Associations between cumulative social risk, psychosocial risk, and ideal cardiovascular health: Insights from the HeartSCORE study

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dc.contributor.authorBerkowitz, Julia
dc.contributor.authorKhetpal, Vishal
dc.contributor.authorEchouffo-Tcheugui, Justin B.
dc.contributor.authorBambs, Claudia E.
dc.contributor.authorAiyer, Aryan
dc.contributor.authorKip, Kevin E.
dc.contributor.authorReis, Steven E.
dc.contributor.authorErqou, Sebhat
dc.date.accessioned2025-01-20T21:00:57Z
dc.date.available2025-01-20T21:00:57Z
dc.date.issued2022
dc.description.abstractBackground: Limited studies have assessed the effects of psychosocial risk factors on achievement of ideal cardiovascular health (CVH).
dc.description.abstractMethods: Using the Heart Strategies Concentrating on Risk Evaluation (HeartSCORE) cohort, we examined the cross-sectional associations of cumulative social risk (CSR) and three psychosocial factors (depression, stress, perceived discrimination) with ideal CVH. CSR was calculated by assigning one point for each of: low family income, low education level, minority race (Black), and single-living status. Ideal CVH was calculated by assigning one point for ideal levels of each factor in American Heart Association's Life's Simple 7. Ideal CVH was dichotomized into fewer versus higher by combining participants achieving <3 versus >= 3 factors. Logistic regression models were used to calculate odds ratios (ORs) and 95% confidence intervals (CIs) of having fewer ideal CVH factors. Psychosocial factors were assessed as mediators of the association between CSR and ideal CVH.
dc.description.abstractResults: We included 2000 participants (mean age 59.1 [7.5] years, 34.6% male, 42.7% Black, and 29.1% with low income), among whom 60.6% had <3 ideal CVH factors. The odds of having fewer ideal CVH factors increased significantly with increasing CSR scores from 1 to 2, to >= 3 compared to individuals with CSR score of zero, after adjusting for age and sex (OR [95% CIs]: 1.77 [1.41 - 2.22]; 2.09 [1.62 - 2.69] 2.67 [1.97 - 3.62], respectively). Taking the components of ideal CVH separately, higher CSR was directly associated with odds of being in 'non-ideal' category for six of the seven factors, but was inversely associated with probability of being in 'non-ideal' category for cholesterol. The association was modestly attenuated after adjusting for depression, stress, and perceived discrimination (corresponding OR [95% CI]: 1.69 [1.34 - 2.12], 1.96 [1.51 - 2.55], 2.34 [1.71 - 3.20]). The psychosocial factors appeared to mediate between 10% and 20% of relationship between CSR and ideal CVH.
dc.description.abstractConclusions: Increased CSR was associated with lower probability of achieving ideal CVH factors. A modest amount of the effect of CSR on ideal CVH appeared to be mediated by depression, stress and perceived discrimination. Public health strategies aimed at improving ideal cardiovascular health may benefit from including interventions targeting social and psychosocial risk factors.
dc.fuente.origenWOS
dc.identifier.doi10.1016/j.ajpc.2022.100367
dc.identifier.issn2666-6677
dc.identifier.urihttps://doi.org/10.1016/j.ajpc.2022.100367
dc.identifier.urihttps://repositorio.uc.cl/handle/11534/92782
dc.identifier.wosidWOS:000907591400007
dc.language.isoen
dc.revistaAmerican journal of preventive cardiology
dc.rightsacceso restringido
dc.subjectSocial risk
dc.subjectPsychosocial risk
dc.subjectIdeal cardiovascular health
dc.subjectPrevention
dc.subjectCardiovascular disease
dc.subject.ods03 Good Health and Well-being
dc.subject.odspa03 Salud y bienestar
dc.titleAssociations between cumulative social risk, psychosocial risk, and ideal cardiovascular health: Insights from the HeartSCORE study
dc.typeartículo
dc.volumen11
sipa.indexWOS
sipa.trazabilidadWOS;2025-01-12
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