Psychosocial determinants of cardiovascular events among black Americans with chronic kidney disease or associated risk factors in the Jackson heart study

Abstract Background Individuals with chronic kidney disease (CKD), hypertension (HTN), or diabetes mellitus (DM) are at increased risk for cardiovascular disease (CVD). The extent to which psychosocial factors are associated with increased CVD risk within these individuals is unclear. Black individu...

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Autores principales:	Nrupen A. Bhavsar, Clemontina A. Davenport, Lexie Zidanyue Yang, Sarah Peskoe, Julia J. Scialla, Rasheeda K. Hall, Crystal C. Tyson, Tara Strigo, Mario Sims, Jane Pendergast, Lesley H. Curtis, L. Ebony Boulware, Clarissa J. Diamantidis
Formato:	article
Lenguaje:	EN
Publicado:	BMC 2021
Materias:	Diseases of the genitourinary system. Urology RC870-923
Acceso en línea:	https://doaj.org/article/d6884082cab747519336222cb9d071d0
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spelling	oai:doaj.org-article:d6884082cab747519336222cb9d071d02021-11-14T12:43:57ZPsychosocial determinants of cardiovascular events among black Americans with chronic kidney disease or associated risk factors in the Jackson heart study10.1186/s12882-021-02594-61471-2369https://doaj.org/article/d6884082cab747519336222cb9d071d02021-11-01T00:00:00Zhttps://doi.org/10.1186/s12882-021-02594-6https://doaj.org/toc/1471-2369Abstract Background Individuals with chronic kidney disease (CKD), hypertension (HTN), or diabetes mellitus (DM) are at increased risk for cardiovascular disease (CVD). The extent to which psychosocial factors are associated with increased CVD risk within these individuals is unclear. Black individuals experience a high degree of psychosocial stressors due to socioeconomic factors, environment, racism, and discrimination. We examined the association between psychosocial factors and risk of CVD events among Black men and women with CKD and CKD risk factors in the Jackson Heart Study. Methods and Results We identified 1919 participants with prevalent CKD or CKD risk factors at baseline. We used rotated principal component analysis - a form of unsupervised machine learning that may identify constructs not intuitively identified by a person - to describe five groups of psychosocial components (including negative moods, religiosity, discrimination, negative outlooks, and negative coping resources) based on a battery of questionnaires. Multiple imputation by chained equation (MICE) was used to impute missing covariate data. Cox models were used to quantify the association between psychosocial components and incident CVD, defined as a fatal coronary heart disease event, myocardial infarction, cardiac procedure (angiography or revascularization procedure), or stroke. Of the 929 participants in the analysis, 67% were female, 28% were current/former smokers with mean age of 56 years and mean BMI of 33 kg/m2. Over a median follow-up of 8 years, 6% had an incident CVD event. In multivariable models, each standard deviation (SD) increase in the religiosity component was associated with an increased hazard for CVD event (hazard ratio [HR] = 1.52, 95% CI: 1.09–2.13). Conclusions Religiosity was associated with CVD among participants with prevalent CKD or CKD risk factors. Studies to better understand the mechanisms of this relationship are needed.Nrupen A. BhavsarClemontina A. DavenportLexie Zidanyue YangSarah PeskoeJulia J. SciallaRasheeda K. HallCrystal C. TysonTara StrigoMario SimsJane PendergastLesley H. CurtisL. Ebony BoulwareClarissa J. DiamantidisBMCarticleDiseases of the genitourinary system. UrologyRC870-923ENBMC Nephrology, Vol 22, Iss 1, Pp 1-13 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Diseases of the genitourinary system. Urology RC870-923
spellingShingle	Diseases of the genitourinary system. Urology RC870-923 Nrupen A. Bhavsar Clemontina A. Davenport Lexie Zidanyue Yang Sarah Peskoe Julia J. Scialla Rasheeda K. Hall Crystal C. Tyson Tara Strigo Mario Sims Jane Pendergast Lesley H. Curtis L. Ebony Boulware Clarissa J. Diamantidis Psychosocial determinants of cardiovascular events among black Americans with chronic kidney disease or associated risk factors in the Jackson heart study
description	Abstract Background Individuals with chronic kidney disease (CKD), hypertension (HTN), or diabetes mellitus (DM) are at increased risk for cardiovascular disease (CVD). The extent to which psychosocial factors are associated with increased CVD risk within these individuals is unclear. Black individuals experience a high degree of psychosocial stressors due to socioeconomic factors, environment, racism, and discrimination. We examined the association between psychosocial factors and risk of CVD events among Black men and women with CKD and CKD risk factors in the Jackson Heart Study. Methods and Results We identified 1919 participants with prevalent CKD or CKD risk factors at baseline. We used rotated principal component analysis - a form of unsupervised machine learning that may identify constructs not intuitively identified by a person - to describe five groups of psychosocial components (including negative moods, religiosity, discrimination, negative outlooks, and negative coping resources) based on a battery of questionnaires. Multiple imputation by chained equation (MICE) was used to impute missing covariate data. Cox models were used to quantify the association between psychosocial components and incident CVD, defined as a fatal coronary heart disease event, myocardial infarction, cardiac procedure (angiography or revascularization procedure), or stroke. Of the 929 participants in the analysis, 67% were female, 28% were current/former smokers with mean age of 56 years and mean BMI of 33 kg/m2. Over a median follow-up of 8 years, 6% had an incident CVD event. In multivariable models, each standard deviation (SD) increase in the religiosity component was associated with an increased hazard for CVD event (hazard ratio [HR] = 1.52, 95% CI: 1.09–2.13). Conclusions Religiosity was associated with CVD among participants with prevalent CKD or CKD risk factors. Studies to better understand the mechanisms of this relationship are needed.
format	article
author	Nrupen A. Bhavsar Clemontina A. Davenport Lexie Zidanyue Yang Sarah Peskoe Julia J. Scialla Rasheeda K. Hall Crystal C. Tyson Tara Strigo Mario Sims Jane Pendergast Lesley H. Curtis L. Ebony Boulware Clarissa J. Diamantidis
author_facet	Nrupen A. Bhavsar Clemontina A. Davenport Lexie Zidanyue Yang Sarah Peskoe Julia J. Scialla Rasheeda K. Hall Crystal C. Tyson Tara Strigo Mario Sims Jane Pendergast Lesley H. Curtis L. Ebony Boulware Clarissa J. Diamantidis
author_sort	Nrupen A. Bhavsar
title	Psychosocial determinants of cardiovascular events among black Americans with chronic kidney disease or associated risk factors in the Jackson heart study
title_short	Psychosocial determinants of cardiovascular events among black Americans with chronic kidney disease or associated risk factors in the Jackson heart study
title_full	Psychosocial determinants of cardiovascular events among black Americans with chronic kidney disease or associated risk factors in the Jackson heart study
title_fullStr	Psychosocial determinants of cardiovascular events among black Americans with chronic kidney disease or associated risk factors in the Jackson heart study
title_full_unstemmed	Psychosocial determinants of cardiovascular events among black Americans with chronic kidney disease or associated risk factors in the Jackson heart study
title_sort	psychosocial determinants of cardiovascular events among black americans with chronic kidney disease or associated risk factors in the jackson heart study
publisher	BMC
publishDate	2021
url	https://doaj.org/article/d6884082cab747519336222cb9d071d0
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Psychosocial determinants of cardiovascular events among black Americans with chronic kidney disease or associated risk factors in the Jackson heart study

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