Psychosocial factors and risk of hypertension: the Coronary Artery Risk Development in Young Adults (CARDIA) study
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 SciencesDocument Type
Journal ArticlePublication Date
2003-10-23Keywords
AdultAffective 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
Metadata
Show full item recordAbstract
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 siteDOI
10.1001/jama.290.16.2138Permanent Link to this Item
http://hdl.handle.net/20.500.14038/47695PubMed ID
14570949Related Resources
Link to Article in PubMedae974a485f413a2113503eed53cd6c53
10.1001/jama.290.16.2138