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Allostatic load in the association of depressive symptoms with incident coronary heart disease: The Jackson Heart Study.

Publication ,  Journal Article
Gillespie, SL; Anderson, CM; Zhao, S; Tan, Y; Kline, D; Brock, G; Odei, J; O'Brien, E; Sims, M; Lazarus, SA; Hood, DB; Williams, KP; Joseph, JJ
Published in: Psychoneuroendocrinology
November 2019

African Americans are at heightened risk for coronary heart disease (CHD), with biologic pathways poorly understood. We examined the role of allostatic load (AL) in the association of depressive symptoms with incident CHD among 2,670 African American men and women in the prospective Jackson Heart Study. Depressive symptoms were quantified using the Center for Epidemiologic Studies Depression Scale (CES-D). Incident CHD was ascertained by self-report, death certificate survey, and adjudicated medical record surveillance. Baseline AL was quantified using biologic parameters of metabolic, cardiovascular, immune, and neuroendocrine subsystems and as a combined meta-factor. Sequential models adjusted for demographic, socioeconomic, and behavioral covariates, stratified to examine differences by sex. Greater depressive symptomatology was associated with greater metabolic, cardiovascular, and immune AL (p-values≤0.036) and AL meta-factor z-scores (p = 0.007), with findings driven by observations among females. Each 1-point increase in baseline depressive symptomatology, and 1-SD increase in metabolic AL, neuroendocrine AL, and AL meta-factor z-scores was associated with 3.3%, 88%, 39%, and 130% increases in CHD risk, respectively (p-values <0.001). Neuroendocrine AL and AL meta-factor scores predicted incident CHD among males but not females in stratified analyses. Metabolic AL partially mediated the association of depressive symptoms with incident CHD (5.79% mediation, p = 0.044), a finding present among females (p = 0.016) but not males (p = 0.840). Among African American adults, we present novel findings of an association between depressive symptomatology and incident CHD, partially mediated by metabolic AL. These findings appear to be unique to females, an important consideration in the design of targeted interventions for CHD prevention.

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Published In

Psychoneuroendocrinology

DOI

EISSN

1873-3360

Publication Date

November 2019

Volume

109

Start / End Page

104369

Location

England

Related Subject Headings

  • White People
  • Sex Factors
  • Risk Factors
  • Psychiatry
  • Prospective Studies
  • Middle Aged
  • Male
  • Longitudinal Studies
  • Incidence
  • Humans
 

Citation

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Gillespie, S. L., Anderson, C. M., Zhao, S., Tan, Y., Kline, D., Brock, G., … Joseph, J. J. (2019). Allostatic load in the association of depressive symptoms with incident coronary heart disease: The Jackson Heart Study. Psychoneuroendocrinology, 109, 104369. https://doi.org/10.1016/j.psyneuen.2019.06.020
Gillespie, Shannon L., Cindy M. Anderson, Songzhu Zhao, Yubo Tan, David Kline, Guy Brock, James Odei, et al. “Allostatic load in the association of depressive symptoms with incident coronary heart disease: The Jackson Heart Study.Psychoneuroendocrinology 109 (November 2019): 104369. https://doi.org/10.1016/j.psyneuen.2019.06.020.
Gillespie SL, Anderson CM, Zhao S, Tan Y, Kline D, Brock G, et al. Allostatic load in the association of depressive symptoms with incident coronary heart disease: The Jackson Heart Study. Psychoneuroendocrinology. 2019 Nov;109:104369.
Gillespie, Shannon L., et al. “Allostatic load in the association of depressive symptoms with incident coronary heart disease: The Jackson Heart Study.Psychoneuroendocrinology, vol. 109, Nov. 2019, p. 104369. Pubmed, doi:10.1016/j.psyneuen.2019.06.020.
Gillespie SL, Anderson CM, Zhao S, Tan Y, Kline D, Brock G, Odei J, O’Brien E, Sims M, Lazarus SA, Hood DB, Williams KP, Joseph JJ. Allostatic load in the association of depressive symptoms with incident coronary heart disease: The Jackson Heart Study. Psychoneuroendocrinology. 2019 Nov;109:104369.
Journal cover image

Published In

Psychoneuroendocrinology

DOI

EISSN

1873-3360

Publication Date

November 2019

Volume

109

Start / End Page

104369

Location

England

Related Subject Headings

  • White People
  • Sex Factors
  • Risk Factors
  • Psychiatry
  • Prospective Studies
  • Middle Aged
  • Male
  • Longitudinal Studies
  • Incidence
  • Humans