Cardiovascular
The Association Between Major Life Stressors and Cardiovascular Disease: Findings from the Jackson Heart Study Shuqi Zhang* Shuqi Zhang Zhang Zhang Zhang Zhang Zhang Zhang Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill
Background: Major life stressors, defined as dramatic and severely taxing situations, may have traumatic and cumulative impacts on cardiovascular disease (CVD), yet evidence remains limited in Black adults. This study investigated the associations between major life stressors and coronary heart disease (CHD), stroke and heart failure (HF) in the Jackson Heart Study (JHS), a cohort of Black adults.
Methods: Major life events (MLEs) were assessed at the first annual follow up call after exam 1 (2000-2004) where participants reported the occurrence of 11 major life stressors in the past year. Another stressor, bereavement (i.e., death of a family member) was assessed annually. CVD events were monitored from the first-year post baseline, except HF which was ascertained from 2005, through 2016. Cox proportional hazard models estimated the HRs and 95% CIs of incident CVD subtypes. Marginal structure models estimated the associations between time-dependent bereavement and CVD.
Results: Among the 4,424 included Black participants (age 54 ± 13 years; 65% female), 71% reported at least one MLE at the first annual follow-up. During a median follow-up of 12 years, 210 CHD events, 146 stroke events and 282 HF events occurred. Serious illness or injury (HR = 1.57, 95% CI: 1.07, 2.28) and unwilling retirement (HR = 2.14, 95% CI: 1.17, 3.91) were associated with higher hazard of CHD. Both dichotomized MLEs (≥1 vs. 0, HR = 1.76, 95% CI: 1.03, 3.01) and continuous MLEs (HR = 1.20, 95% CI: 1.01, 1.42) were associated with higher risk of CHD among males. We also observed an association between bereavement and CHD within one year following the loss, but not thereafter (Figure 1). Additionally, bereavement was consistently associated with a higher risk of HF over time, particularly among males within one year following the loss.
Conclusion: Some major life stressors are associated with higher hazard of CHD and HF among Black adults, with associations varying by stressors, sex, and timing.
