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    Psychosocial factors and risk of hypertension: the Coronary Artery Risk Development in Young Adults (CARDIA) study

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    Authors
    Yan, Lijing L.
    Liu, Kiang
    Matthews, Karen A.
    Daviglus, Martha L.
    Ferguson, T. Freeman
    Kiefe, Catarina I.
    UMass Chan Affiliations
    Department of Quantitative Health Sciences
    Document Type
    Journal Article
    Publication Date
    2003-10-23
    Keywords
    Adult
    Affective Symptoms
    African Americans
    Anxiety
    Blood Pressure
    Competitive Behavior
    Coronary Artery Disease
    Depression
    Educational Status
    Emotions
    European Continental Ancestry Group
    Female
    Hostility
    Humans
    Hypertension
    Logistic Models
    Longitudinal Studies
    Male
    Multivariate Analysis
    Prospective Studies
    Risk Factors
    Stress, Psychological
    Bioinformatics
    Biostatistics
    Epidemiology
    Health Services Research
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    Link to Full Text
    http://jama.ama-assn.org/cgi/content/abstract/290/16/2138
    Abstract
    CONTEXT: Although psychosocial factors are correlated, previous studies on risk factors for hypertension have typically examined psychosocial factors individually and have yielded inconsistent findings. OBJECTIVE: To examine the role of psychosocial factors of time urgency/impatience (TUI), achievement striving/competitiveness (ASC), hostility, depression, and anxiety on long-term risk of hypertension. DESIGN, SETTING, AND STUDY POPULATION: A population-based, prospective, observational study using participant data from the Coronary Artery Risk Development in Young Adults (CARDIA) study. A total of 3308 black and white adults aged 18 to 30 years (when recruited in 1985 and 1986) from 4 US metropolitan areas and followed up through 2000 to 2001. MAIN OUTCOME MEASURES: Fifteen-year cumulative incidence of hypertension (systolic blood pressure of 140 mm Hg or higher, diastolic blood pressure of 90 mm Hg or higher, or taking antihypertensive medication). RESULTS: The incidence of hypertension at year 15 was 15% from baseline and 13.6% from year 5. After adjusting for the same set of hypertension risk factors and each of the psychosocial factors of TUI, ASC, hostility, depression, and anxiety in 5 separate logistic regression models, higher TUI and hostility were significantly associated with risk of developing hypertension at 15-year follow-up for the total sample. Compared with the lowest score group, the adjusted odds ratio (OR) for TUI was 1.51 (95% confidence interval [CI], 1.12-2.03) for a score of 1; 1.47 (95% CI, 1.08-2.02) for a score of 2; and 1.84 (95% CI, 1.29-2.62) for a score of 3 to 4 (P for trend =.001). Compared with the lowest quartile group, the adjusted OR for hostility was 1.06 (95% CI, 0.76-1.47) for quartile 2; 1.38 (95% CI, 1.00-1.91) for quartile 3; and 1.84 (95% CI, 1.33-2.54) for quartile 4 (P for trend <.001). No consistent patterns were found for ASC, depression, or anxiety. Race- and sex-specific analyses and multivariable models with simultaneous adjustment for all 5 psychosocial factors and other hypertension risk factors had generally similar results. CONCLUSION: Among young adults, TUI and hostility were associated with a dose-response increase in the long-term risk of hypertension.
    Source
    JAMA. 2003 Oct 22;290(16):2138-48. Link to article on publisher's site
    DOI
    10.1001/jama.290.16.2138
    Permanent Link to this Item
    http://hdl.handle.net/20.500.14038/47695
    PubMed ID
    14570949
    Related Resources
    Link to Article in PubMed
    ae974a485f413a2113503eed53cd6c53
    10.1001/jama.290.16.2138
    Scopus Count
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    Population and Quantitative Health Sciences Publications

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