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

Matthew R Deshotels1, Mahmoud Al Rifai2, Caroline Sun3

  • 1Section of Cardiology, Department of Medicine, Baylor College of Medicine, Houston, Texas, USA.

JACC. Advances
|November 14, 2024
PubMed

Insights

Vital exhaustion, a state of chronic stress, is linked to higher levels of cardiovascular disease (CVD) biomarkers. Identifying individuals with vital exhaustion and elevated biomarkers can predict increased risk of CVD events and mortality.

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.
Abstract

Keywords:
C-reactive protein (CRP)CVD (cardiovascular disease)NT-pro terminal BNP (NT-proBNP)cardiac biomarkerstroponin-Tvital exhaustion

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