Associations of stressful life events and social strain with incident cardiovascular disease in the Women's Health Initiative

Kiarri N Kershaw; Gretchen A Brenes; Luenda E Charles; Mace Coday; Martha L Daviglus; Natalie L Denburg; Candyce H Kroenke; Monika M Safford; Tina Savla; Hilary A Tindle; Lesley F Tinker; Linda Van Horn

doi:10.1161/JAHA.113.000687

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Associations of stressful life events and social strain with incident cardiovascular disease in the Women's Health Initiative

Journal article

Open access

Associations of stressful life events and social strain with incident cardiovascular disease in the Women's Health Initiative

Kiarri N Kershaw, Gretchen A Brenes, Luenda E Charles, Mace Coday, Martha L Daviglus, Natalie L Denburg, Candyce H Kroenke, Monika M Safford, Tina Savla, Hilary A Tindle, …

Journal of the American Heart Association, Vol.3(3), pp.e000687-n/a

06/27/2014

DOI: 10.1161/JAHA.113.000687

PMCID: PMC4309050

PMID: 24973226

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Abstract

Epidemiologic studies have yielded mixed findings on the association of psychosocial stressors with cardiovascular disease (CVD) risk. In this study, we examined associations of stressful life events (SLE) and social strain with incident coronary heart disease (CHD) and stroke (overall, and for hemorrhagic and ischemic strokes) independent of sociodemographic characteristics, and we evaluated whether these relationships were explained by traditional behavioral and biological risk factors. Data from approximately 82 000 Women's Health Initiative Observational Study participants were used for the SLE and social strain analyses, respectively. Participants were followed for events for up to 18.0 years (median, 14.0). Separate Cox proportional hazards models were generated to estimate associations of each stress measure with incident CVD. After adjusting for sociodemographic characteristics and depressive symptoms, higher SLE and social strain were associated with higher incident CHD and stroke (each P trend <0.05). Hazard ratios and 95% confidence intervals were 1.12 (1.01, 1.25) for incident CHD and 1.14 (1.01, 1.28) for incident stroke among participants reporting high versus low SLE. Findings were similar for social strain. Associations were attenuated with further adjustment for mediating behavioral and biological risk factors. Findings were similar for associations of SLE with ischemic stroke and hemorrhagic stroke, but social strain was only associated with ischemic stroke. Higher SLE and social strain were associated with higher incident CVD independent of sociodemographic factors and depressive symptoms, but not behavioral and biological risk factors.

Cardiovascular Diseases - etiology

United States - epidemiology

Age Factors

Humans

Life Change Events

Middle Aged

Psychology

Risk Factors

Proportional Hazards Models

Coronary Disease - etiology

Coronary Disease - epidemiology

Socioeconomic Factors

Incidence

Stroke - etiology

Women's Health - statistics & numerical data

Cardiovascular Diseases - epidemiology

Female

Stroke - epidemiology

Aged

Stress, Psychological - complications

Cohort Studies

Details

Title: Subtitle: Associations of stressful life events and social strain with incident cardiovascular disease in the Women's Health Initiative
Creators: Kiarri N Kershaw - Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL (K.N.K., M.L.D., L.V.H.)
Gretchen A Brenes - Department of Psychiatry, Wake Forest School of Medicine, Winston-Salem, NC (G.A.B.)
Luenda E Charles - National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Morgantown, WV (L.E.C.)
Mace Coday - Departments of Preventive Medicine and Psychiatry, University of Tennessee Health Science Center, Memphis, TN (M.C.)
Martha L Daviglus - Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL (K.N.K., M.L.D., L.V.H.) Department of Medicine, University of Illinois at Chicago, Chicago, IL (M.L.D.)
Natalie L Denburg - Department of Neurology, University of Iowa Carver College of Medicine, Des Moines, IA (N.L.D.)
Candyce H Kroenke - Kaiser Permanente Division of Research, Oakland, CA (C.H.K.)
Monika M Safford - Department of Medicine, University of Alabama Birmingham, Birmingham, AL (M.M.S.)
Tina Savla - Department of Human Development, Virginia Polytechnic Institute and State University, Blacksburg, VA (T.S.)
Hilary A Tindle - Division of General Internal Medicine, University of Pittsburgh, Pittsburgh, PA (H.A.T.)
Lesley F Tinker - Women's Health Initiative, Fred Hutchinson Cancer Research Center, Seattle, WA (L.F.T.)
Linda Van Horn - Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL (K.N.K., M.L.D., L.V.H.)
Resource Type: Journal article
Publication Details: Journal of the American Heart Association, Vol.3(3), pp.e000687-n/a
DOI: 10.1161/JAHA.113.000687
PMID: 24973226
PMCID: PMC4309050
NLM abbreviation: J Am Heart Assoc
ISSN: 2047-9980
eISSN: 2047-9980
Publisher: England
Grant note: P20 MD006899 / NIMHD NIH HHS HHSN268201100002I / NHLBI NIH HHS HHSN271201100004C / NIA NIH HHS HHSN268201100046C / PHS HHS HHSN268201100001C / WHI NIH HHS HHSN268201100004I / NHLBI NIH HHS HHSN271201100004C / PHS HHS HHSN268201100003C / PHS HHS HHSN268201100004C / WHI NIH HHS HHSN268201100046C / NHLBI NIH HHS P30 DK079626 / NIDDK NIH HHS HHSN268201100002C / WHI NIH HHS HHSN268201100001I / NHLBI NIH HHS HHSN268201100004C / PHS HHS HHSN268201100002C / PHS HHS HHSN268201100003C / WHI NIH HHS N01-HC-95164 / NHLBI NIH HHS HHSN268201100001C / PHS HHS
Language: English
Date published: 06/27/2014
Academic Unit: Neurology; Psychological and Brain Sciences; Iowa Neuroscience Institute
Record Identifier: 9984020653802771

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