Race, psychosocial factors, and aortic pulse wave velocity: the Health, Aging, and Body Composition Study.
BACKGROUND
Increasingly, researchers have begun to explore pathways through which psychosocial factors might influence cardiovascular disease, with some emphasis on early markers. The current study examined the cross-sectional association between psychosocial factors and aortic pulse wave velocity (an early marker of cardiovascular disease) in a biracial cohort of older adults. We were particularly interested in determining whether the association between psychosocial factors and aortic pulse wave velocity differed for older blacks compared with whites.


METHODS
Participants were 2,488 (40% black and 52% female) older adults from the Health, Aging, and Body Composition Study. Carotid-femoral aortic pulse wave velocity was assessed using standard methodologies. Depressive symptoms, anxiety symptoms, negative life events, and inadequate emotional support were assessed, and a summary psychosocial risk index was created.


RESULTS
In multivariable linear regression models, psychosocial risk was not associated with aortic pulse wave velocity (Estimate [Est] = .00, p = .83), but there was a significant Race × Psychosocial risk interaction (Est = .07, p = .01), after adjusting for age, race, sex, and education. Further analyses revealed that this association was driven by the inadequate emotional support component of psychosocial risk (Race × Inadequate emotional support, p = .005). In race-stratified analyses, inadequate emotional support was associated with higher levels of arterial stiffness in older blacks (Est = .05, p = .04) but not whites (Est = -.04, p = .13). This association persisted after adjusting for demographics, cardiovascular risk factors, and social network characteristics.


CONCLUSIONS
Findings suggest that older blacks may be particularly vulnerable to the effects of inadequate emotional support on vascular health. Interventions aimed at increasing social support among this population might be beneficial in reducing cardiovascular disease risk.
Department of Epidemiology and Public Health, Yale University, New Haven, Connecticut, USA. tene.lewis@yale.edu
Tené T
TT
Lewis
Kim
K
Sutton-Tyrrell
Brenda W
BW
Penninx
Nicole
N
Vogelzangs
Tamara B
TB
Harris
Georgeta D
GD
Vaidean
Hilsa N
HN
Ayonayon
Lauren
L
Kim
Edward G
EG
Lakatta
Anne B
AB
Newman
D001741:Black or African American; D000368:Aged; D000375:Aging / Q000502:physiology*; D001007:Anxiety / Q000503:physiopathology; D001011:Aorta / Q000502:physiology; D050197:Atherosclerosis / Q000209:etiology / Q000503:physiopathology*; D003863:Depression / Q000503:physiopathology; D005260:Female; D006801:Humans; D008016:Life Change Events; D016014:Linear Models; D008297:Male; D011584:Psychology; D011673:Pulsatile Flow / Q000502:physiology; D044469:Racial Groups; D012307:Risk Factors; D012944:Social Support; D044465:White People