학술논문

Psychosocial profiles and longitudinal achievement of optimal cardiovascular risk factor levels: the Coronary Artery Risk Development in Young Adults (CARDIA) study.
Document Type
Article
Source
Journal of Behavioral Medicine. Apr2022, Vol. 45 Issue 2, p172-185. 14p. 4 Charts, 1 Graph.
Subject
*DIABETES complications
*CHRONIC diseases & psychology
*CARDIOVASCULAR diseases risk factors
*PERSONALITY
*HYPERTENSION
*GLYCOSYLATED hemoglobin
*SYSTOLIC blood pressure
*CLASSIFICATION
*DISCRIMINATION (Sociology)
*SOCIAL factors
*HYPERCHOLESTEREMIA
*MENTAL health
*LOW density lipoproteins
*PATIENTS
*LATENT structure analysis
*PSYCHOLOGICAL stress
*DISEASE complications
Language
ISSN
0160-7715
Abstract
Psychosocial factors are associated with the achievement of optimal cardiovascular disease risk factor (CVDRF) levels. To date, little research has examined multiple psychosocial factors simultaneously to identify distinguishing psychosocial profiles among individuals with CVDRF. Further, it is unknown whether profiles are associated with achievement of CVDRF levels longitudinally. Therefore, we characterized psychosocial profiles of individuals with CVDRF and assessed whether they are associated with achievement of optimal CVDRF levels over 15 years. We included 1148 CARDIA participants with prevalent hypertension, hypercholesterolemia and/or diabetes mellitus in 2000–2001. Eleven psychosocial variables reflecting psychological health, personality traits, and social factors were included. Optimal levels were deemed achieved if: Hemoglobin A1c (HbA1c) < 7.0%, low-density lipoprotein (LDL) cholesterol < 100 mg/dl, and systolic blood pressure (SBP) < 140 mm Hg. Latent profile analysis revealed three psychosocial profile groups "Healthy", "Distressed and Disadvantaged" and "Discriminated Against". There were no significant differences in achievement of CVDRF levels of the 3 targets combined across profiles. Participants in the "Distressed and Disadvantaged" profile were less likely to meet optimal HbA1c levels compared to individuals in the "Healthy" profile after demographic adjustment. Associations were attenuated after full covariate adjustment. Distinct psychosocial profiles exist among individuals with CVDRF, representing meaningful differences. Implications for CVDRF management are discussed. [ABSTRACT FROM AUTHOR]