Psychosocial Factors Versus Single Predictors: A Factor Analytic Approach to Cardiovascular Outcomes in The Women's Ischemia Syndrome Evaluation (WISE) Study
Abstract
Introduction: Cardiovascular disease (CVD) is the leading cause of death among womenin all developed countries(Rosamond, et al., 2008). There are important genderdifferences in the onset, diagnosis, and progression of CVD, particularly coronary arterydisease (CAD). In addition to the traditional health-related risk factors for CAD, a varietyof psychosocial variables play a role in the etiology, onset and progression of CAD.Additionally, many of these psychosocial variables co-occur and cluster in the sameindividuals, and research suggests that several psychosocial variables overlap (i.e., sharevariance). Relatively few studies have examined these issues in women. Methods: Datawere analyzed from the National Heart, Lung, and Blood Institute-sponsored WomensIschemia Syndrome Evaluation (WISE) study (Merz, et al., 1999) . Principal componentsfactor analysis with varimax rotation was conducted to examine the clustering ofpsychosocial factors and Cox proportional hazards regressions were used to evaluate thepredictive value of these factors for adverse cardiovascular (CV) events (stroke,myocardial infarction, congestive heart failure, and cardiovascular related death).Results: Factor analysis of psychosocial scales (including BDI, STAI, SNI, Cook-Medley, and measure of panic and autonomic perception) revealed 3 underlying factors(Eigenvalues > 1): Negative Affectivity, Hostility, and Social Support. In a diseaseadjustedCox regression model, the Social Support factor (consisting primarily of theSNI) was protective against CV events (HR: 0.78, 95% CI 0.61-0.99). In Cox regression analysis the addition of a block including the individual psychosocial variable (amultivariate approach), was a significant addition to the model (2 [10]=71.51, p<0.001). Conclusions: Factor analysis of multiple psychosocial scales yielded 3 factors: Negative Affectivity, Hostility, and Social Support. The Social Support factor was protective against CV events in women with suspected CAD.
Document Details
- Document Type
- Technical Report
- Publication Date
- Feb 18, 2010
- Accession Number
- AD1013436
Entities
People
- Kerry S. Whittaker
Organizations
- Uniformed Services University of the Health Sciences