CundiffSupplementalMaterial – Supplemental material for Friends With Health Benefits: The Long-Term Benefits of Early Peer Social Integration for Blood Pressure and Obesity in Midlife

<p>Supplemental material, CundiffSupplementalMaterial for Friends With Health Benefits: The Long-Term Benefits of Early Peer Social Integration for Blood Pressure and Obesity in Midlife by Jenny M. Cundiff and Karen A. Matthews in Psychological Science</p

Indices of Socioeconomic Position across the Life Course as Predictors of Coronary Calcification in Black and White Men and Women: Coronary Artery Risk Development in Young Adults study

Few studies have investigated the association of socioeconomic status (SES) and coronary artery calcification (CAC) and only one study has examined African Americans separately from Caucasians, despite empirical evidence suggesting that blacks have equivalent or lower CAC, relative to whites. We tested the hypotheses that lower childhood SES and lower average education, occupation, and income and change in SES (slope) in adulthood are related to risk of CAC in blacks and whites in the US CARDIA study. Parental education and occupation were measured at study entry (Year 0 in 1985–1986) and participant education, occupation, and household income were evaluated multiple times throughout a 20 year follow-up period at four sites in the United States. CAC was measured at Year 20 in 3138 (45% black) participants in CARDIA; 19% had CAC. Latent growth models and multivariate logistic regression analyses adjusted for the major risk factors for CAC. Multivariate models showed that lower paternal education in blacks and lower maternal occupational status in the full sample and in whites were related to higher risk of any CAC, independent of adult SES. Lower average adult education, occupation, and income were related to higher risk of any CAC, with the effects primarily in blacks. Our results are the first to show that SES, measured retrospectively and prospectively in multiple ways, is related to CAC, and the first to document the effects primarily in blacks.</p

Does who you marry matter for your health? Influence of patients' and spouses' personality on their partners' psychological well-being following coronary artery bypass surgery.

Research suggests that presurgical personality attributes influence postsurgical well-being in both patients and their spouses in the context of coronary artery bypass grafting (CABG) surgery. The authors hypothesized that a spouse's characteristics would influence a partner's psychological well-being, regardless of whether he or she was the patient or the caregiver. In this study, 111 male patients and their caregiver spouses completed measures of neuroticism, optimism, perceived marital satisfaction, and depression prior to elective CABG. Follow-up was conducted at 18 months. As expected, higher caregiver presurgical neuroticism predicted higher patient depressive symptoms at follow-up, with caregiver's concurrent 18-month affect controlled for. Likewise, higher patient presurgical neuroticism predicted higher caregiver depressive symptoms at follow-up. Additionally, higher patient presurgical depressive symptoms and lower presurgical optimism contributed to greater caregiving burden. Relationship satisfaction moderated these effects. These results suggest that partners' personality traits are important determinants of both patients' and their caregiving spouses' well-being.</p

The prospective association of socioeconomic status with C-reactive protein levels in the CARDIA study

<p>Better health is a well-documented benefit of having a higher socioeconomic status (SES). Inflammation may be one pathway through which SES influences health. Using 2658 participants in the Coronary Artery Risk Development in Young Adults (CARDIA) Study, we examine whether two measures of SES assessed at baseline (mean age, 32 ± 4 years)—years of education and household income—predict change in C-reactive protein (CRP) concentrations over the course of 13 years. We also examine whether four health-related behaviors—smoking, fruit and vegetable consumption, physical activity, and alcohol consumption—mediate the prospective association of SES with CRP. Both higher education and household income predicted smaller increases in CRP over the 13 years of follow-up independent of age, sex, race, CARDIA center, body mass, medical diagnoses, medications, and hormone use (among women). Associations did not differ by race or sex. When examined in separate analyses, smoking and fruit and vegetable intake each accounted for a significant proportion of the respective effects of education and household income on CRP change, and physical activity a significant proportion of the effect of household income. These findings suggest that poor health behaviors among persons of lower socioeconomic status can have long-term effects on inflammation.</p

Sex Differences in the Association of Childhood Socioeconomic Status With Adult Blood Pressure Change: The CARDIA Study

<p><strong>Objective</strong> To examine sex differences in the relation of childhood socioeconomic status (CSES) to systolic (SBP) and diastolic blood pressure (DBP) trajectories during 15 years, spanning young (mean [M] [standard deviation {SD}] = 30 [3] years) and middle (M [SD] = 45 [3] years) adulthood, independent of adult SES.</p> <p><strong>Methods</strong> A total of 4077 adult participants reported father’s and mother’s educational attainments at study enrollment (Year 0) and own educational attainment at enrollment and at all follow-up examinations. Resting BP also was measured at all examinations. Data from examination Years 5 (when participant M [SD] age = 30 [3] years), 7, 10, 15, and 20 are examined here. Associations of own adult (Year 5), mother’s, and father’s educations with 15-year BP trajectories were examined in separate multilevel models. Fully controlled models included time-invariant covariates (age, sex, race, recruitment center) and time-varying covariates that were measured at each examination (marital status, body mass, cholesterol, oral contraceptives/hormones, and antihypertensive drugs). Analyses of parental education controlled for own education.</p> <p><strong>Results</strong> When examined without covariates, higher education — own (SBP γ = −0.03, DBP γ = −0.03), mother’s (SBP γ = −0.02, DBP γ = −0.02), and father’s (SBP γ = −0.02, DBP γ = −0.01) — were associated with attenuated 15-year increases in BP (<em>p</em> < .001). Associations of own (but not either parent’s) education with BP trajectories remained independent of standard controls. Sex moderated the apparent null effects of parental education, such that higher parental education—especially mother’s, predicted attenuated BP trajectories independent of standard covariates among women (SBP γ = −0.02, <em>p</em> = .02; DBP γ = −0.01, <em>p</em> = .04) but not men (SBP γ = 0.02, <em>p</em> = .06; DBP γ = 0.005, <em>p</em> = .47; <em>p</em> interaction SBP < .001, <em>p</em> interaction DBP = .01).</p> <p><strong>Conclusions</strong> Childhood socioeconomic status may influence women’s health independent of their own adult status.</p

History of Unemployment Predicts Future Elevations in C-Reactive Protein among Male Participants in the Coronary Artery Risk Development in Young Adults (CARDIA) Study

Background Unemployment is associated with risk of future morbidity and premature mortality. Purpose To examine whether unemployment history predicts future C-reactive protein (CRP) levels in male participants in the Coronary Artery Risk Development in Young Adults (CARDIA) Study. Methods Unemployment, body mass index (BMI), and health behaviors were measured at 7, 10, and 15 years post-recruitment. CRP was measured at Years 7 and 15. Results Having a history of unemployment at Year 10 was associated with higher CRP at Year 15, independent of age, race, BMI, Year 7 CRP, Year 15 unemployment, and average income across Years 10–15. Poor health practices and depressive symptoms explained 22% of the association, but Year 10 unemployment history remained a significant predictor. Findings did not differ across age, race, education, or income. Conclusions Discrete episodes of unemployment may have long-term implications for future CRP levels.</p

Diurnal Cortisol Decline is Related to Coronary Calcification: CARDIA Study

OBJECTIVE: Chronic stress may be a risk factor for coronary heart disease and is associated with dysregulation of the hypothalamic-pituitary-adrenal (HPA) axis. We tested the hypotheses that two markers of HPA axis dysregulation, elevated average level (area under the curve, adjusted for time awake) and diurnal decline of salivary cortisol, were associated with presence of coronary calcification (CaC). METHOD: Seven hundred eighteen black and white middle-aged adults enrolled in an ancillary study of Coronary Artery Risk Development in Young Adults provided six salivary cortisol samples throughout one full day and had measurements of CaC. RESULTS: The prevalence of any calcification was low, 8.1% in the participants of the ancillary study, with white men having the highest proportion. Average cortisol did not differentiate groups, means = 2.15 and 2.08. Those with any CaC declined approximately 6% per hour in cortisol over the course of the day, whereas those with no CaC declined more than 8% per hour (p CONCLUSIONS: Our results are consistent with the hypothesis that HPA axis dysregulation may affect risk for atherosclerosis.</p

Association of Socioeconomic Status with Inflammation Markers in Black and White Men and Women in the Coronary Artery Risk Development in Young Adults (CARDIA) Study

Inflammatory processes are implicated in a number of diseases for which there are known socioeconomic status (SES) disparities, including heart disease and diabetes. Growing evidence also suggests SES gradients in levels of peripheral blood markers of inflammation. However, we know little about potential gender and racial/ethnic differences in associations between SES and inflammation, despite the fact that the burden of inflammation-related diseases varies by gender and race. The present study examines SES (education and income) gradients in levels of two inflammatory biomarkers, C-reactive protein (CRP) and interleukin-6 (IL-6), in a biethnic (White and Black) sample of men and women (n = 3549, aged 37–55 years) in the USA from the CARDIA Study. Health status, behavioral and psychosocial variables that may underlie SES differences in inflammatory biomarker levels were also examined. Age-adjusted CRP and IL-6 levels were inversely associated with education level in each race/gender group except Black males. Income gradients were also observed in each race/gender group for IL-6 and in White females and males for CRP. In general, differences in CRP and IL-6 levels between low and high SES groups were reduced in magnitude and significance with the addition of health status, behavioral, and psychosocial variables, although the impact of the addition of model covariates varied across race/gender groups and different SES-inflammation models. Overall, findings indicate SES gradients in levels of inflammation burden in middle-aged White and Black males and females.</p

A higher sense of purpose in life is associated with sexual enjoyment in midlife women.

OBJECTIVE: The aim of this study was to understand the association between sense of purpose in life and sexual well-being in a cohort of midlife women. METHODS: Participation in partnered sexual activities and indicators of sexual well-being (the engagement in and enjoyment of sexually intimate activities) were measured in a longitudinal cohort of 677 eligible women aged 40 to 65 years. At a single time point, women completed the Life Engagement Test, a measure of life purpose. Univariable and multivariable mixed models were used to assess the association between the Life Engagement Test and longitudinal sexual well-being. RESULTS: A higher sense of purpose in life was associated with higher levels of enjoyment (coefficient = 2.89, P CONCLUSIONS: Higher sense of purpose in life is associated with more enjoyment of sexually intimate activities, adjusting for other known factors that influence sexual well-being and independent of demographic factors and menopause or hormone therapy status.</p

Occupational Mobility and Carotid Artery Intima-Media Thickness: Findings From the Coronary Artery Risk Development in Young Adults Study

OBJECTIVE: To examine whether a 10-year change in occupational standing is related to carotid artery intima-media thickness (IMT) 5 years later. METHODS: Data were obtained from 2350 participants in the Coronary Artery Risk Development in Young Adults (CARDIA) Study. Occupational standing was measured at the Year 5 and 15 CARDIA follow-up examinations when participants were 30.2 (standard deviation = 3.6) and 40.2 (standard deviation = 3.6) years of age, respectively. IMT (common carotid artery [CCA], internal carotid artery [ICA], and bulb) was measured at Year 20. Occupational mobility was defined as the change in occupational standing between Years 5 and 15 using two semicontinuous variables. Analyses controlled for demographics, CARDIA center, employment status, parents' medical history, own medical history, Year 5 Framingham Risk Score, physiological risk factors and health behaviors averaged across the follow-up, and sonography reader. RESULTS: Occupational mobility was unrelated to IMT save for an unexpected association of downward mobility with less CCA-IMT (β = -0.04, p = .04). However, associations differed depending on initial standing (Year 5) and sex. For those with lower initial standings, upward mobility was associated with less CCA-IMT (β = -0.07, p = .003), and downward mobility was associated with greater CCA-IMT and bulb-ICA-IMT (β = 0.14, p = .01 and β = 0.14, p = .03, respectively); for those with higher standings, upward mobility was associated with greater CCA-IMT (β = 0.15, p = .008), but downward mobility was unrelated to either IMT measure (p values > .20). Sex-specific analyses revealed associations of upward mobility with less CCA-IMT and bulb-ICA-IMT among men only (p values CONCLUSIONS: Occupational mobility may have implications for future cardiovascular health. Effects may differ depending on initial occupational standing and sex.</p