Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN
National Heart, Lung, and Blood Institute/National Institutes of Health, Bethesda, MD.
J Am Heart Assoc. 2018 Jun 5;7(11):e008855. doi: 10.1161/JAHA.118.008855.
BACKGROUND: Ideal cardiovascular health metrics (defined by the American Heart Association Life's Simple 7 [LS7]) are suboptimal among blacks, which results in high risk of cardiovascular disease. We examined the association of multiple stressors with LS7 components among blacks. METHODS AND RESULTS: Using a community-based cohort of blacks (N=4383), we examined associations of chronic stress, minor stressors, major life events, and a cumulative stress score with LS7 components (smoking, diet, physical activity, body mass index, blood pressure, total cholesterol, and fasting plasma glucose) and an LS7 composite score. Multivariable logistic regression assessed the odds of achieving intermediate/ideal levels of cardiovascular health adjusted for demographic, socioeconomic, behavioral, and biomedical factors. The LS7 components with the lowest percentages of intermediate/ideal cardiovascular health levels were diet (39%), body mass index (47%), and physical activity (51%). Higher chronic, minor, and cumulative stress scores were associated with decreased odds (odds ratio [OR]) of achieving intermediate/ideal levels for smoking (OR [95% confidence interval], 0.80 [0.73-0.88], 0.84 [0.75-0.94], and 0.81 [0.74-0.90], respectively). Participants with more major life events had decreased odds of achieving intermediate/ideal levels for smoking (OR, 0.84; 95% confidence interval, 0.76-0.92) and fasting plasma glucose (OR, 0.90; 95% confidence interval, 0.82-0.98). Those with higher scores for minor stressors and major life events were less likely to achieve intermediate or ideal LS7 composite scores (OR [95% confidence interval], 0.89 [0.81-0.97] and 0.91 [0.84-0.98], respectively). CONCLUSIONS: Blacks with higher levels of multiple stress measures are less likely to achieve intermediate or ideal levels of overall cardiovascular health (LS7 composite score), specific behaviors (smoking), and biological factors (fasting plasma glucose).
背景:理想心血管健康指标(由美国心脏协会的生命的简单 7 项指标定义)在黑人中并不理想,这导致了心血管疾病的高风险。我们研究了多种压力源与黑人的 LS7 成分之间的关系。
方法和结果:我们使用一个基于社区的黑人队列(N=4383),研究了慢性压力、小压力源、大生活事件和累积压力评分与 LS7 成分(吸烟、饮食、身体活动、体重指数、血压、总胆固醇和空腹血糖)以及 LS7 综合评分的关系。多变量逻辑回归评估了在调整人口统计学、社会经济、行为和生物医学因素后,达到中等/理想心血管健康水平的可能性。LS7 成分中,达到中等/理想心血管健康水平的比例最低的是饮食(39%)、体重指数(47%)和身体活动(51%)。较高的慢性、小和累积压力评分与较低的中等/理想水平的可能性相关,例如,对于吸烟,较高的慢性压力评分(比值比[OR],0.80[0.73-0.88])、小压力评分(OR,0.84[0.75-0.94])和累积压力评分(OR,0.81[0.74-0.90])。经历更多大生活事件的参与者实现中等/理想的吸烟和空腹血糖水平的可能性降低(OR,0.84;95%置信区间,0.76-0.92 和 OR,0.90;95%置信区间,0.82-0.98)。小压力源和大生活事件得分较高的人不太可能达到中等或理想的 LS7 综合评分(OR[95%置信区间],0.89[0.81-0.97]和 0.91[0.84-0.98])。
结论:黑人的多种压力指标水平越高,达到整体心血管健康(LS7 综合评分)、特定行为(吸烟)和生物因素(空腹血糖)的中等或理想水平的可能性就越低。
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