Burden of cardiovascular risk factors, subclinical atherosclerosis, and incident cardiovascular events across dimensions of religiosity: The multi-ethnic study of atherosclerosis

Abstract

Background: Religious involvement has been associated with improved health practices and outcomes; however, no ethnically diverse community-based study has examined differences in cardiac risk factors, subclinical cardiovascular disease, and cardiovascular disease (CVD) events across levels of religiosity.

Methods and results: We included 5474 white, black, Hispanic, and Chinese participants who attended examination 2 of the National Heart, Lung, and Blood Institute's Multi-Ethnic Study of Atherosclerosis (MESA). We compared cross-sectional differences in cardiac risk factors and subclinical CVD and longitudinal CVD event rates across self-reported levels of religious participation, prayer/meditation, and spirituality. Multivariable-adjusted regression models were fitted to assess associations of measures of religiosity with risk factors, subclinical CVD, and CVD events. MESA participants (52.4% female; mean age, 63) with greater levels of religious participation were more likely to be female and black. After adjustment for demographic covariates, participants who attended services daily, compared with never, were significantly more likely to be obese (adjusted odds ratio 1.57, 95% confidence interval [CI] 1.12 to 1.72) but less likely to smoke (adjusted odds ratio 0.39, 95% CI 0.26 to 0.58). Results were similar for those with frequent prayer/meditation or high levels of spirituality. There were no consistent patterns of association observed between measures of religiosity and presence/extent of subclinical CVD at baseline or incident CVD events during longitudinal follow-up in the course of 4 years.

Conclusions: Our results do not confirm those of previous studies associating greater religiosity with overall better health risks and status, at least with regard to CVD. There was no reduction in risk for CVD events associated with greater religiosity.

Figure 1

Adjusted Hazards Ratios (95% CI) for CVD Events by Frequency of Religious Participation, Frequency of Prayer or Meditation, and Spirituality. Hazards ratios were adjusted for demographics (age, sex, race, education and income), RFs (hypertension, diabetes, current cigarette smoking, hypercholesterolemia, and obesity), and Medication for Lipid-Lowering and Hypertension.