JACC. Advances · 2026
Psychological Health, Polysocial Risk, and Cardiovascular Health Among Women of Reproductive Age.
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Metlock Faith E, Stanislas Ketum Ateh, Vaidya Dhananjay, Hladek Melissa D, Dennison Himmelfarb Cheryl R, Ouyang Pamela, Hall Jennifer, Sharma Garima, Commodore-Mensah Yvonne
Аннотация
BACKGROUND: Psychological health may contribute to cardiovascular health (CVH) risk among women of reproductive age, but this relationship remains understudied.
OBJECTIVES: The purpose of this study was to examine the associations of depressive symptoms, anxiety symptoms, and perceived stress with adverse CVH risk factors among women of reproductive age after accounting for cumulative social disadvantage.
METHODS: We conducted a cross-sectional analysis of women enrolled in the SAFE HEART (Social Determinants of Hypertension Among Women of Reproductive Age) study. Depressive symptoms, anxiety symptoms, and perceived stress were assessed using the Patient Health Questionnaire-2, Generalized Anxiety Disorder-2, and Perceived Stress Scale-4, respectively. Adverse CVH risk factors were defined using Life's Essential 8 factors. Multivariable logistic regression models adjusted for age, race/ethnicity, and polysocial risk score.
RESULTS: Among 361 women (mean age 30.87 ± 6.68 years), psychological distress was highly prevalent. Depressive symptoms, anxiety symptoms, and perceived stress were each associated with higher odds of diabetes, hypertension, hyperlipidemia, and smoking after adjustment for age, race, and cumulative social disadvantage. The strongest association was observed between depressive symptoms and smoking (adjusted OR: 4.71; 95% CI: 2.49-8.91). In contrast, low physical activity, low fruit and vegetable intake, suboptimal sleep duration, and elevated body mass index were not meaningfully associated with psychological health measures. In analyses using continuous psychological health scores, higher depressive, anxiety, and stress scores were associated with greater CVH risk, with the strongest gradient observed for depressive symptoms.
CONCLUSIONS: Psychological distress was associated with several adverse CVH risk factors independent of cumulative social disadvantage, supporting more comprehensive CVH risk assessment and prevention in women of reproductive age.
OBJECTIVES: The purpose of this study was to examine the associations of depressive symptoms, anxiety symptoms, and perceived stress with adverse CVH risk factors among women of reproductive age after accounting for cumulative social disadvantage.
METHODS: We conducted a cross-sectional analysis of women enrolled in the SAFE HEART (Social Determinants of Hypertension Among Women of Reproductive Age) study. Depressive symptoms, anxiety symptoms, and perceived stress were assessed using the Patient Health Questionnaire-2, Generalized Anxiety Disorder-2, and Perceived Stress Scale-4, respectively. Adverse CVH risk factors were defined using Life's Essential 8 factors. Multivariable logistic regression models adjusted for age, race/ethnicity, and polysocial risk score.
RESULTS: Among 361 women (mean age 30.87 ± 6.68 years), psychological distress was highly prevalent. Depressive symptoms, anxiety symptoms, and perceived stress were each associated with higher odds of diabetes, hypertension, hyperlipidemia, and smoking after adjustment for age, race, and cumulative social disadvantage. The strongest association was observed between depressive symptoms and smoking (adjusted OR: 4.71; 95% CI: 2.49-8.91). In contrast, low physical activity, low fruit and vegetable intake, suboptimal sleep duration, and elevated body mass index were not meaningfully associated with psychological health measures. In analyses using continuous psychological health scores, higher depressive, anxiety, and stress scores were associated with greater CVH risk, with the strongest gradient observed for depressive symptoms.
CONCLUSIONS: Psychological distress was associated with several adverse CVH risk factors independent of cumulative social disadvantage, supporting more comprehensive CVH risk assessment and prevention in women of reproductive age.