Impact of psychosocial factors on cardiovascular morbimortality: a prospective cohort study
Cília Mejía-Lancheros, Ramón Estruch, Miguel-Angel Martínez-González
1Department of Paediatrics, Obstetrics, Gynaecology and Preventive Medicine, Universitat Autònoma de Barcelona, Bellaterra, Spain. mamunoz.bcn.ics@gencat.cat.
Insights
Low educational attainment increases stroke risk in high-risk adults. However, depression and low social support did not show a significant association with cardiovascular events in this population.
Area of Science:
- Cardiology
- Public Health
- Psychosocial Medicine
Background:
- Psychosocial factors are known contributors to cardiovascular diseases (CVD), but data on specific high-risk populations are limited.
- This study investigates the impact of psychosocial determinants on cardiovascular events and mortality in adults at high risk for CVD.
Purpose of the Study:
- To determine the contribution of educational attainment, depression, and social support to the risk of myocardial infarction, stroke, and CVD-related death.
- To analyze these associations in a high-risk adult population.
Main Methods:
- A longitudinal prospective study involving 7263 patients (57.5% women, mean age 67.0 years) initially free from CVD.
- Median follow-up was 4.8 years, with data collected between October 2003 and December 2010.
- Multivariate Cox regression models estimated Hazard Ratios (HRs) for cardiovascular events based on educational level, diagnosed depression, and social support.
Main Results:
- Stroke incidence was significantly associated with low educational level (HR: 1.83) in the entire cohort, and particularly in men (HR: 2.11).
- No significant associations were found between myocardial infarction, CVD mortality, and the psychosocial factors examined (educational attainment, depression, social support).
Conclusions:
- Low educational attainment is a risk factor for stroke in high-risk adults.
- Diagnosed depression and low social support were not found to be associated with increased cardiovascular disease incidence in this study population.
Background:
Whilst it is well known that psychosocial determinants may contribute to cardiovascular diseases (CVD), data from specific groups are scarce. The present study aims to determine the contribution of psychosocial determinants in increasing the risk of cardiovascular events (myocardial infarction and stroke), and death from CVD, in a high risk adult population.
Methods:
Longitudinal prospective study of 7263 patients (57.5% women), mean age 67.0 (SD 6.2) free from CVD but at high risk, with a median follow-up of 4.8 years (from October 2003 to December 2010). The Hazard Ratios (HRs) of cardiovascular events (myocardial infarction, stroke, and death from cardiovascular causes) related to educational attainment, diagnosed depression (based on medical records), and low social support (number of people living in the household) were estimated by multivariate Cox regression models.
Results:
Stroke incidence was associated with low educational level in the whole population (HR: 1.83, 95% CI: 1.09-3.09), and especially in men (HR: 2.11, 95% CI 1.09-4.06). Myocardial infarction and CVD mortality were not associated with any of the psychosocial factors considered.
Conclusion:
Adults with low educational level had a higher risk of stroke. Depression and low social support were not associated with CVD incidence.
Trial Registration:
Clinical trial registration information unique identifier: ISRCTN35739639.
