03-1.56] and 1.30 [1.04-1.64]). Being married or in an intimate relationship was related to decreased risk of CHD (HR 0.82 [95% CI 0.69-0.97]). CONCLUSIONS: Among postmenopausal women with type 2 diabetes, higher levels of stressful life events were associated with higher risk of CHD. Experience of stressful life events might be considered as a risk factor for CHD among women with type 2 diabetes.
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