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. 2022 Apr;45(2):172-185.
doi: 10.1007/s10865-021-00259-1. Epub 2021 Oct 20.

Psychosocial profiles and longitudinal achievement of optimal cardiovascular risk factor levels: the Coronary Artery Risk Development in Young Adults (CARDIA) study

Emily A Vargas  1 , Diana A Chirinos  2 , Mandy Wong  2 , Mercedes R Carnethon  2 , Allison J Carroll  3 , Catarina I Kiefe  4 , April P Carson  5 , Kiarri N Kershaw  2
Affiliations

Psychosocial profiles and longitudinal achievement of optimal cardiovascular risk factor levels: the Coronary Artery Risk Development in Young Adults (CARDIA) study

Emily A Vargas et al. J Behav Med. 2022 Apr.

Abstract

Psychosocial factors are associated with the achievement of optimal cardiovascular disease risk factor (CVDRF) levels. To date, little research has examined multiple psychosocial factors simultaneously to identify distinguishing psychosocial profiles among individuals with CVDRF. Further, it is unknown whether profiles are associated with achievement of CVDRF levels longitudinally. Therefore, we characterized psychosocial profiles of individuals with CVDRF and assessed whether they are associated with achievement of optimal CVDRF levels over 15 years. We included 1148 CARDIA participants with prevalent hypertension, hypercholesterolemia and/or diabetes mellitus in 2000-2001. Eleven psychosocial variables reflecting psychological health, personality traits, and social factors were included. Optimal levels were deemed achieved if: Hemoglobin A1c (HbA1c) < 7.0%, low-density lipoprotein (LDL) cholesterol < 100 mg/dl, and systolic blood pressure (SBP) < 140 mm Hg. Latent profile analysis revealed three psychosocial profile groups "Healthy", "Distressed and Disadvantaged" and "Discriminated Against". There were no significant differences in achievement of CVDRF levels of the 3 targets combined across profiles. Participants in the "Distressed and Disadvantaged" profile were less likely to meet optimal HbA1c levels compared to individuals in the "Healthy" profile after demographic adjustment. Associations were attenuated after full covariate adjustment. Distinct psychosocial profiles exist among individuals with CVDRF, representing meaningful differences. Implications for CVDRF management are discussed.

Keywords: Chronic disease management; Diabetes mellitus; Hypercholesterolemia; Hypertension; Psychosocial factors.

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Conflict of interest statement

APC has received investigator-initiated support unrelated to this work from Amgen, Inc. All other authors declare no conflicts of interest relevant to the content of this article.

Figures

Fig. 1:
Fig. 1:
In this fgure, all psychosocial variables are z-scored, and higher values indicate a more “negative” score on that variable. CES-D=Center for epidemiologic studies depression scale; NC=Neighborhood cohesion; PC=Perceived control; ER=Emotional reactivity; GO=Goal orientation; VIG=Vigilance; OP=Optimism; ANG=AngerIn expression; CE=Childhood environment; SS=Family social support; ST=Family social strain; SN=Social network; CB=Chronic burden; DG=Discrimination-gender; DR=Discrimination-race; DS=Discrimination-SES
See this image and copyright information in PMC

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