Psychosocial determinants of cardiovascular events among black Americans with chronic kidney disease or associated risk factors in the Jackson heart study
Autor: | Rasheeda K. Hall, Nrupen A. Bhavsar, Crystal C. Tyson, Lesley H. Curtis, Julia J. Scialla, Sarah B. Peskoe, Lexie Zidanyue Yang, Clemontina A. Davenport, L. Ebony Boulware, Jane F. Pendergast, Clarissa J. Diamantidis, Tara S. Strigo, Mario Sims |
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Jazyk: | angličtina |
Rok vydání: | 2021 |
Předmět: |
Adult
Male medicine.medical_specialty Social Determinants of Health Disease Social Environment Young Adult Age Distribution Racism Internal medicine Diabetes mellitus Adaptation Psychological medicine Humans Longitudinal Studies Myocardial infarction Renal Insufficiency Chronic Sex Distribution Stroke Aged Aged 80 and over Principal Component Analysis Proportional hazards model business.industry Research Hazard ratio Middle Aged medicine.disease Diseases of the genitourinary system. Urology Black or African American Pessimism Religion Cardiovascular Diseases Nephrology Female RC870-923 business Psychosocial Kidney disease |
Zdroj: | BMC Nephrology, Vol 22, Iss 1, Pp 1-13 (2021) BMC Nephrology |
ISSN: | 1471-2369 |
Popis: | Background Individuals with chronic kidney disease (CKD), hypertension (HTN), or diabetes mellitus (DM) are at increased risk for cardiovascular disease (CVD). The extent to which psychosocial factors are associated with increased CVD risk within these individuals is unclear. Black individuals experience a high degree of psychosocial stressors due to socioeconomic factors, environment, racism, and discrimination. We examined the association between psychosocial factors and risk of CVD events among Black men and women with CKD and CKD risk factors in the Jackson Heart Study. Methods and Results We identified 1919 participants with prevalent CKD or CKD risk factors at baseline. We used rotated principal component analysis - a form of unsupervised machine learning that may identify constructs not intuitively identified by a person - to describe five groups of psychosocial components (including negative moods, religiosity, discrimination, negative outlooks, and negative coping resources) based on a battery of questionnaires. Multiple imputation by chained equation (MICE) was used to impute missing covariate data. Cox models were used to quantify the association between psychosocial components and incident CVD, defined as a fatal coronary heart disease event, myocardial infarction, cardiac procedure (angiography or revascularization procedure), or stroke. Of the 929 participants in the analysis, 67% were female, 28% were current/former smokers with mean age of 56 years and mean BMI of 33 kg/m2. Over a median follow-up of 8 years, 6% had an incident CVD event. In multivariable models, each standard deviation (SD) increase in the religiosity component was associated with an increased hazard for CVD event (hazard ratio [HR] = 1.52, 95% CI: 1.09–2.13). Conclusions Religiosity was associated with CVD among participants with prevalent CKD or CKD risk factors. Studies to better understand the mechanisms of this relationship are needed. |
Databáze: | OpenAIRE |
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