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

Emily A. Vargas; Diana A. Chirinos; Mandy Wong; Mercedes R. Carnethon; Allison J. Carroll; Catarina I. Kiefe; April P. Carson; Kiarri N. Kershaw

doi:10.1007/s10865-021-00259-1

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

Emily A. Vargas^*, Diana A. Chirinos, Mandy Wong, Mercedes R. Carnethon, Allison J. Carroll, Catarina I. Kiefe, April P. Carson, Kiarri N. Kershaw

^*Corresponding author for this work

Research output: Contribution to journal › Article › peer-review

2 Scopus citations

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.

Original language	English (US)
Pages (from-to)	172-185
Number of pages	14
Journal	Journal of Behavioral Medicine
Volume	45
Issue number	2
DOIs	https://doi.org/10.1007/s10865-021-00259-1
State	Published - Apr 2022

Funding

The Coronary Artery Risk Development in Young Adults Study (CARDIA) is conducted and supported by the National Heart, Lung, and Blood Institute (NHLBI) in collaboration with the University of Alabama at Birmingham (HHSN268201800005I & HHSN268201800007I), Northwestern University (HHSN268201800003I), University of Minnesota (HHSN268201800006I), and Kaiser Foundation Research Institute (HHSN268201800004I). EAV was funded by the T32 Research Training Program in Cardiovascular Disease Epidemiology and Prevention at Northwestern University, Department of Preventive Medicine at the time of data analysis and manuscript preparation. EAV’s effort is currently funded by the NIH/NHLBI Diversity Supplement HHSN268201800003I.

Keywords

Chronic disease management
Diabetes mellitus
Hypercholesterolemia
Hypertension
Psychosocial factors

ASJC Scopus subject areas

Psychiatry and Mental health
General Psychology

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1007/s10865-021-00259-1

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Vargas, E. A., Chirinos, D. A., Wong, M., Carnethon, M. R., Carroll, A. J., Kiefe, C. I., Carson, A. P., & Kershaw, K. N. (2022). Psychosocial profiles and longitudinal achievement of optimal cardiovascular risk factor levels: the Coronary Artery Risk Development in Young Adults (CARDIA) study. Journal of Behavioral Medicine, 45(2), 172-185. https://doi.org/10.1007/s10865-021-00259-1

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

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",

author = "Vargas, {Emily A.} and Chirinos, {Diana A.} and Mandy Wong and Carnethon, {Mercedes R.} and Carroll, {Allison J.} and Kiefe, {Catarina I.} and Carson, {April P.} and Kershaw, {Kiarri N.}",

note = "Publisher Copyright: {\textcopyright} 2021, The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.",

year = "2022",

month = apr,

doi = "10.1007/s10865-021-00259-1",

language = "English (US)",

volume = "45",

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Vargas, EA, Chirinos, DA, Wong, M, Carnethon, MR , Carroll, AJ, Kiefe, CI, Carson, AP & Kershaw, KN 2022, 'Psychosocial profiles and longitudinal achievement of optimal cardiovascular risk factor levels: the Coronary Artery Risk Development in Young Adults (CARDIA) study', Journal of Behavioral Medicine, vol. 45, no. 2, pp. 172-185. https://doi.org/10.1007/s10865-021-00259-1

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T2 - the Coronary Artery Risk Development in Young Adults (CARDIA) study

AU - Vargas, Emily A.

AU - Chirinos, Diana A.

AU - Wong, Mandy

AU - Carnethon, Mercedes R.

AU - Carroll, Allison J.

AU - Kiefe, Catarina I.

AU - Carson, April P.

AU - Kershaw, Kiarri N.

PY - 2022/4

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N2 - 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.

AB - 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.

KW - Chronic disease management

KW - Diabetes mellitus

KW - Hypercholesterolemia

KW - Hypertension

KW - Psychosocial factors

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ER -

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

Abstract

Funding

Keywords

ASJC Scopus subject areas

UN SDGs

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