Goal-Striving Stress and Incident Cardiovascular Disease in Blacks: The Jackson Heart Study.
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2020-05
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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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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
LaShaunta Glover
LaShaunta 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.
Emily O'Brien
Dr. Emily O’Brien is Associate Professor in Population Health Sciences, Associate Professor in Neurology, Core Faculty Member at Duke-Margolis Center for Health Policy, and Co-Director of Population Health Sciences at the Duke Clinical Research Institute. Her research focuses on comparative effectiveness, patient-centered outcomes, and pragmatic health systems research in cardiovascular and pulmonary disease. Her areas of expertise include: Epidemiology, Pragmatic Clinical Trials, and Clinical Decision Sciences. Dr. O’Brien received her PhD in Epidemiology from the University of North Carolina in Chapel Hill. As principal investigator for projects funded by the FDA, NIH, and PCORI, she has extensive experience working with diverse data sources including registries, epidemiologic cohorts, electronic health records, and administrative claims data. Dr. O’Brien teaches Analytic Methods in the Department of Population Health Sciences PhD program and has co-authored over 160 manuscripts in peer-reviewed journals on topics ranging from epidemiologic methods, comparative effectiveness, and pragmatic clinical trials. She is an associate editor for Circulation: Cardiovascular Quality and Outcomes, Chair of the AHA QCOR Scientific & Clinical Education Lifelong Learning Committee, social media editor for the Journal of the American Heart Association, and a fellow of the American Heart Association.
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