Vital Exhaustion and Biomarkers Associated With Cardiovascular Risk: The ARIC Study

Area of Science:

• Cardiology
• Psychosomatic Medicine
• Biomarker Research

Background:

• Vital exhaustion, characterized by fatigue, demoralization, and irritability from chronic stress, is an independent risk factor for cardiovascular disease (CVD).
• Understanding the link between vital exhaustion and CVD biomarkers is crucial for risk assessment.

Purpose of the Study:

• To investigate the association between vital exhaustion and key CVD risk biomarkers in a large cohort.
• To determine if vital exhaustion predicts incident CVD events and all-cause mortality.

Main Methods:

• Cross-sectional analysis of 11,542 participants from the Atherosclerosis Risk In Communities (ARIC) study without prevalent CVD.
• Assessed vital exhaustion using the Maastricht Vital Exhaustion Questionnaire (MVEQ) and measured cardiac biomarkers: high-sensitivity troponin T (hs-TnT), N-terminal pro-B-type natriuretic peptide (NT-proBNP), and high-sensitivity C-reactive protein (hs-CRP).
• Longitudinal analysis using Cox proportional hazard models to assess incident CVD events and all-cause mortality over 10- and 20-year follow-ups.

Main Results:

• Higher quartiles of vital exhaustion were significantly associated with elevated levels of hs-TnT, NT-proBNP, and hs-CRP.
• The highest quartile of vital exhaustion showed increased odds for elevated hs-TnT (OR 1.75), NT-proBNP (OR 1.40), and hs-CRP (OR 1.14).
• Combined presence of severe vital exhaustion symptoms and elevated biomarkers indicated a substantially greater risk for CVD events and all-cause mortality.

Conclusions:

• Vital exhaustion is associated with elevated CVD biomarkers (hs-TnT, NT-proBNP, hs-CRP) in middle-aged adults, independent of traditional risk factors.
• Assessing vital exhaustion symptoms alongside cardiac biomarker levels can enhance identification of individuals at higher risk for future CVD events and mortality.