Psychological distress as a risk factor for incident cardiometabolic disease and multimorbidity in the population-based Tromsø Study in Norway.

OBJECTIVE

It is unclear whether psychological distress is an independent risk factor for cardiometabolic disease and multimorbidity. This cohort study investigated the relationship of psychological distress with incident cardiometabolic disease and multimorbidity.

METHODS

All individuals who participated in the sixth survey of the Tromsø Study, conducted in Norway in 2007-2008, and completed the 10-item version of Hopkins Symptom Checklist (HSCL-10) were included. In total, 5264 individuals who had no cardiometabolic diseases, i.e. atrial fibrillation, coronary artery disease (CAD), diabetes, hypertension, and stroke, at baseline, and participated in the seventh survey (2015-2016) were included in the final study population. Multivariable logistic regression models were fitted to assess association of HSCL-10 score and clinically relevant psychological distress (HSCL-10 ≥ 1.85) with cardiometabolic disease and multimorbidity.

RESULTS

At baseline, 325 (6.2%) individuals had psychological distress. Psychological distress was negatively correlated with higher education, exercise frequency, and systolic blood pressure and positively correlated with smoking and alcohol use. Incidence of cardiometabolic disease and multimorbidity was 23.7% (N = 1246) and 3.9% (N = 204), respectively. Psychological distress was linked to cardiometabolic disease (OR, 2.08; 95% CI, 1.56-2.76) and multimorbidity (OR, 2.32; 95% CI, 1.32-4.08). Furthermore, psychological distress was associated with incident atrial fibrillation, diabetes, and hypertension whereas no significant association was found with CAD and stroke. Among the psychological distress symptoms, feeling hopeless about the future was associated with incident atrial fibrillation, hypertension, and CAD.

CONCLUSIONS

Our findings emphasize psychological distress as an independent risk factor for cardiometabolic disease and multimorbidity.