Abstract P291: Psychosocial Factors are Associated with Cardiovascular Disease among African Americans in the Jackson Heart Study

Abstract

Introduction: African Americans (AA) have a higher risk for cardiovascular disease (CVD) than Whites. This disparity has been attributed to risk factors such as hypertension, diabetes, and obesity. This disparity has also been attributed to psychosocial factors across groups. Using Jackson Heart Study (JHS) data, we examined the associations of negative affect and stress measures with CVD risk factors and prevalent CVD among AA. Hypothesis: Negative affect and stress measures are associated with prevalent CVD risk factors and CVD among men and women in the JHS. Methods: Cross-sectional associations of negative affect (cynicism, anger in, anger out, and depressive symptoms) and stress (global stress, weekly stress, and major life events) with prevalent BMI, hypertension, diabetes and CVD were examined among 5,301 participants 34-85 years old (women=3,360; men=1,941). We estimated mean differences in BMI and prevalence ratios (PR) of hypertension, diabetes and CVD with measures of negative affect and stress and adjusted for demographic and clinical risk factors. Results: Men had higher cynical distrust and anger in scores than women (p<.05). Women had higher depressive symptoms, global stress, weekly stress and major life event scores than men (p<.05). After adjustment for age, sex, education, behaviors and risk factors, each psychosocial factor (except anger out and weekly stress-event) was associated with an increased mean average of BMI. For example, the mean difference in BMI increased by 41% for each 1 SD increase in cynical distrust (p<.01); and the mean difference in BMI increased by 45% for each 1 SD increase in global stress (p<.01). In fully-adjusted models, global perceived stress was associated with prevalent hypertension and diabetes (PR for hypertension: 1.07, 95%CI 1.00,1.07; PR for diabetes: 1.24, 95%CI 1.04, 1.47). Major life events were also associated with hypertension and diabetes. Each psychosocial measure (except cynicism and anger in) was associated with prevalent CVD. Conclusion: Efforts to reduce disparities in CVD may need to address environmental and psychosocial factors that place AA at higher risk.