Combining psychosocial data to improve prediction of cardiovascular disease risk factors and events: The National Heart, Lung, and Blood Institute-sponsored women's ischemia syndrome evaluation study

Kerry S. Whittaker, David S. Krantz, Thomas Rutledge, B. Delia Johnson, Andrew J. Wawrzyniak, Vera Bittner, Jo Ann Eastwood, Wafia Eteiba, Carol E. Cornell, Carl J. Pepine, Diane A. Vido, Eileen Handberg, C. Noel Bairey Merz

Research output: Contribution to journalArticle

17 Scopus citations

Abstract

BACKGROUND: There is overlap among psychosocial predictors of cardiovascular disease (CVD). The usefulness of combining psychosocial variables as risk markers for CVD needs investigation. METHODS: Participants were 493 women in the NHLBI WISE study. Multivariate combination of Beck Depression Inventory (BDI), State-Trait Anxiety Inventory (STAI), Social Network Index (SNI), and Cook-Medley hostility subscales was evaluated, and principal components analysis also conducted. Relationships of composite psychosocial risk markers to CVD events and risk factors were assessed. RESULTS: The multivariate block of SNI, Cook-Medley Hostile Affect subscale, STAI, and BDI predicted CVD events (χ = 27.8, df = 6, p < .001). Scalewise factor analysis revealed 2 factors: negative affectivity (NA) and hostility (explained variance, 45.6% and 17.1%, respectively). NA was associated with BMI (β [SE] = 0.18 [0.09], p = .04), hostility with metabolic syndrome (exp(β) = 0.60 [0.28], p = .04). Both factors were associated with blood pressure (BP): NA with SBP (β = 2.53 [1.04], p = .02) and DBP (β = 1.66 [0.60], p = .02); hostility with SBP (β = 2.72 [1.13], p = .02) and DBP (β = 1.83 [0.65], p = .005). Neither factor predicted CVD events. Original scales predicted CVD events: lower SNI (HR = 0.74, CI = 0.57-0.96), lower Hostile Affect (HR = 0.80, CI = 0.56-1.03), and higher BDI (HR = 1.33, CI = 1.08-1.74). CONCLUSIONS: In women with suspected ischemia, multivariate combination of psychosocial risk markers predicts CVD events; derived psychosocial factors were associated with CVD risk factors but not events. Measuring common variance among psychosocial variables may be a useful research strategy.

Original languageEnglish (US)
Pages (from-to)263-270
Number of pages8
JournalPsychosomatic medicine
Volume74
Issue number3
DOIs
StatePublished - Apr 1 2012
Externally publishedYes

Keywords

  • cardiovascular disease
  • cardiovascular events
  • factor analysis
  • psychosocial variables
  • women

ASJC Scopus subject areas

  • Psychiatry and Mental health
  • Applied Psychology
  • Arts and Humanities (miscellaneous)
  • Developmental and Educational Psychology

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    Whittaker, K. S., Krantz, D. S., Rutledge, T., Johnson, B. D., Wawrzyniak, A. J., Bittner, V., Eastwood, J. A., Eteiba, W., Cornell, C. E., Pepine, C. J., Vido, D. A., Handberg, E., & Merz, C. N. B. (2012). Combining psychosocial data to improve prediction of cardiovascular disease risk factors and events: The National Heart, Lung, and Blood Institute-sponsored women's ischemia syndrome evaluation study. Psychosomatic medicine, 74(3), 263-270. https://doi.org/10.1097/PSY.0b013e31824a58ff