Goal-Striving Stress and Incident Cardiovascular Disease in Blacks: The Jackson Heart Study.

Abstract

Background Goal-striving stress (GSS), the stress from striving for goals, is associated with poor health. Less is known about its association with cardiovascular disease (CVD). Methods and Results We used data from the JHS (Jackson Heart Study), a study of CVD among blacks (21-95 years old) from 2000 to 2015. Participants free of CVD at baseline (2000-2004) were included in this analysis (n=4648). GSS was examined in categories (low, moderate, high) and in SD units. Incident CVD was defined as fatal or nonfatal stroke, coronary heart disease (CHD), and/or heart failure. We used Cox proportional hazards regression to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) of incident CVD by levels of GSS, adjusting for demographics, socioeconomic status, health behaviors, risk factors, and perceived stress. The distribution of GSS categories was as follows: 40.77% low, 33.97% moderate, and 25.26% high. Over an average of 12 years, there were 140 incident stroke events, 164 CHD events, and 194 heart failure events. After full adjustment, high (versus low) GSS was associated with a lower risk of stroke (HR, 0.38; 95% CI, 0.17-0.83) and a higher risk of CHD (HR, 1.91; 95% CI, 1.10-3.33) among women. A 1-standard deviation unit increase in GSS was associated with a 31% increased risk of CHD (HR, 1.31; 95% CI, 1.10-1.56) among women. Conclusions Higher GSS may be a risk factor for developing CHD among women; however, it appears to be protective of stroke among women. These analyses should be replicated in other samples of black individuals.

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Citation

Published Version (Please cite this version)

10.1161/jaha.119.015707

Publication Info

Glover, LáShauntá M, Loretta R Cain-Shields, Tanya M Spruill, Emily C O'Brien, Sharrelle Barber, Laura Loehr and Mario Sims (2020). Goal-Striving Stress and Incident Cardiovascular Disease in Blacks: The Jackson Heart Study. Journal of the American Heart Association, 9(9). p. e015707. 10.1161/jaha.119.015707 Retrieved from https://hdl.handle.net/10161/26510.

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Scholars@Duke

Glover

LaShaunta Glover

Medical Instructor in the Department of Population Health Sciences

Dr. Glover is an epidemiologist with expertise in cardiovascular, social, and genetic epidemiology. Her research focuses on evaluating and understanding the social determinants of health that exacerbate cardiovascular disease. Her research additionally focuses on exploring social-biological pathways to cardiovascular disease risk with specific focus on OMICs (e.g. epigenomics, proteomics, metabolomics), as a way to understand how social factors lead to upstream cardiovascular disease. Dr. Glover primarily utilizes data from longitudinal cohort studies to understand these associations, and is passionate about investigating reasons for health disparities in populations.

O'Brien

Emily O'Brien

Associate Professor in Population Health Sciences

I am an epidemiologist and health services researcher at the Duke Clinical Research Institute. My research focuses on comparative effectiveness, patient-centered outcomes, and pragmatic health services research in cardiovascular and pulmonary disease.

Areas of expertise: Epidemiology, Health Services Research, and Clinical Decision Sciences


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