Financial Stress and Risk of Coronary Heart Disease in the Jackson Heart Study

Moran, Kaitlyn E.; Ommerborn, Mark J.; Blackshear, Chad; Sims, Mario; Clark, Cheryl R.

doi:10.1016/j.amepre.2018.09.022

Cited by 45 publications

(38 citation statements)

References 31 publications

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“…Our observation of an increased incidence of cardiovascular events when individuals feel that they have no financial support or did not get enough financial support might be explained by the stress response caused by this perception of lack of financial support 13 14. Consistent with our results regarding lack of financial support, participants of the Jackson Heart study experiencing high financial stress were more likely to be depressed, were more often smokers and had lower education and income compared with participants not experiencing financial stress 14. In contrast to our results, which showed that the association of lack of financial support with incident cardiovascular disease was only slightly explained by depression (4%), the Jackson Heart study showed the association of financial stress with coronary heart disease was considerably influenced by depression (20%), which was also assessed with the Center for Epidemiological Studies - Depression Scale (CES-D), as in our study.…”

Section: Discussionsupporting

confidence: 85%

“…We for the first time analysed prevalence and health consequences of three important types of support that is available via social relationships, that is, instrumental support, implying help in activities of daily living like buying groceries, house cleaning and preparing meals; emotional support, implying counselling and comforting in case of problems; and financial support, implying paying bills and household expenses. Our observation of an increased incidence of cardiovascular events when individuals feel that they have no financial support or did not get enough financial support might be explained by the stress response caused by this perception of lack of financial support 13 14. Consistent with our results regarding lack of financial support, participants of the Jackson Heart study experiencing high financial stress were more likely to be depressed, were more often smokers and had lower education and income compared with participants not experiencing financial stress 14.…”

Section: Discussionsupporting

confidence: 85%

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Association of social relationships with incident cardiovascular events and all-cause mortality

Gronewold

Kropp

Lehmann

et al. 2020

Heart

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ObjectiveTo examine how different aspects of social relationships are associated with incident cardiovascular events and all-cause mortality.MethodsIn 4139 participants from the population-based Heinz Nixdorf Recall study without previous cardiovascular disease (mean (SD) age 59.1 (7.7) years, 46.7% men), the association of self-reported instrumental, emotional and financial support and social integration at baseline with incident fatal and non-fatal cardiovascular events and all-cause mortality during 13.4-year follow-up was assessed in five different multivariable Cox proportional hazards regression models: minimally adjusted model (adjusting for age, sex, social integration or social support, respectively); biological model (minimally adjusted+systolic blood pressure, low-density and high-density lipoprotein cholesterol, glycated haemoglobin, body mass index, antihypertensive medication, lipid-lowering medication and antidiabetic medication); health behaviour model (minimally adjusted+alcohol consumption, smoking and physical activity); socioeconomic model (minimally adjusted+income, education and employment); and depression model (minimally adjusted+depression, antidepressants and anxiolytics).Results339 cardiovascular events and 530 deaths occurred during follow-up. Lack of financial support was associated with an increased cardiovascular event risk (minimally adjusted HR=1.30(95% CI 1.01 to 1.67)). Lack of social integration (social isolation) was associated with increased mortality (minimally adjusted HR=1.47 (95% CI 1.09 to 1.97)). Effect estimates did not decrease to a relevant extent in any regression model.ConclusionsPerceiving a lack of financial support is associated with a higher cardiovascular event incidence, and being socially isolated is associated with increased all-cause mortality. Future studies should investigate how persons with deficient social relationships could benefit from targeted interventions.

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Section: Discussionsupporting

confidence: 85%

Section: Discussionsupporting

confidence: 85%

Association of social relationships with incident cardiovascular events and all-cause mortality

Gronewold

Kropp

Lehmann

et al. 2020

Heart

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“…In this study, CHD was selected from ICD-10 rubric I20-I25. CHD cases included [14][15][16][17]: (2) Cardiac procedure, de ned as a) angiography proven CHD with a result of ≥ 50% stenosis in at least one major coronary vessel, b) history of angioplasty or bypass surgery.…”

Section: De Nition Of Chdmentioning

confidence: 99%

Sex-specific Prevalence of coronary heart disease among Tehranian adult population across different glycemic status: Tehran Lipid and Glucose Study, 2008-2011

Moazzeni

Ghafelehbashi

Hasheminia

et al. 2020

Preprint

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Background: Coronary heart disease (CHD) is one of the main causes of deaths. Alarmingly Iranian populations had a high rank of CHD worldwide. The current study aimed to assess the prevalence of CHD across different glycemic categories. Methods: This study was conducted on 7,718 Tehranian participants (Men=3427) aged ≥ 30 years from 2008 to 2011. They were categorized based on glycemic status. The prevalence of CHD was calculated in each group, separately. CHD was defined as hospital records adjudicated by an outcome committee. The association of different glycemic categories with CHD was calculated using multivariate logistic regression, compared with normal fasting glucose /normal glucose tolerance (NFG/NGT) group as reference. Results: The age-standardized prevalence of isolated impaired fasting glucose (iIFG), isolated impaired glucose tolerance (iIGT), both impaired fasting glucose and impaired glucose tolerance (IFG/IGT), newly diagnosed diabetes mellitus (NDM), and known diabetes mellitus (KDM) were 14.30% [95% confidence interval (CI): 13.50-15.09], 4.81% [4.32-5.29], 5.19% [4.71-5.67], 5.79% [5.29-6.28] and 7.72% [7.17-8.27], respectively. Among a total of 750 individuals diagnosed as cases of CHD (398 in men), 117 (15.6%), 453 (60.4%), and 317 (42.3%) had history of myocardial infarction (MI), cardiac procedure, and unstable angina, respectively. The age-standardized prevalence of CHD for Tehranian population was 7.71% [7.18-8.24] in total population, 8.62 [7.81-9.44] in men and 7.19 [6.46-7.93] in women. Moreover, among diabetic participants, the age-standardized prevalence of CHD were 13.10 [9.83-16.38] in men 10.67 [8.90-12.44] in women, respectively, which were significantly higher than corresponding values for NFG/NGT and prediabetic groups. Across 6 levels of glycemic status, CHD was associated with IFG/IGT [ odds ratio (OR) and 95% CI: 1.38 (1.01-1.89)], NDM [1.83 (1.40-2.41)], and KDM [2.83 (2.26-3.55)] groups, in the age and sex adjusted model. Furthermore, in the full-adjusted model, only NDM and KDM status remained to be associated with the presence of CHD by ORs of 1.40 (1.06-1.85) for NDM and 1.90 (1.50-2.41) for KDM. Conclusion: The high prevalence of CHD, especially among diabetic populations, necessitates urgent implementation of behavioral interventions among Tehranian population, according to evidence-based guidelines for the clinical management of diabetic patients.

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“…The biomedical literature continues to grapple with risk factors that go beyond the traditional interpretations of risk. A recent study revealed the role of financial stress in the incidence of CHD among the African American population (Moran et al, 2019), while other studies have identified psychiatric conditions impacting extent (Allan et al, 2019;Hamieh et al, 2019), including stress from situations such as prolonged armed conflict (Jawad et al, 2019).…”

Section: Heart Health Disparitiesmentioning

confidence: 99%

A Community-Based Heart Health Intervention: Culture-Centered Study of Low-Income Malays and Heart Health Practices

2020

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This paper reports the formative research findings of a culture-centered heart health intervention with Malay community members belonging to low-income households. The community-based culture-centered intervention entailed working in the grassroots with community stakeholders to tailor a heart health campaign with and for low-income Malay Singaporeans. Community stakeholders designed and developed the heart health communicative infrastructures during six focus group sessions detailed in the results. The intervention included building smoking cessation information accessible to the community, the curation of heart healthy Malay centric recipes, and developing culturally responsive information infrastructures to understand a myocardial infarction. The intervention sought to bridge the gap for the community where there is an absence of culturally-centered communicative infrastructures on heart health.

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Financial Stress and Risk of Coronary Heart Disease in the Jackson Heart Study

Cited by 45 publications

References 31 publications

Association of social relationships with incident cardiovascular events and all-cause mortality

Association of social relationships with incident cardiovascular events and all-cause mortality

Sex-specific Prevalence of coronary heart disease among Tehranian adult population across different glycemic status: Tehran Lipid and Glucose Study, 2008-2011

A Community-Based Heart Health Intervention: Culture-Centered Study of Low-Income Malays and Heart Health Practices

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