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https://doi.org/10.1161/circ.141.suppl_1.p542
Journal: Circulation | Publication Date: Mar 3, 2020 |
Introduction: Psychosocial factors are associated with cardiovascular morbidity and mortality, but our understanding of causal mechanisms is limited. Understanding such mechanisms may help formulate prevention strategies. We therefore sought to evaluate potential physiologic effects of psychosocial factors by studying their associations with heart rate variability (HRV), a measure of autonomic function, in the Atherosclerosis Risk in Communities (ARIC) study. Hypothesis: Higher psychosocial stress levels are associated with lower HRV cross-sectionally in a diverse community sample. Methods: We included ARIC cohort participants with information on psychosocial factors in 1990-1992 into our analysis. Psychosocial factors were assessed using validated instruments, including: 1) vital exhaustion, a somatic manifestation of chronic stress and depression, 2) anger proneness, a personality trait, and 3) perceived social support, a potential buffering factor for stress. Short-term time and frequency domain HRV were measured from a two-minute electrocardiographic recording in 1987-1989. Linear regression models adjusted for sociodemographic and cardiovascular risk factors. Results: We included 9,332 participants (mean age 54.4 ± 5.7 years, 55% women, and 25% black) in the analysis. Only vital exhaustion was consistently associated with HRV, as per the table, which shows the change in ln(HRV) per point increase in score. Compared to the lowest quartile, the highest quartile of vital exhaustion was associated with a 13.3% (95% CI, 3.9% - 21.3%) decrease in low frequency HRV in adjusted models. By comparison, each year of added age was associated with a 3.7% (95% CI, 3.1% to 4.2%) decrease in LF HRV. Conclusion: A high level of vital exhaustion was associated with low HRV, while anger proneness and social support were not. The inverse vital exhaustion-HRV association raises concern regarding the somatic manifestations of stress, a potential target for preventive interventions.
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