The Modifying Role of Resilience on Allostatic Load and Cardiovascular Disease Risk in the Jackson Heart Study.

Autor: Felix AS; Division of Epidemiology, The Ohio State University College of Public Health, Columbus, OH, USA., Nolan TS; Martha S. Pitzer Center for Women, Children, and Youth, The Ohio State University College of Nursing, Columbus, OH, USA., Glover LM; Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA., Sims M; Department of Medicine, University of Mississippi Medical Center, Jackson, MS, USA., Addison D; Cardio-Oncology Program, Division of Cardiology, Department of Internal Medicine, The Ohio State University Medical Center, Columbus, OH, USA., Smith SA; Cardio-Oncology Program, Division of Cardiology, Department of Internal Medicine, The Ohio State University Medical Center, Columbus, OH, USA.; Division of Cardiology, Department of Internal Medicine, The Ohio State University College of Medicine, Columbus, OH, USA., Anderson CM; Martha S. Pitzer Center for Women, Children, and Youth, The Ohio State University College of Nursing, Columbus, OH, USA., Warren BJ; Martha S. Pitzer Center for Women, Children, and Youth, The Ohio State University College of Nursing, Columbus, OH, USA., Woods-Giscombe C; School of Nursing, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA., Hood DB; Division of Environmental Health Sciences, The Ohio State University College of Public Health, Columbus, OH, USA., Williams KP; Martha S. Pitzer Center for Women, Children, and Youth, The Ohio State University College of Nursing, Columbus, OH, USA. Williams.5963@osu.edu.
Jazyk: angličtina
Zdroj: Journal of racial and ethnic health disparities [J Racial Ethn Health Disparities] 2023 Oct; Vol. 10 (5), pp. 2124-2135. Date of Electronic Publication: 2022 Sep 22.
DOI: 10.1007/s40615-022-01392-6
Abstrakt: We examined whether resilience modified associations between allostatic load (AL), a physiological indicator of coping with repeated stressors, and cardiovascular disease (CVD) among 2758 African Americans in the Jackson Heart Study. Baseline AL was quantified using biological measures of metabolic, cardiovascular, and immune markers. We constructed a multidimensional resilience measure using validated questionnaires for social support, social networks, religious experiences, and optimism. Participants were followed until 2016 for stroke, coronary heart disease (CHD), and heart failure (HF). We used multivariable-adjusted, sex-stratified Cox regression to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for associations between dichotomous AL and CVD. High AL was associated with CHD among women (HR = 1.73, 95% CI = 1.00, 2.99) and HF among women (HR = 1.52, 95% CI = 0.98, 2.37) and men (HR = 2.17, 95% CI = 1.28, 3.68). Among women, resilience did not modify the AL-CVD relationship. Among men, we observed higher stroke risk among men with low resilience (HR = 2.21, 95% CI = 0.94, 5.22) and no association among those with high resilience. Counterintuitively, high AL was associated with greater HF (HR = 5.80, 95% CI = 2.32, 14.47) in the subgroup of men with high resilience. Future studies addressing different facets of resilience are needed to elucidate underlying mechanisms for CVD prevention among African Americans.
(© 2022. W. Montague Cobb-NMA Health Institute.)
Databáze: MEDLINE
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