Abstract 18364: Cumulative Psychosocial Stress & Ideal Cardiovascular Health in Women: Data According to Race/Ethnicity
Introduction: Research implicates acute and chronic stressors in racial/ethnic health disparities, but the joint impact of multiple stressors and their effect on racial/ethnic disparities in cardiovascular health is unknown.
Methods & Results: In 26744 women (N: white: 25408; Hispanic: 262; black: 458; Asian: 325) participating in the Women’s Health Study (WHS) follow-up cohort, we examined the relationship between cumulative psychological stress (CPS) and ideal cardiovascular health (ICH), as defined by the AHA Strategic 2020 goals. This health metric includes smoking, body mass index, physical activity, diet, blood pressure, total cholesterol and glucose. A CPS score summarized acute (negative/traumatic life events) and chronic stressors (work, work-family spillover, financial, discrimination, relationship and neighborhood) reported on a stress questionnaire administered in 2012-2013 [score range 16-394]. Whites had lower mean CPS scores (white: 161.4 ± 50.6; Hispanic: 171.2 ± 52.6; black: 172.7 ± 54.8; Asian: 170.7 ± 50.7; poverall <0.01). In linear regression models, mean CPS scores were higher in Hispanics, blacks and Asians versus whites after control for age, socioeconomic (SES: income and education) and psychological (depression and anxiety) status; [peach <0.01]. Decreased cumulative stress was associated with improved ICH (p<0.01). Mean ICH scores varied by race/ethnicity (p< 0.01), and were significantly lower and higher for blacks and Asians respectively versus whites (β-coefficient, 95% CI: Hispanics -0.014, -0.16-0.13; blacks-0.41,-0.52,-0.92; Asians 0.57, 0.43-0.70), despite control for SES. One standard-deviation difference in cumulative stress had a predicted effect on ICH about half the magnitude of the effect of black race; either of these effects was only slightly attenuated when both were included in the model. Interactions between cumulative stress and race/ethnicity in ICH models were not significant.
Conclusion: In this cross-sectional analysis, cumulative stress varied by race/ethnicity in relatively educated female health professionals. Ideal cardiovascular health was worst in blacks and better in Asians compared to whites, despite taking into account socioeconomic factors and cumulative stress.
Author Disclosures: R. Siliki Mbassa: None. A.M. Zaslavsky: None. D.R. Williams: None. S.B. Natalie: None. J. Buring: None. M.A. Albert: None.
- © 2016 by American Heart Association, Inc.