Stroke Acute myocardial infarction Cardiovascular death Educational level Socioeconomic position Depression Social support Health inequalities
Mejía-Lancheros C, Estruch R, Martínez-González M.A, Salas-Salvadó J, Castañer O, Corella D, et al. Impact of psychosocial factors on cardiovascular morbimortality: a prospective cohort study. BMC Cardiovasc Disord. 2014 Oct 3;14:135.
Background: Whilst it is well known that psychosocial determinants may contribute to cardiovascular diseases
(CVD), data from specific groups are scarce. The present study aims to determine the contribution of psychosocial
determinants in increasing the risk of cardiovascular events (myocardial infarction and stroke), and death from CVD,
in a high risk adult population.
Methods: Longitudinal prospective study of 7263 patients (57.5% women), mean age 67.0 (SD 6.2) free from CVD
but at high risk, with a median follow-up of 4.8 years (from October 2003 to December 2010). The Hazard Ratios
(HRs) of cardiovascular events (myocardial infarction, stroke, and death from cardiovascular causes) related to
educational attainment, diagnosed depression (based on medical records), and low social support (number of
people living in the household) were estimated by multivariate Cox regression models.
Results: Stroke incidence was associated with low educational level in the whole population (HR: 1.83, 95% CI:
1.09–3.09), and especially in men (HR: 2.11, 95% CI 1.09–4.06). Myocardial infarction and CVD mortality were not
associated with any of the psychosocial factors considered.
Conclusion: Adults with low educational level had a higher risk of stroke. Depression and low social support were
not associated with CVD incidence.
Trial registration: Clinical trial registration information unique identifier: ISRCTN35739639.