Abstract
Background:
Studies show that cardiovascular disease (CVD) risk factors are correlated with psychological distress. Minimal research has been conducted exploring the relationship between psychological distress and CVD risk among Hispanic/ Latinos (H/L) of different background groups. The aim of this study was to investigate which CVD risk factors were most strongly correlated with psychological distress.
Methods:
The multi-site prospective population-based Hispanic Community Health Study/ Study of Latinos enrolled a cohort of H/L adults (n = 16,415) ages 18-74 in four US communities (Chicago, San Diego, Miami, and Bronx). Households were selected using a stratified two-stage probability sampling design and door-to-door recruitment, and sampling weights calibrated to the 2010 US Population Census. Analyses involve 15,464 participants with complete data. Psychological distress (i.e., 10-item Center for Epidemiological Studies Depression Scale and 10 item Spielberger Trait Anxiety Scale), socio-demographics (i.e., age, education, health insurance, gender, and H/L background), acculturation (i.e., years in the U.S., country of birth, and language), and CVD risk factors [i.e., dyslipidemia (HDL cholesterol < 40, LDL cholesterol ≥ 160,or triglycerides ≥ 200), body mass index (BMI), current cigarette smoking, diabetes (i.e., fasting time > 8 hr AND fasting glucose ≥ 126, or fasting time ≤ 8 hr AND fasting glucose ≥ 200, or post-OGTT glucose ≥ 200, or A1C≥ 6.5 or on medication), and hypertension (blood pressure ≥140/90 or on mediations)] were measured during the HCHS/SOL baseline exam. Associations between CVD risk factors and psychological distress were assessed using multiple linear regression models with depression and anxiety as dependent variables, accounting for the complex survey design and sampling weights, and controlling for socio-demographic and acculturation covariates.
Results:
Current smoking, diabetes, and BMI were significantly associated with depression and anxiety symptoms, after adjusting for covariates. Mean depressive symptomatology was 1.66 higher among smokers, .58 higher among diabetics, and increased by .04 for every one unit increase in BMI; mean anxiety symptomatology was 1.31 higher among smokers, .58 higher among diabetics, and increased by .05 for every one unit increase in BMI, adjusting for other factors. Dyslipidemia and hypertension were not associated with depression or anxiety.
Discussion:
Results demonstrate that certain CVD risk factors (i.e., smoking, diabetes, and BMI) were associated with psychological distress. Among the multiple CVD risk factors, current smoking was the strongest correlate; indicating its importance in CVD risk reduction among patients with depressive symptomatology.