Observational studyJournal of the American Heart Association2016
Effects of Concurrent Depressive Symptoms and Perceived Stress on Cardiovascular Risk in Low- and High-Income Participants: Findings From the Reasons for Geographical and Racial Differences in Stroke (REGARDS) Study.
Observational study in Journal of the American Heart Association, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 33 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
33 citing papers in PubMed.
- Neighborhood poverty and hemodynamic, neuroendocrine, and immune response to acute stress among patients with coronary artery disease.Psychoneuroendocrinology · 2019Trial
- Anger-reduction treatment reduces negative affect reactivity to daily stressors.Journal of consulting and clinical psychology · 2019Trial
- National Trends in Stroke Presentation, Treatments, and Outcomes During the First 2 Years of the COVID-19 Pandemic.Neurology. Clinical practice · 2025Article
- Trajectories of health conditions predict cardiovascular disease risk among middle-aged and older adults: a national cohort study.Frontiers in nutrition · 2025Article
- 2024 Guidelines of the Taiwan Society of Cardiology on the Primary Prevention of Atherosclerotic Cardiovascular Disease --- Part I.Acta Cardiologica Sinica · 2024Article
- Improving mental health in black men through a 24-week community-based lifestyle change intervention: the black impact program.BMC psychiatry · 2024Article
- DECODING STROKE DISPARITIES: ZIP CODES, COLOR CODES, AND EPIGENETIC CODES.Transactions of the American Clinical and Climatological Association · 2024Article
- Diet quality, psychological factors and their associations with risk factors of cardiovascular disease: a cross-sectional pilot study.BMJ nutrition, prevention & health · 2024Article
- Harnessing Wearables and Digital Technologies to Decode the Cardiovascular Exposome.Methodist DeBakey cardiovascular journal · 2024Review
- Zip Code Health Disparities: Mapping Cardiovascular Inequities at the Neighborhood Level.Methodist DeBakey cardiovascular journal · 2024Review
- Interventions to tackle health inequalities in cardiovascular risks for socioeconomically disadvantaged populations: a rapid review.British medical bulletin · 2023Review
- Depressive Symptoms and Mortality Among US Adults.JAMA network open · 2023Article
- The association of baseline depressive symptoms and stress on withdrawal in a national longitudinal cohort: the REGARDS study.Annals of epidemiology · 2023Article
- Article
- Perceived Stress in Relation to Demographics and Clinical Forms among Patients with Infective Endocarditis: A Cross-Sectional Study.International journal of environmental research and public health · 2022Article
- Depressive symptoms, cognitive impairment, and all-cause mortality among REGARDS participants with heart failure.European heart journal open · 2022Article
- Impact of Social Vulnerability on Comorbid Cancer and Cardiovascular Disease Mortality in the United States.JACC. CardioOncology · 2022Article
- Article
- Stress and Depression Are Associated With Life's Simple 7 Among African Americans With Hypertension: Findings From the Jackson Heart Study.American journal of hypertension · 2021Article
- Cardiovascular risk assessment using ASCVD risk score in fibromyalgia: a single-centre, retrospective study using "traditional" case control methodology and "novel" machine learning.Advances in rheumatology (London, England) · 2021Article
Corrections and comments
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Authors and funding
9 authors.
Funding
Abstract
backgroundPsychosocial risk for cardiovascular disease (CVD) may be especially deleterious in persons with low socioeconomic status. Most work has focused on psychosocial factors individually, but emerging research suggests that the confluence of psychosocial risk may be particularly harmful. Using data from the Reasons for Geographical and Racial Differences in Stroke (REGARDS) study, we examined associations among depressive symptoms and stress, alone and in combination, and incident CVD and all-cause mortality as a function of socioeconomic status. METHODS AND
resultsAt baseline, 22 658 participants without a history of CVD (58.8% female, 41.7% black, mean age 63.9±9.3 years) reported on depressive symptoms, stress, annual household income, and education. Participants were classified into 1 of 3 psychosocial risk groups at baseline: (1) neither depressive symptoms nor stress, (2) either depressive symptoms or stress, or (3) both depressive symptoms and stress. Cox proportional hazards models were used to predict physician-adjudicated incident total CVD events (nonfatal myocardial infarction, nonfatal stroke, and cardiovascular death) and all-cause mortality over a median of 7.0 years (interquartile range 5.4-8.3 years) of follow-up. In fully adjusted models, participants with both depressive symptoms and stress had the greatest elevation in risk of developing total CVD (hazard ratio 1.48, 95% CI 1.21-1.81) and all-cause mortality (hazard ratio 1.33, 95% CI 1.13-1.56) but only for those with low income (<$35 000) and not high (≥$35 000) income. This pattern of results was not observed in models stratified by education.
conclusionsFindings suggest that screening for a combination of elevated depressive symptoms and stress in low-income persons may help identify those at increased risk of incident CVD and mortality.
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