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Psychological Well-being’s Link with Cardiovascular Health in Older Adults

      Introduction

      Favorable cardiovascular health (FCH) is associated with healthy longevity and reduced cardiovascular mortality risk. However, limited work has investigated the distribution of FCH in older age or considered the antecedents of FCH. Based on prior work linking psychological well-being with cardiovascular endpoints, higher psychological well-being was hypothesized to be associated with increased likelihood of maintaining FCH over time.

      Methods

      Data were from the English Longitudinal Study of Ageing. The first study wave (2002–2003) included men and women aged ≥50 years. The analytic sample (N=4,925) was restricted to individuals without baseline cardiovascular disease and with clinical data from three follow-ups through 2013. Psychological well-being was assessed with 17 items from the Control, Autonomy, Satisfaction, and Pleasure scale. FCH was defined as being a non-smoker, diabetes-free, and having healthy levels of blood pressure, cholesterol, and BMI (FCH scores ranged from 0–5). Statistical analyses conducted in 2016–2017 used linear mixed models to examine associations between psychological well-being and FCH scores over time. Secondary analyses examined cardiovascular-related mortality.

      Results

      Only 1% of participants had achieved complete FCH at study baseline. Adjusting for sociodemographic factors and depression, greater psychological well-being was associated with higher FCH scores across time (β=0.05, 95% CI=0.02, 0.08), but not rate of change in FCH. Psychological well-being was also associated with a 29% reduced risk of cardiovascular-related mortality in multivariable-adjusted models.

      Conclusions

      Findings suggest that psychological well-being is associated with having FCH at older ages, and add to knowledge of assets that may increase likelihood of healthy aging.
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      References

      1. Global, regional, and national age-sex specific all-cause and cause-specific mortality for 240 causes of death, 1990-2013: a systematic analysis for the Global Burden of Disease Study 2013.
        Lancet. 2015; 385: 117-171https://doi.org/10.1016/S0140-6736(14)61682-2
        • Liu K.
        • Colangelo L.A.
        • Daviglus M.L.
        • et al.
        Can antihypertensive treatment restore the risk of cardiovascular disease to ideal levels?: The Coronary Artery Risk Development in Young Adults (CARDIA) Study and the Multi-Ethnic Study of Atherosclerosis (MESA).
        J Am Heart Assoc. 2015; 4: e002275https://doi.org/10.1161/JAHA.115.002275
        • Daviglus M.L.
        • Stamler J.
        • Pirzada A.
        • et al.
        Favorable cardiovascular risk profile in young women and long-term risk of cardiovascular and all-cause mortality.
        JAMA. 2004; 292: 1588-1592https://doi.org/10.1001/jama.292.13.1588
        • Lloyd-Jones D.M.
        • Leip E.P.
        • Larson M.G.
        • et al.
        Prediction of lifetime risk for cardiovascular disease by risk factor burden at 50 years of age.
        Circulation. 2006; 113: 791-798https://doi.org/10.1161/CIRCULATIONAHA.105.548206
        • Stamler J.
        • Stamler R.
        • Neaton J.D.
        • et al.
        Low risk-factor profile and long-term cardiovascular and noncardiovascular mortality and life expectancy: findings for 5 large cohorts of young adult and middle-aged men and women.
        JAMA. 1999; 282: 2012-2018https://doi.org/10.1001/jama.282.21.2012
        • Strasser T.
        Reflections on cardiovascular diseases.
        Interdiscip Sci Rev. 1978; 3: 225-230https://doi.org/10.1179/030801878791925921
        • Folsom A.R.
        • Yatsuya H.
        • Nettleton J.A.
        • Lutsey P.L.
        • Cushman M.
        • Rosamond W.D.
        Community prevalence of ideal cardiovascular health, by the American Heart Association definition, and relationship with cardiovascular disease incidence.
        J Am Coll Cardiol. 2011; 57: 1690-1696https://doi.org/10.1016/j.jacc.2010.11.041
        • Shay C.M.
        • Ning H.
        • Allen N.B.
        • et al.
        Status of cardiovascular health in U.S. adults: prevalence estimates from the National Health and Nutrition Examination Surveys (NHANES) 2003-2008.
        Circulation. 2012; 125: 45-56https://doi.org/10.1161/CIRCULATIONAHA.111.035733
        • Fang J.
        • Yang Q.
        • Hong Y.
        • Loustalot F.
        Status of cardiovascular health among adult Americans in the 50 States and the District of Columbia, 2009.
        J Am Heart Assoc. 2012; 1: e005371https://doi.org/10.1161/JAHA.112.005371
        • Appleton A.A.
        • Buka S.L.
        • Loucks E.B.
        • Rimm E.B.
        • Martin L.T.
        • Kubzansky L.D.
        A prospective study of positive early-life psychosocial factors and favorable cardiovascular risk in adulthood.
        Circulation. 2013; 127: 905-912https://doi.org/10.1161/CIRCULATIONAHA.112.115782
        • Pulkki-Raback L.
        • Elovainio M.
        • Hakulinen C.
        • et al.
        Cumulative effect of psychosocial factors in youth on ideal cardiovascular health in adulthood: The Cardiovascular Risk in Young Finns study.
        Circulation. 2015; 131: 245-253https://doi.org/10.1161/CIRCULATIONAHA.113.007104
        • Kubzansky L.D.
        • Winning A.
        • Kawachi I.
        Affective states and health.
        in: Berkman L. Kawachi I. Glymour M.M. Social Epidemiology: New Perspectives on Social Determinants of Global Population Health. Oxford University Press, New York2014: 320-364https://doi.org/10.1093/med/9780195377903.003.0009
        • Chida Y.
        • Steptoe A.
        The association of anger and hostility with future coronary heart disease: a meta-analytic review of prospective evidence.
        J Am Coll Cardiol. 2009; 53: 936-946https://doi.org/10.1016/j.jacc.2008.11.044
        • Rugulies R.
        Depression as a predictor for coronary heart disease: a review and meta-analysis.
        Am J Prev Med. 2002; 23: 51-61https://doi.org/10.1016/S0749-3797(02)00439-7
        • Boehm J.K.
        • Kubzansky L.D.
        The heart's content: the association between positive psychological well-being and cardiovascular health.
        Psychol Bull. 2012; 138: 655-691https://doi.org/10.1037/a0027448
        • Boehm J.K.
        • Peterson C.
        • Kivimaki M.
        • Kubzansky L.D.
        Heart health when life is satisfying: evidence from the Whitehall II cohort study.
        Eur Heart J. 2011; 32: 2672-2677https://doi.org/10.1093/eurheartj/ehr203
        • Davidson K.W.
        • Mostofsky E.
        • Whang W.
        Don't worry, be happy: positive affect and reduced 10-year incident coronary heart disease: The Canadian Nova Scotia Health Survey.
        Eur Heart J. 2010; 31: 1065-1070https://doi.org/10.1093/eurheartj/ehp603
        • Tindle H.A.
        • Chang Y.F.
        • Kuller L.H.
        • et al.
        Optimism, cynical hostility, and incident coronary heart disease and mortality in the Women's Health Initiative.
        Circulation. 2009; 120: 656-662https://doi.org/10.1161/CIRCULATIONAHA.108.827642
        • Steptoe A.
        • Breeze E.
        • Banks J.
        • Nazroo J.
        Cohort profile: The English Longitudinal Study of Ageing.
        Int J Epidemiol. 2013; 42: 1640-1648https://doi.org/10.1093/ije/dys168
        • Hyde M.
        • Wiggins R.D.
        • Higgs P.
        • Blane D.B.
        A measure of quality of life in early old age: the theory, development and properties of a needs satisfaction model (CASP-19).
        Aging Ment Health. 2003; 7: 186-194https://doi.org/10.1080/1360786031000101157
        • Wiggins R.D.
        • Netuveli G.
        • Hyde M.
        • Higgs P.
        • Blane D.
        The evaluation of a self-enumerated Scale of Quality of Life (CASP-19) in the context of research on ageing: a combination of exploratory and confirmatory approaches.
        Soc Indic Res. 2008; 89: 61-77https://doi.org/10.1007/s11205-007-9220-5
        • Lloyd-Jones D.M.
        Improving the cardiovascular health of the U.S. population.
        JAMA. 2012; 307: 1314-1316https://doi.org/10.1001/jama.2012.361
        • Lloyd-Jones D.M.
        • Hong Y.
        • Labarthe D.
        • et al.
        Defining and setting national goals for cardiovascular health promotion and disease reduction: The American Heart Association's strategic impact goal through 2020 and beyond.
        Circulation. 2010; 121: 586-613https://doi.org/10.1161/CIRCULATIONAHA.109.192703
        • Graig R.
        • Deverill C.
        • Pickering K.
        Quality control of blood saliva and urine analytes.
        in: Spronston K. Mindell J. Health Survey for England 2004, Methodology and Documentation. The Information Centre, London2006: 34-41
        • Seaman S.R.
        • White I.R.
        Review of inverse probability weighting for dealing with missing data.
        Stat Methods Med Res. 2013; 22: 278-295https://doi.org/10.1177/0962280210395740
        • Hernandez R.
        • Kershaw K.N.
        • Siddique J.
        • et al.
        Optimism and cardiovascular health: Multi-Ethnic Study of Atherosclerosis (MESA).
        Health Behav Policy Rev. 2015; 2: 62-73https://doi.org/10.14485/HBPR.2.1.6
        • Friedman H.S.
        • Booth-Kewley S.
        The 'disease-prone personality': a meta-analytic view of the construct.
        Am Psychol. 1987; 42: 539-555https://doi.org/10.1037/0003-066X.42.6.539
        • Roberts B.W.
        • Kuncel N.R.
        • Shiner R.
        • Caspi A.
        • Goldberg L.R.
        The power of personality: the comparative validity of personality traits, socioeconomic status, and cognitive ability for predicting important life outcomes.
        Perspect Psychol Sci. 2007; 2: 313-345https://doi.org/10.1111/j.1745-6916.2007.00047.x
        • Abelson R.P.
        A variance explanation paradox: when a little is a lot.
        Psychol Bull. 1985; 97: 129-133https://doi.org/10.1037/0033-2909.97.1.129
        • Bolier L.
        • Haverman M.
        • Westerhof G.J.
        • Riper H.
        • Smit F.
        • Bohlmeijer E.
        Positive psychology interventions: a meta-analysis of randomized controlled studies.
        BMC Public Health. 2013; 13: 119https://doi.org/10.1186/1471-2458-13-119
        • Huffman J.C.
        • Mastromauro C.A.
        • Boehm J.K.
        • et al.
        Development of a positive psychology intervention for patients with acute cardiovascular disease.
        Heart Int. 2011; 6: 47-54https://doi.org/10.4081/hi.2011.e14
        • Boehm J.K.
        • Vie L.L.
        • Kubzansky L.D.
        The promise of well-being interventions for improving health risk behaviors.
        Curr Cardiovasc Risk Rep. 2012; 6: 511-519https://doi.org/10.1007/s12170-012-0273-x