Impact of psychosocial factors on cardiovascular morbimortality: A prospective cohort study
Abstract
[Background] Whilst it is well known that psychosocial determinants may contribute to cardiovascular diseases (CVD), data from specific groups are scarce. The present study aims to determine the contribution of psychosocial determinants in increasing the risk of cardiovascular events (myocardial infarction and stroke), and death from CVD, in a high risk adult population. ; [Methods] Longitudinal prospective study of 7263 patients (57.5% women), mean age 67.0 (SD 6.2) free from CVD but at high risk, with a median follow-up of 4.8 years (from October 2003 to December 2010). The Hazard Ratios (HRs) of cardiovascular events (myocardial infarction, stroke, and death from cardiovascular causes) related to educational attainment, diagnosed depression (based on medical records), and low social support (number of people living in the household) were estimated by multivariate Cox regression models. ; [Results] Stroke incidence was associated with low educational level in the whole population (HR: 1.83, 95% CI: 1.09–3.09), and especially in men (HR: 2.11, 95% CI 1.09–4.06). Myocardial infarction and CVD mortality were not associated with any of the psychosocial factors considered. ; [Conclusion] Adults with low educational level had a higher risk of stroke. Depression and low social support were not associated with CVD incidence. ; [Trial registration] Clinical trial registration information unique identifier: ISRCTN35739639. ; Instituto de Salud Carlos III, and Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición, and Centro Nacional de Investigaciones Cardiovasculares, Fondo de Investigación Sanitaria–Fondo Europeo de Desarrollo Regional, Ministerio de Ciencia e Innovación, Fundación Mapfre 2010, Consejería de Salud de la Junta de Andalucía, Public Health Division of the Department of Health of the Autonomous Government of Catalonia, Generalitat Valenciana, and the Regional Government of Navarra. None of the institutions described above have influenced the design, collection, analysis, and interpretation of data; the writing of the manuscript; and the decision to submit the manuscript for publication. ; Peer Reviewed
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