Psychosocial stressors predict lower cardiovascular disease risk among Mexican-American adults living in a high-risk community: Findings from the Texas City Stress and Health Study.

Maryam Hussain,Raymond P Stowe,Jennifer L Howell,M Kristen Peek,Matthew J Zawadzki

doi:10.1371/journal.pone.0257940

Abstract

The objective of this study was to examine the link between systemic and general psychosocial stress and cardiovascular disease (CVD) risk in a group of U.S. Latinos as a function of acculturation and education within the blended guiding conceptual framework of the biopsychosocial model of the stress process plus the reserve capacity model. We analyzed data from self-identifying Mexican-origin adults (n = 396, 56.9% female, Mage = 58.2 years, 55.5% < 12 years of education, 79% U.S.-born) from the Texas City Stress and Health Study. We used established measures of perceived stress (general stress), neighborhood stress and discrimination (systemic stress) to capture psychosocial stress, our primary predictor. We used the atherosclerotic CVD calculator to assess 10-year CVD risk, our primary outcome. This calculator uses demographics, cholesterol, blood pressure, and history of hypertension, smoking, and diabetes to compute CVD risk in the next 10 years. We also created an acculturation index using English-language use, childhood interaction, and preservation of cultural values. Participants reported years of education. Contrary to expectations, findings showed that higher levels of all three forms of psychosocial stress, perceived stress, neighborhood stress, and perceived discrimination, predicted lower 10-year CVD risk. Acculturation and education did not moderate the effects of psychosocial stress on 10-year CVD risk. Contextualized within the biopsychosocial and reserve capacity framework, we interpret our findings such that participants who accurately reported their stressors may have turned to their social networks to handle the stress, thereby reducing their risk for CVD. We highlight the importance of examining strengths within the sociocultural environment when considering cardiovascular inequities among Latinos.

Highlights

Cardiovascular disease (CVD) is the leading cause of death in the U.S, with almost one-quarter of deaths result from CVD [1]
Diastolic blood pressure and total cholesterol did not correlate with 10-year CVD risk
Contrary to prior work suggesting that higher levels of stress predict higher cardiovascular related risk [5,6,7, 9, 23], the present study showed that three forms of psychosocial stress— neighborhood stress, perceived discrimination, and perceived stress—correlated with lower 10-year CVD risk in a sample of U.S Latino adults

Summary

Introduction

Cardiovascular disease (CVD) is the leading cause of death in the U.S, with almost one-quarter of deaths result from CVD [1]. Relevant to the present endeavor, the Biopsychosocial Model of the stress process highlights the link between environmental demands (i.e., psychological and social stressors) and the physiological and/or behavioral responses to those stressors [3, 4], which predict increased risk for chronic diseases, such as CVD [5,6,7]. Most studies examining the link between psychosocial stress and CVD do not include multidimensional forms of stress [8, 9] and focus on non-Hispanic/Latino/a/x populations [10]. U.S Latinos comprise more than half the of the total U.S population growth [11], and CVD is the leading cause of death amongst Latinos [12, 13].

Objectives

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Conclusion