Coronary heart disease and risk factors as predictors of trajectories of psychological distress from midlife to old age.

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  • Additional Information
    • Source:
      Publisher: BMJ Pub. Group Country of Publication: England NLM ID: 9602087 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1468-201X (Electronic) Linking ISSN: 13556037 NLM ISO Abbreviation: Heart Subsets: MEDLINE
    • Publication Information:
      Original Publication: London : BMJ Pub. Group, c1996-
    • Subject Terms:
      Aging/*physiology ; Coronary Disease/*psychology ; Stress, Psychological/*psychology; Adult ; Age Factors ; Comorbidity ; Coronary Disease/diagnosis ; Coronary Disease/epidemiology ; Female ; Humans ; Life Style ; London/epidemiology ; Longitudinal Studies ; Male ; Middle Aged ; Multivariate Analysis ; Nonlinear Dynamics ; Obesity/epidemiology ; Obesity/psychology ; Odds Ratio ; Prevalence ; Prospective Studies ; Risk Assessment ; Risk Factors ; Smoking/adverse effects ; Smoking/epidemiology ; Smoking/psychology ; Stress, Psychological/diagnosis ; Stress, Psychological/epidemiology ; Surveys and Questionnaires ; Time Factors
    • Abstract:
      Objective: To examine coronary heart disease (CHD) and its risk factors as predictors of long-term trajectories of psychological distress from midlife to old age.
      Methods: In the Whitehall II cohort study, 6890 participants (4814 men, 2076 women; mean age 49.5 years) had up to seven repeat assessments of psychological distress over 21 years (mean follow-up 19 years). CHD and its risk factors (lifestyle-related risk factors, diabetes, hypertension and cholesterol) were assessed at baseline. Group-based trajectory modelling was used to identify clusters of individuals with a similar pattern of psychological distress over time.
      Results: We identified four trajectories of psychological distress over the follow-up: 'persistently low' (69% of the participants), 'persistently intermediate' (13%), 'intermediate to low' (12%) and 'persistently high' (7%). The corresponding proportions were 60%, 16%, 13% and 11% among participants with CHD; 63%, 15%, 12% and 10% among smokers and 63%, 16%, 12% and 10% among obese participants. In multivariable adjusted multinomial regression analyses comparing other trajectories to persistently low trajectory, prevalent CHD was associated with intermediate to low (OR 1.70, 95% CI 1.08 to 2.68) and persistently high (OR 1.92, 95% CI 1.16 to 3.19) trajectories. Smoking (OR 1.33, 95% CI 1.07 to 1.64; OR 1.55, 95% CI 1.19 to 2.04) and obesity (OR 1.33, 95% CI 1.04 to 1.70; OR 1.47, 95% CI 1.07 to 2.01) were associated with persistently intermediate and persistently high trajectories, respectively.
      Conclusion: CHD, smoking and obesity may have a role in the development of long-lasting psychological distress from midlife to old age.
      (Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.)
    • Comments:
      Comment in: Heart. 2017 May;103(9):649-650. (PMID: 27940968)
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    • Grant Information:
      K013351 United Kingdom MRC_ Medical Research Council; RG/13/2/30098 United Kingdom BHF_ British Heart Foundation; R01 HL036310 United States HL NHLBI NIH HHS; R01 AG034454 United States AG NIA NIH HHS; MR/K013351/1 United Kingdom MRC_ Medical Research Council; R01 AG013196 United States AG NIA NIH HHS
    • Publication Date:
      Date Created: 20161120 Date Completed: 20170724 Latest Revision: 20240327
    • Publication Date:
      20240327
    • Accession Number:
      PMC5529979
    • Accession Number:
      10.1136/heartjnl-2016-310207
    • Accession Number:
      27864318