Psychosocial determinants of cardiovascular events among black Americans with chronic kidney disease or associated risk factors in the Jackson heart study.
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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DOI：
10.1186/s12882-021-02594-6
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发表时间：
2021-11-11
期刊：
影响因子：
2.3
通讯作者：
Diamantidis CJ
中科院分区：
文献类型：
--
作者：
Bhavsar NA;Davenport CA;Yang LZ;Peskoe S;Scialla JJ;Hall RK;Tyson CC;Strigo T;Sims M;Pendergast J;Curtis LH;Boulware LE;Diamantidis CJ
患有慢性肾病（CKD）、高血压（HTN）或糖尿病（DM）的个体患心血管疾病（CVD）的风险增加。心理社会因素在多大程度上与这些个体的心血管疾病风险增加有关尚不清楚。由于社会经济因素、环境、种族主义和歧视，黑人个体经历了高度的心理社会压力。在杰克逊心脏研究中，我们检测了患有CKD的黑人男性和女性的心理社会因素与CVD事件风险之间的关系以及CKD风险因素。我们确定了1919名在基线时有普遍CKD或CKD风险因素的参与者。我们使用旋转主成分分析-一种无监督机器学习的形式，可以识别人无法直观识别的结构-根据一系列问卷描述五组心理社会成分（包括消极情绪，宗教信仰，歧视，消极观点和消极应对资源）。使用链式方程（MICE）多重插补来插补缺失的协变量数据。使用考克斯模型量化心理社会因素与CVD事件之间的相关性，CVD事件定义为致死性冠心病事件、心肌梗死、心脏手术（血管造影术或血运重建术）或卒中。在分析的929名参与者中，67%为女性，28%为当前/既往吸烟者，平均年龄为56岁，平均BMI为33 kg/m2。在中位随访8年期间，6%的患者发生了CVD事件。在多变量模型中，宗教信仰分量的每个标准差（SD）增加与CVD事件的风险增加相关（风险比[HR] = 1.52，95% CI：1.09-2.13）。在有CKD或CKD危险因素的参与者中，肥胖与CVD相关。需要进行研究以更好地了解这种关系的机制。在线版本包含补充材料，可通过10.1186/s12882-021-02594-6获得。
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. 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). 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. The online version contains supplementary material available at 10.1186/s12882-021-02594-6.
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影响因子：
3.1
作者：
Kendzor, Darla E.;Businelle, Michael S.;Wetter, David W.
通讯作者：
Wetter, David W.
影响因子：
12.8
作者：
Carver, Charles S.;Scheier, Michael F.;Segerstrom, Suzanne C.
通讯作者：
Segerstrom, Suzanne C.
影响因子：
3.3
作者：
BAREFOOT, JC;DODGE, KA;WILLIAMS, RB
通讯作者：
WILLIAMS, RB
影响因子：
2.4
作者：
Krause, N;Ellison, CG;Boardman, JD
通讯作者：
Boardman, JD
影响因子：
39.2
作者：
Levey AS;Stevens LA;Schmid CH;Zhang YL;Castro AF 3rd;Feldman HI;Kusek JW;Eggers P;Van Lente F;Greene T;Coresh J;CKD-EPI (Chronic Kidney Disease Epidemiology Collaboration)
通讯作者：
CKD-EPI (Chronic Kidney Disease Epidemiology Collaboration)