title: Frequency of private spiritual activity and cardiovascular risk in postmenopausal women: the Women's Health Initiative.
abstract: OBJECTIVE
  Spirituality has been associated with better cardiac autonomic balance, but its association with cardiovascular risk is not well studied. We examined whether more frequent private spiritual activity was associated with reduced cardiovascular risk in postmenopausal women enrolled in the Women's Health Initiative Observational Study.
  
  
  METHODS
  Frequency of private spiritual activity (prayer, Bible reading, and meditation) was self-reported at year 5 of follow-up. Cardiovascular outcomes were centrally adjudicated, and cardiovascular risk was estimated from proportional hazards models.
  
  
  RESULTS
  Final models included 43,708 women (mean age, 68.9 ± 7.3 years; median follow-up, 7.0 years) free of cardiac disease through year 5 of follow-up. In age-adjusted models, private spiritual activity was associated with increased cardiovascular risk (hazard ratio [HR], 1.16; 95% confidence interval [CI], 1.02-1.31 for weekly vs. never; HR, 1.25; 95% CI, 1.11-1.40 for daily vs. never). In multivariate models adjusted for demographics, lifestyle, risk factors, and psychosocial factors, such association remained significant only in the group with daily activity (HR, 1.16; 95% CI, 1.03-1.30). Subgroup analyses indicate this association may be driven by the presence of severe chronic diseases.
  
  
  CONCLUSIONS
  Among aging women, higher frequency of private spiritual activity was associated with increased cardiovascular risk, likely reflecting a mobilization of spiritual resources to cope with aging and illness.
authors.affiliation: Department of Medicine, University of Massachusetts Medical School, Worcester, MA 01655, USA. Elena.Salmoirago-Blotcher@umassmed.edu
authors.forename: Elena
authors.initials: E
authors.lastname: Salmoirago-Blotcher
authors.forename: George
authors.initials: G
authors.lastname: Fitchett
authors.forename: Kathleen M
authors.initials: KM
authors.lastname: Hovey
authors.forename: Eliezer
authors.initials: E
authors.lastname: Schnall
authors.forename: Cynthia
authors.initials: C
authors.lastname: Thomson
authors.forename: Christopher A
authors.initials: CA
authors.lastname: Andrews
authors.forename: Sybil
authors.initials: S
authors.lastname: Crawford
authors.forename: Mary Jo
authors.initials: MJ
authors.lastname: O'Sullivan
authors.forename: Stephen
authors.initials: S
authors.lastname: Post
authors.forename: Rowan T
authors.initials: RT
authors.lastname: Chlebowski
authors.forename: Judith
authors.initials: J
authors.lastname: Ockene
mesh_terms: D000368:Aged; D002318:Cardiovascular Diseases / Q000453:epidemiology / Q000517:prevention & control*; D016001:Confidence Intervals; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D019122:Meditation; D008875:Middle Aged; D017698:Postmenopause / Q000523:psychology*; D016016:Proportional Hazards Models; D011603:Psychophysiology; D018570:Risk Assessment; D012307:Risk Factors; D057566:Self Report; D012959:Socioeconomic Factors; D029181:Spirituality; D011795:Surveys and Questionnaires; D016387:Women's Health