Psychological Distress Across the Life Course and Cardiometabolic Risk

• Published in: Journal of the American College of Cardiology Vol. 66; no. 14; pp. 1577 - 1586
• Main Authors: Winning, Ashley, ScD, MPH, Glymour, M. Maria, ScD, MS, McCormick, Marie C., MD, ScD, Gilsanz, Paola, ScD, MPH, Kubzansky, Laura D., PhD, MPH
• Format: Journal Article
• Language: English
• Published: New York Elsevier Inc 06.10.2015; Elsevier Limited
• Subjects: Adults; Age; Anxiety; Behavior; Biomarkers; Birth weight; Blood pressure; Cardiology; cardiometabolic risk; Cardiovascular; Disease; epidemiology; Health risk assessment; Internal Medicine; life course; Metabolic disorders; Mortality; Nutrition research; prospective study; psychological distress; Reading; Regression analysis; Socioeconomic factors; Studies; epidemiology; cardiometabolic risk; socioeconomic position; biomarkers; prospective study; CMR; psychological distress; life course; SEP
• ISSN: 0735-1097; 1558-3597
• DOI: 10.1016/j.jacc.2015.08.021

Abstract Background Research suggests cardiovascular and metabolic diseases are influenced by psychological distress in adulthood; however, this research is often limited to adult populations and/or a snapshot measure of distress. Given emerging recognition that cardiometabolic diseases have childhood origins, an important question is whether psychological distress earlier in life influences disease development. Objectives This study sought to assess whether life course patterns of psychological distress assessed from childhood through adulthood predict biomarkers of cardiometabolic risk in adulthood and whether effects of sustained distress differ from more limited exposure. Methods The sample (n = 6,714) consists of members of the 1958 British Birth Cohort Study who completed repeated measures of psychological distress and a biomedical survey at age 45 years. Psychological distress profiles over the life course (no distress, childhood only, adulthood only, or persistent distress) were identified from 6 assessments between ages 7 and 42 years. Cardiometabolic risk was assessed by combining information on 9 biomarkers of immune, cardiovascular, and metabolic system function. Covariate adjusted linear regression models were used to assess associations between distress profiles and cardiometabolic risk. Results Compared with those with no distress, cardiometabolic risk was higher among people with psychological distress in childhood only (β = 0.11, SE = 0.03, p = 0.0002), in adulthood only (β = 0.09, SE = 0.03, p = 0.007), and persistent across the life course (β = 0.26, SE = 0.04, p < 0.0001). Conclusions Psychological distress at any point in the life course is associated with higher cardiometabolic risk. This is the first study to suggest that even if distress appears to remit by adulthood, heightened risk of cardiometabolic disease remains. Findings suggest early emotional development may be a target for primordial prevention and for promoting lifelong cardiovascular health.