Social Support and Subclinical Coronary Artery Disease in Middle-Aged Men and Women: Findings from the Pilot of Swedish CArdioPulmonary bioImage Study

Social support has been associated with coronary artery disease (CAD), particularly in individuals who have sustained a cardiovascular event. This study investigated the relationship between social support and subclinical CAD among 1067 healthy middle-aged men and women. Social support was assessed...

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Main Authors: Demir Djekic, Erika Fagman, Oskar Angerås, George Lappas, Kjell Torén, Göran Bergström, Annika Rosengren
Format: Article
Language:English
Published: MDPI AG 2020-01-01
Series:International Journal of Environmental Research and Public Health
Subjects:
Online Access:https://www.mdpi.com/1660-4601/17/3/778
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spelling doaj-f387d6bb224547619c0fb3ad94aa49132020-11-25T02:21:14ZengMDPI AGInternational Journal of Environmental Research and Public Health1660-46012020-01-0117377810.3390/ijerph17030778ijerph17030778Social Support and Subclinical Coronary Artery Disease in Middle-Aged Men and Women: Findings from the Pilot of Swedish CArdioPulmonary bioImage StudyDemir Djekic0Erika Fagman1Oskar Angerås2George Lappas3Kjell Torén4Göran Bergström5Annika Rosengren6Department of Cardiology, School of Medical Sciences, Örebro University, Örebro University Hospital, 701 85 Örebro, SwedenDepartment of Radiology, Institute of Clinical Sciences, The Sahlgrenska Academy at University of Gothenburg, Sahlgrenska University Hospital, 413 90 Gothenburg, SwedenDepartment of Molecular and Clinical Medicine, The Sahlgrenska Academy at University of Gothenburg, Sahlgrenska University Hospital, 416 85 Gothenburg, SwedenDepartment of Molecular and Clinical Medicine, The Sahlgrenska Academy at University of Gothenburg, Sahlgrenska University Hospital, 416 85 Gothenburg, SwedenSection of Occupational and Environmental Medicine, Sahlgrenska Academy, University of Gothenburg, 413 90 Gothenburg, SwedenDepartment of Molecular and Clinical Medicine, The Sahlgrenska Academy at University of Gothenburg, Sahlgrenska University Hospital, 416 85 Gothenburg, SwedenDepartment of Molecular and Clinical Medicine, The Sahlgrenska Academy at University of Gothenburg, Sahlgrenska University Hospital, 416 85 Gothenburg, SwedenSocial support has been associated with coronary artery disease (CAD), particularly in individuals who have sustained a cardiovascular event. This study investigated the relationship between social support and subclinical CAD among 1067 healthy middle-aged men and women. Social support was assessed with validated social integration and emotional attachment measures. Subclinical CAD was assessed as a coronary artery calcium score (CACS) using computed tomography. There was no association between social support and CACS in men. In women, low social support was strongly linked to cardiovascular risk factors, high levels of inflammatory markers, and CACS > 0. In a logistic regression model, after adjustment for 12 cardiovascular risk factors, the odds ratio (95% confidence intervals) for CACS > 0 in women with the lowest social integration, emotional attachment, and social support groups (reference: highest corresponding group) were 2.47 (1.23−5.12), 1.87 (0.93−3.59), and 4.28 (1.52−12.28), respectively. Using a machine learning approach (random forest), social integration was the fourth (out of 12) most important risk factor for CACS > 0 in women. Women with lower compared to higher or moderate social integration levels were about 14 years older in “vascular age”. This study showed an association between lack of social support and subclinical CAD in middle-aged women, but not in men. Lack of social support may affect the atherosclerotic process and identify individuals vulnerable to CAD events.https://www.mdpi.com/1660-4601/17/3/778social supportwomencoronary artery calciumcoronary artery calcificationsubclinical coronary artery diseaseinflammation
collection DOAJ
language English
format Article
sources DOAJ
author Demir Djekic
Erika Fagman
Oskar Angerås
George Lappas
Kjell Torén
Göran Bergström
Annika Rosengren
spellingShingle Demir Djekic
Erika Fagman
Oskar Angerås
George Lappas
Kjell Torén
Göran Bergström
Annika Rosengren
Social Support and Subclinical Coronary Artery Disease in Middle-Aged Men and Women: Findings from the Pilot of Swedish CArdioPulmonary bioImage Study
International Journal of Environmental Research and Public Health
social support
women
coronary artery calcium
coronary artery calcification
subclinical coronary artery disease
inflammation
author_facet Demir Djekic
Erika Fagman
Oskar Angerås
George Lappas
Kjell Torén
Göran Bergström
Annika Rosengren
author_sort Demir Djekic
title Social Support and Subclinical Coronary Artery Disease in Middle-Aged Men and Women: Findings from the Pilot of Swedish CArdioPulmonary bioImage Study
title_short Social Support and Subclinical Coronary Artery Disease in Middle-Aged Men and Women: Findings from the Pilot of Swedish CArdioPulmonary bioImage Study
title_full Social Support and Subclinical Coronary Artery Disease in Middle-Aged Men and Women: Findings from the Pilot of Swedish CArdioPulmonary bioImage Study
title_fullStr Social Support and Subclinical Coronary Artery Disease in Middle-Aged Men and Women: Findings from the Pilot of Swedish CArdioPulmonary bioImage Study
title_full_unstemmed Social Support and Subclinical Coronary Artery Disease in Middle-Aged Men and Women: Findings from the Pilot of Swedish CArdioPulmonary bioImage Study
title_sort social support and subclinical coronary artery disease in middle-aged men and women: findings from the pilot of swedish cardiopulmonary bioimage study
publisher MDPI AG
series International Journal of Environmental Research and Public Health
issn 1660-4601
publishDate 2020-01-01
description Social support has been associated with coronary artery disease (CAD), particularly in individuals who have sustained a cardiovascular event. This study investigated the relationship between social support and subclinical CAD among 1067 healthy middle-aged men and women. Social support was assessed with validated social integration and emotional attachment measures. Subclinical CAD was assessed as a coronary artery calcium score (CACS) using computed tomography. There was no association between social support and CACS in men. In women, low social support was strongly linked to cardiovascular risk factors, high levels of inflammatory markers, and CACS > 0. In a logistic regression model, after adjustment for 12 cardiovascular risk factors, the odds ratio (95% confidence intervals) for CACS > 0 in women with the lowest social integration, emotional attachment, and social support groups (reference: highest corresponding group) were 2.47 (1.23−5.12), 1.87 (0.93−3.59), and 4.28 (1.52−12.28), respectively. Using a machine learning approach (random forest), social integration was the fourth (out of 12) most important risk factor for CACS > 0 in women. Women with lower compared to higher or moderate social integration levels were about 14 years older in “vascular age”. This study showed an association between lack of social support and subclinical CAD in middle-aged women, but not in men. Lack of social support may affect the atherosclerotic process and identify individuals vulnerable to CAD events.
topic social support
women
coronary artery calcium
coronary artery calcification
subclinical coronary artery disease
inflammation
url https://www.mdpi.com/1660-4601/17/3/778
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