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Associations of psychological factors with atherosclerosis and cardiovascular health in middle-age: the population-based Swedish CArdioPulmonary bioImage study (SCAPIS)
Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden; Department of Preventive Medicine and Public Health, Universidad Autónoma de Madrid, Madrid, Spain.
Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden.
Department of Biomedicine, Aarhus University, Aarhus, Denmark; Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden.
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2024 (English)In: BMC Public Health, E-ISSN 1471-2458, Vol. 24, no 1, article id 1455Article in journal (Refereed) Published
Abstract [en]

Background: Cardiovascular disease (CVD) is a major global health issue, primarily caused by atherosclerosis. Psychological factors may play a role in the development and progression of CVD. However, the relationship between psychological factors and atherosclerosis is complex and poorly understood. This study, therefore, aimed to examine the association of psychological factors with (i) coronary and carotid atherosclerosis and (ii) cardiovascular health according to Life’s Essential 8, in a large Swedish cohort.

Methods: This study utilized data from the Swedish CArdioPulmonary bioImage Study (SCAPIS), a large population-based project including individuals aged 50 to 65 years. Several psychological factors were analysed: general stress, stress at work, financial stress, major adverse life events, locus of control, feeling depressed, and depression. Coronary atherosclerosis was assessed as the degree of stenosis by coronary computed tomography angiography (CCTA) and coronary artery calcification (CAC) scores. Carotid atherosclerosis was examined using ultrasound. In addition, cardiovascular health was examined using the Life’s Essential 8 concept created by the American Heart Association, which includes four health behaviors and four health factors. Associations were examined through binomial logistic regression (atherosclerosis variables) and linear regression (Life’s Essential 8).

Results: A total of 25,658 participants were included in the study. The presence of financial stress, higher locus of control, and depression was weakly associated with increased odds of CCTA stenosis, CAC ≥ 1 and the presence of carotid plaques (all odds ratios: 1.10–1.21, 95% CI: 1.02–1.32) after adjusting for sex, age, and study site. However, these associations were attenuated and not statistically significant after additional adjustments for socioeconomic factors and health behaviors. Conversely, we observed inverse associations between the worst category for all psychological factors and cardiovascular health according to Life’s Essential 8 score (all standardized β-Coefficient ≤-0.033, p < 0.001).

Conclusion: While there were no strong and consistent associations between psychological factors and atherosclerosis, the consistent associations of psychological factors with cardiovascular health by Life’s Essential 8 may have relevance for future CVD risk. However, further studies are needed to elucidate the long-term effects of psychological factors on atherosclerosis development and cardiovascular health.

Place, publisher, year, edition, pages
BioMed Central (BMC), 2024. Vol. 24, no 1, article id 1455
Keywords [en]
Atherosclerosis, Cardiovascular disease, Coronary artery calcification, Coronary computed tomography angiography, Life’s Essential 8, Middle-aged, Psychological factors, SCAPIS
National Category
Cardiac and Cardiovascular Systems Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
URN: urn:nbn:se:umu:diva-225954DOI: 10.1186/s12889-024-18924-wISI: 001236172000004PubMedID: 38816713Scopus ID: 2-s2.0-85195013299OAI: oai:DiVA.org:umu-225954DiVA, id: diva2:1868641
Funder
Swedish Heart Lung FoundationKnut and Alice Wallenberg FoundationSwedish Research CouncilVinnovaUniversity of GothenburgKarolinska InstituteRegion StockholmLinköpings universitetLund UniversityUmeå UniversityUppsala UniversityAvailable from: 2024-06-12 Created: 2024-06-12 Last updated: 2024-06-12Bibliographically approved

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Wennberg, Patrik

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