Sex Differences in Associations of Depressive Symptoms with Cardiovascular Risk Factors and Metabolic Syndrome among African Americans

Young to middle-aged women usually have notably lower rates of cardiovascular disease (CVD) than their male counterparts, but African American women lack this advantage. Their elevated CVD may be influenced by sex differences in associations between depressed mood and CVD risk factors. This cross-sectional study examined whether relations between scores on the Center for Epidemiologic Studies-Depression (CES-D) scale and a spectrum of CVD risk factors varied by sex among African Americans (n=1076; ages 30–64) from the Healthy Aging in Neighborhoods of Diversity across the Life Span (HANDLS) study. Sex-stratified multiple regressions and logistic regressions were conducted. Among women, CES-D scores correlated positively with systolic blood pressure and waist-to-hip ratio (P's<.05), but inversely with high-density lipoprotein cholesterol (HDL-C) (P<.01). Women had twice the odds for metabolic syndrome if CES-D scores ≥16 and had a ≥14% increase in odds of hypertension, abdominal obesity, and low HDL-C with each 5-unit increase in CES-D scores. Among men, CES-D scores correlated positively with high-sensitivity C-reactive protein (P<.05), and odds of hypertension increased by 21% with each 5-unit increase in CES-D scores. Depressive symptoms may promote premature CVD risk in African Americans, at least in part, via CVD risk factors and prevalent metabolic syndrome, particularly in African American women.

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Relationship between Depressive Symptoms and Cardiovascular Disease Risk Factors in African American Individuals

Depression Research and Treatment ◽

10.1155/2011/836542 ◽

2011 ◽

Vol 2011 ◽

pp. 1-6 ◽

Cited By ~ 1

Author(s):

Ali A. Weinstein ◽

Preetha Abraham ◽

Guoqing Diao ◽

Stacey A. Zeno ◽

Patricia A. Deuster

Keyword(s):

Risk Factors ◽

Cardiovascular Disease ◽

African American ◽

Depressive Symptoms ◽

Disease Risk ◽

Cardiovascular Disease Risk ◽

Regression Analyses ◽

Cvd Risk Factors ◽

Cvd Risk ◽

The Relationship

Objective. To examine the relationship between depressive symptoms and cardiovascular disease (CVD) risk factors in a group of African American individuals.Design. A nonrandom sample of 253 (age 43.7 ± 11.6 years; 37% male) African American individuals was recruited by advertisements. Data were obtained by validated questionnaires, anthropometric, blood pressure, and blood sample measurements.Results. Regression analyses were performed to assess the relationship between depressive symptoms and CVD risk factors controlling for socioeconomic status indicators. These analyses demonstrated that those with higher levels of depressive symptoms had larger waist-to-hip ratios, higher percent body fat, higher triglycerides, and were more likely to be smokers.Conclusions. It has been well documented that higher levels of depressive symptoms are associated with higher CVD risk. However, this evidence is derived primarily from samples of predominantly Caucasian individuals. The present investigation demonstrates that depressive symptoms are related to CVD risk factors in African American individuals.

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Effect of Obesity on Cardiovascular Disease Risk Factors in African American Women

Biological Research For Nursing ◽

10.1177/1099800411405031 ◽

2011 ◽

Vol 14 (2) ◽

pp. 171-179 ◽

Cited By ~ 3

Author(s):

Queen Henry-Okafor ◽

Patricia A. Cowan ◽

Mona N. Wicks ◽

Muriel Rice ◽

Donna S. Husch ◽

...

Keyword(s):

Risk Factors ◽

Cardiovascular Disease ◽

African American ◽

African American Women ◽

Normal Weight ◽

Cvd Risk Factors ◽

Cvd Risk ◽

American Women ◽

History Of ◽

Hs Crp

Obesity is a growing health care concern with implications for cardiovascular disease (CVD). Obesity and CVD morbidity and mortality are highly prevalent among African American women. This pilot study examined the association between obesity and the traditional and emerging CVD risk factors in a sample of African American women. Participants comprised 48 women (27 obese, 21 normal weight) aged 18–45. with no known history of CVD. The women completed demographic and 7-day physical activity recall questionnaires. Height and weight were used to determine body mass index (BMI). Hypertension risk was assessed using the average of two resting blood pressure (BP) measurements. Lipid profile, blood glucose, fibrinogen, high-sensitivity C-reactive protein (hs-CRP), plasminogen activator inhibitor-1 (PAI-1), soluble intercellular adhesion molecule-1 (sICAM-1), and E-selectin (eSel) levels were assessed using fasting blood samples. Laboratory findings were interpreted using the American Diabetes Association (ADA) and Adult Treatment Panel (ATP) III reference guidelines as well as manufacturers’ reference ranges for the novel CVD risk factors. The most common traditional risk factors were physical inactivity (72.9%), positive family history of CVD (58.3%), and obesity (56.3%). Obese individuals had elevated systolic BP ( p = .0002), diastolic BP ( p = .0007) and HDL-cholesterol ( p = .01), triglyceride ( p = .02), hs-CRP ( p = .002), and fibrinogen ( p = .01), when compared with normal-weight women. The findings suggest an association between obesity and higher prevalence of both traditional and emerging CVD risk factors in young African American women.

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EXERCISE VERSUS BODY MASS INDEX AS PREDICTORS OF CVD RISK FACTORS IN AFRICAN-AMERICAN WOMEN 501

Medicine & Science in Sports & Exercise ◽

10.1097/00005768-199705001-00500 ◽

1997 ◽

Vol 29 (Supplement) ◽

pp. 87

Author(s):

C. L. Melby ◽

B. Finnestead ◽

W. D. Schmidt ◽

M. L. Toohey ◽

M. A. Harris

Keyword(s):

Risk Factors ◽

Body Mass Index ◽

African American ◽

African American Women ◽

Body Mass ◽

Cvd Risk Factors ◽

Cvd Risk ◽

American Women

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Mind-Body Therapies for African-American Women at Risk for Cardiometabolic Disease: A Systematic Review

Evidence-based Complementary and Alternative Medicine ◽

10.1155/2018/5123217 ◽

2018 ◽

Vol 2018 ◽

pp. 1-11 ◽

Cited By ~ 5

Author(s):

Candace C. Johnson ◽

Karen M. Sheffield ◽

Roy E. Brown

Keyword(s):

Risk Factors ◽

Blood Pressure ◽

African American ◽

High Risk ◽

African American Women ◽

Cardiometabolic Health ◽

Adult Women ◽

Cvd Risk Factors ◽

Cvd Risk ◽

Health Domains

Background. A major determinant in cardiometabolic health is metabolic syndrome (MetS), a cluster of symptoms that portend the development of cardiovascular disease (CVD). As mind-body therapies are thought to help in lowering physiological and environmental CVD risk factors including blood pressure and psychological stress, they may also be beneficial for the primary prevention of CVD. Objectives. To synthesize and summarize existing knowledge on the effectiveness of mind-body therapies on MetS outcomes in African-American (AA) women, a US subpopulation at high risk for CVD. Search Methods. A systematic search of eight databases was conducted in order to identify published papers addressing the topic. We included trials involving AA adult women, ages 18–64, and we included RCTs that involved multifactorial interventions. Outcomes of interest were MetS, chronic disease, and CVD risk factors (blood pressure, blood lipids, blood glucose, BMI, waist circumference, and mental health domains). Two authors independently selected trials for inclusion, extracted data, and assessed risks of bias. Main Results. We identified five trials for inclusion in this review. One study reported outcomes associated with the full MetS symptom cluster. The included trials were small, short term, and at high risk of bias. All interventions lasted at least 6 weeks.

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Neighborhood Environment Associates with Trimethylamine-N-Oxide (TMAO) as a Cardiovascular Risk Marker

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18084296 ◽

2021 ◽

Vol 18 (8) ◽

pp. 4296

Author(s):

Nicole Farmer ◽

Cristhian A. Gutierrez-Huerta ◽

Briana S. Turner ◽

Valerie M. Mitchell ◽

Billy S. Collins ◽

...

Keyword(s):

Risk Factors ◽

African American ◽

Dietary Intake ◽

Cvd Risk Factors ◽

Cvd Risk ◽

Neighborhood Deprivation ◽

Microbial Metabolite ◽

African American Adults ◽

Tnf Α ◽

The Relationship

Background: Neighborhoods and the microbiome are linked to cardiovascular disease (CVD), yet investigations to identify microbiome-related factors at neighborhood levels have not been widely investigated. We sought to explore relationships between neighborhood deprivation index (NDI) and the microbial metabolite, trimethylamine-N-oxide. We hypothesized that inflammatory markers and dietary intake would be mediators of the relationship. Methods: African-American adults at risk for CVD living in the Washington, DC area were recruited to participate in a cross-sectional community-based study. US census-based neighborhood deprivation index (NDI) measures (at the census-tract level) were determined. Serum samples were analyzed for CVD risk factors, cytokines, and the microbial metabolite, trimethylamine-N-oxide (TMAO). Self-reported dietary intake based on food groups was collected. Results: Study participants (n = 60) were predominantly female (93.3%), with a mean (SD) age of 60.83 (+/−10.52) years. Mean (SD) NDI was −1.54 (2.94), and mean (SD) TMAO level was 4.99 (9.65) µmol/L. Adjusting for CVD risk factors and BMI, NDI was positively associated with TMAO (β = 0.31, p = 0.02). Using mediation analysis, the relationship between NDI and TMAO was significantly mediated by TNF-α (60.15%) and interleukin)-1 β (IL; 49.96%). When controlling for clustering within neighborhoods, the NDI-TMAO association was no longer significant (β = 5.11, p = 0.11). However, the association between NDI and IL-1 β (β = 0.04, p = 0.004) and TNF-α (β = 0.17, p = 0.003) remained. Neither NDI nor TMAO was significantly associated with daily dietary intake. Conclusion and Relevance: Among a small sample of African-American adults at risk for CVD, there was a significant positive relationship with NDI and TMAO mediated by inflammation. These hypothesis-generating results are initial and need to be confirmed in larger studies.

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Anthropometric cut-points for discriminating diabetes and the metabolic syndrome among Arabs and Asians: the Kuwait Diabetes Epidemiology Program

British Journal Of Nutrition ◽

10.1017/s0007114521000751 ◽

2021 ◽

pp. 1-11

Author(s):

Victor M. Oguoma ◽

Neil T. Coffee ◽

Saad Alsharrah ◽

Mohamed Abu-Farha ◽

Faisal H. Al-Refaei ◽

...

Keyword(s):

Risk Factors ◽

Metabolic Syndrome ◽

Ethnic Groups ◽

South Asian ◽

International Diabetes Federation ◽

Cvd Risk Factors ◽

Cvd Risk ◽

Data Set ◽

Cut Points ◽

The Metabolic Syndrome

Abstract This study aimed to determine anthropometric cut-points for screening diabetes and the metabolic syndrome (MetS) in Arab and South Asian ethnic groups in Kuwait and to compare the prevalence of the MetS based on the ethnic-specific waist circumference (WC) cut-point and the International Diabetes Federation (IDF) and American Heart Association/National Heart, Lung, and Blood Institute WC criteria. The national population-based survey data set of diabetes and obesity in Kuwait adults aged 18–60 years was analysed. Age-adjusted logistic regression and receiver operating characteristic (ROC) analyses were conducted to evaluate for 3589 individuals the utility of WC, waist:height ratio (WHtR) and BMI to discriminate both diabetes and ≥3 CVD risk factors. Areas under the ROC curve were similar for WC, WHtR and BMI. In Arab men, WC, WHtR and BMI cut-offs for diabetes were 106 cm, 0·55 and 28 kg/m2 and for ≥3 CVD risk factors, 97 cm, 0·55 and 28 kg/m2, respectively. In Arab women, cut-offs for diabetes were 107 cm, 0·65 and 33 kg/m2 and for ≥3 CVD risk factors, 93 cm, 0·60 and 30 kg/m2, respectively. WC cut-offs were higher for South Asian women than men. IDF-based WC cut-offs corresponded to a higher prevalence of the MetS across sex and ethnic groups, compared with Kuwait-specific cut-offs. Any of the assessed anthropometric indices can be used in screening of diabetes and ≥3 CVD risk factors in Kuwaiti Arab and Asian populations. ROC values were similar. The WC threshold for screening the MetS in Kuwaiti Arabs and South Asians is higher for women.

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Abstract 1814: Perceived Cardiac Risk Underestimated Among Urban Diabetics

Circulation ◽

10.1161/circ.116.suppl_16.ii_386-c ◽

2007 ◽

Vol 116 (suppl_16) ◽

Author(s):

Jerilyn K Allen ◽

Cheryl Dennison ◽

Allison Purcell ◽

Sarah Szanton ◽

Martha Hill ◽

...

Keyword(s):

Risk Factors ◽

Depressive Symptoms ◽

Perceived Risk ◽

Type Ii ◽

Cvd Risk Factors ◽

Cvd Risk ◽

Current Smoking ◽

Actual Risk ◽

Developing Heart ◽

Objective Risk

Cardiovascular disease (CVD) is the leading cause of death in diabetics; however, understanding among diabetics of the importance of CVD as a major health threat is unknown. We studied perceived and actual risk of developing CVD and the factors associated with perceptions of CVD risk in a sample of 82 type II diabetic patients without diagnosed CVD. Data were collected during baseline evaluation for a randomized trial to reduce total CVD risk in urban community clinics. Perceived risk was determined by the patients’ estimation of their personal likelihood of developing heart disease and objective risk was calculated using the Framingham Index. Depressive symptoms were measured by the CES-D and overall perception of health by the EuroQuol. CVD risk factors were measured directly using standardized procedures. The sample was 73% female and 93% Black. Mean age was 54 ± 11 years, 32% had not graduated from high school and 55% had annual household incomes <$20,000. CVD risk factor burden was high: 70% were obese; 68% had BP≥130/80; 56% had high LDL-C; and 31% were current smokers. The Framingham 10 year CVD risk ranged from 1–33% with average risk of 11.4 ± 7.2%. In contrast, only 18% of patients perceived themselves at high risk for developing heart disease. Objective and perceived CVD risk were not significantly associated (β=−0.38; p<0.31). Increased levels of perceived risk were associated with younger age (β= −0.648; p=0.007), greater depressive symptoms (β=0.87; p<.000), poorer general health perception (β= −0.51; p<.000); and current smoking (β=14.27; p=0.02); but there was no association with HgA1c, LDL-C, or blood pressure levels. In a multivariate model, greater depressive symptoms, poorer general health perceptions, and current smoking were independently associated with perceived risk for CVD. Urban, disadvantaged diabetics in this study of predominately Black women had many CVD risk factors and increased objective risk for developing CVD. However, there was a gap between perceived and actual risk of CVD. Attempts to improve the cardiovascular health of underserved groups should include interventions to increase awareness and control of CVD risk factors among type II diabetics, particularly aimed at racial/ethnic minority women.

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Abstract P115: Relationship between Cardiovascular Risk Factors and Psychological Distress among Hispanic/Latinos: The Hispanic Community Health Study/ Study of Latinos

Circulation ◽

10.1161/circ.127.suppl_12.ap115 ◽

2013 ◽

Vol 127 (suppl_12) ◽

Author(s):

Sheila F Castaneda ◽

Patricia Gonzalez ◽

Linda C Gallo ◽

Gregory A Talavera ◽

Addie L Fortmann ◽

...

Keyword(s):

Risk Factors ◽

Psychological Distress ◽

Depressive Symptomatology ◽

Health Study ◽

Cvd Risk Factors ◽

Cvd Risk ◽

Sampling Weights ◽

Hispanic Community ◽

Unit Increase ◽

Hispanic Latinos

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.

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Reversal Rate of Clustering of Cardiovascular Disease Risk Factors of Metabolic Syndrome in the General Population: The Niigata Preventive Medicine Study

Journal of Obesity ◽

10.1155/2010/623593 ◽

2010 ◽

Vol 2010 ◽

pp. 1-5 ◽

Cited By ~ 3

Author(s):

Shinsuke Okada ◽

Akiko Suzuki ◽

Hiroshi Watanabe ◽

Toru Watanabe ◽

Yoshifusa Aizawa

Keyword(s):

Risk Factors ◽

Cardiovascular Disease ◽

Metabolic Syndrome ◽

Risk Factor ◽

Disease Risk ◽

Fasting Blood Glucose ◽

Reversal Rate ◽

Cvd Risk Factors ◽

Cvd Risk ◽

The Metabolic Syndrome

The reversal rate from clustering of cardiovascular disease (CVD) risk factors—components of the metabolic syndrome (MetS) is not known.Methods and Results. Among 35,534 subjects who received the annual health examinations at the NiigataHealth Foundation (Niigata, Japan), 4,911 subjects had clustering of 3 or more of the following CVD risk factors: (1) body mass index (BMI) ≥25 Kg/m2, (2) blood pressure ≥130 mm Hg in systolic and/or ≥85 mm Hg in diastolic, (3) triglycerides ≥150 mg/dL, (4) high-density lipoprotein cholesterol ≤40 mg/dL in men, ≤50 mg/dL in women, and (5) fasting blood glucose ≥100 mg/dL. After 5 years 1,929 subjects had a reversal of clustering (39.4%). A reversal occurred more often in males. The subjects with a reversal of clustering had milder level of each risk factor and a smaller number of risk factors, while BMI was associated with the least chance of a reversal.Conclusion. We concluded that a reversal of clustering CVD risk factors is possible in 4/10 subjects over a 5-year period by habitual or medical interventions. Gender and each CVD risk factor affected the reversal rate adversely, and BMI was associated with the least chance of a reversal.

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