Abstract MP80: Psychosocial Factors and Risk of Incident Heart Failure: The Multi-Ethnic Study of Atherosclerosis (MESA)
Background: Heart failure is a major source of morbidity and mortality in the United States. Psychosocial factors have frequently been studied as risk factors for coronary heart disease, but not for heart failure.
Methods: We examined the relationship between psychological status and incident heart failure among 6,782 individuals from the Multi-Ethnic Study of Atherosclerosis (MESA) who were free of cardiovascular disease at baseline. Anger, anxiety, chronic burden, depression, and hostility were measured using validated scales and were modeled categorically. Physician reviewers adjudicated incident heart failure events. Cox proportional hazards models were used to generate hazard ratios (HR) and 95% confidence intervals (CI) and adjusted for relevant demographic, behavioral, and physiological covariates. In exploratory analyses, we evaluated interactions between self-rated health and each psychosocial factor, and then stratified by baseline self-rated health (fair/poor and good/very good/excellent).
Results: During a mean follow up of 9.3 years, 242 participants developed incident heart failure. Compared to participants in the lowest level, hazard ratios for those categorized in the highest level of anger [HR=1.14 (95%CI: 0.81-1.60)], anxiety [HR=0.74 (95%CI: 0.51-1.07), chronic burden [HR=1.25 (95%CI: 0.90-1.72), depression [HR=1.19 (95%CI: 0.76-1.85), and hostility [HR=0.95 (95%CI: 0.62-1.42) revealed no association with incident heart failure. In the exploratory analysis, interactions between the psychosocial factors and self-rated health were only statistically significant for hostility, but stratified models differed according to baseline health status. Compared to the lowest level, hazard ratios for those categorized in the highest level of anxiety [HR=2.11 (95%CI: 1.00-4.47)], chronic burden [HR=2.25 (95%CI: 1.08-4.67)], and depression [HR=2.15 (95%CI: 0.98-4.68)] revealed a positive association with incident heart failure among participants self-rated poor health at baseline, but there was no association for those with good self-rated health at baseline. For hostility, HRs for the highest versus lowest categorization were larger among those with good self-rated health and for anger, associations were similar regardless of self-rated health status.
Conclusions: Overall these five psychosocial factors were not significantly associated with incident heart failure. However, for participants reporting poor health at baseline, anxiety, chronic burden, and depression were associated with an increased risk of heart failure. Future research with greater statistical power is necessary to confirm these findings and seek explanations.
Author Disclosures: R.P. Ogilvie: None. S. Everson-Rose: None. C. Rodriguez: None. W. Longstreth, Jr: None. M. Albert: None. A. Diez-Roux: None. P.L. Lutsey: None.
- © 2015 by American Heart Association, Inc.