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

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Virtanen , M , Elovainio , M , Josefsson , K , Batty , G D , Singh-Manoux , A & Kivimaki , M 2017 , ' Coronary heart disease and risk factors as predictors of trajectories of psychological distress from midlife to old age ' , Heart , vol. 103 , no. 9 , pp. 659-665 . https://doi.org/10.1136/heartjnl-2016-310207

Title: Coronary heart disease and risk factors as predictors of trajectories of psychological distress from midlife to old age
Author: Virtanen, Marianna; Elovainio, Marko; Josefsson, Kim; Batty, G. David; Singh-Manoux, Archana; Kivimaki, Mika
Contributor: University of Helsinki, Medicum
University of Helsinki, National Institute for Health and Welfare (THL)
University of Helsinki, Clinicum
Date: 2017-05
Language: eng
Number of pages: 7
Belongs to series: Heart
ISSN: 1355-6037
URI: http://hdl.handle.net/10138/195369
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.
Subject: MYOCARDIAL-INFARCTION
DEPRESSIVE SYMPTOMS
PROSPECTIVE COHORT
WHITEHALL-II
CARDIOVASCULAR-DISEASE
LATER-LIFE
METAANALYSIS
MORTALITY
ASSOCIATION
PREVALENCE
3121 General medicine, internal medicine and other clinical medicine
3142 Public health care science, environmental and occupational health
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