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Annals of Behavioral Medicine
Published in: Annals of Behavioral Medicine 4/2016

Open Access 01-08-2016 | Original Article

A Role for Behavior in the Relationships Between Depression and Hostility and Cardiovascular Disease Incidence, Mortality, and All-Cause Mortality: the Prime Study

Authors: K. M. Appleton, PhD, J. V. Woodside, PhD, D. Arveiler, MD, B. Haas, MD, P. Amouyel, PhD, M. Montaye, MD, J. Ferrieres, MD, J. B. Ruidavets, MD, J. W. G. Yarnell, MD, F. Kee, MD, A. Evans, MD, A. Bingham, MA, P. Ducimetiere, PhD, C. C. Patterson, PhD, for the PRIME study group

Published in: Annals of Behavioral Medicine | Issue 4/2016

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Abstract

Background

Behavioral factors are important in disease incidence and mortality and may explain associations between mortality and various psychological traits.

Purpose

These analyses investigated the impact of behavioral factors on the associations between depression, hostility and cardiovascular disease(CVD) incidence, CVD mortality, and all-cause mortality.

Methods

Data from the PRIME Study (N = 6953 men) were analyzed using Cox proportional hazards models, following adjustment for demographic and biological CVD risk factors, and other psychological traits, including social support.

Results

Following initial adjustment, both depression and hostility were significantly associated with both mortality outcomes (smallest SHR = 1.24, p < 0.001). Following adjustment for behavioral factors, all relationships were attenuated both when accounting for and not accounting for other psychological variables. Associations with all-cause mortality remained significant (smallest SHR = 1.14, p = 0.04). Of the behaviors included, the most significant contribution to outcomes was found for smoking, but a role was also found for fruit and vegetable intakes and high alcohol consumption.

Conclusions

These findings demonstrate well-known associations between depression, hostility, and mortality and suggest the potential importance of behaviors in explaining these relationships.
Literature
1.
Haynes SG, Levine S, Scotch N, et al. The relationship of psychosocial factors to coronary heart disease in the Framingham study. Methods and risk factors. Am J Epidemiol. 1978; 107: 362-83.PubMed
2.
Rosenman RH, Brand RJ, Jenkins CD, et al. Coronary heart disease in the Western Collaborative Group Study: Final follow-up experience of 81/2 years. JAMA. 1975; 233: 872-7.CrossRefPubMed
3.
Chida Y, Steptoe A. The association of anger and hostility with future coronary heart disease: A meta-analytic review of prospective evidence. J Am Coll Cardiol. 2009; 53: 936-46.CrossRefPubMed
4.
Everson-Rose SA, Lewis TT. Psychosocial factors and cardiovascular diseases. Ann Rev Publ Health. 2005; 26: 469-500.CrossRef
5.
Haynes SG, Feinleib M, Kannel WB. The relationship between psychosocial factors to coronary heart disease in the Framingham study. Am J Epidemiol. 1980; 111: 37-58.PubMed
6.
Miller TQ, Smith TW, Turner CW, Guijarro ML, Hallet AJ. A meta-analytic review of research on hostility and physical health. Psychol Bull. 1996; 119: 322-48.CrossRefPubMed
7.
Haukkala A, Konttinen H, Laatikainen T, Kawachi I, Uutela A. Hostility, anger control and anger expression as predictors of cardiovascular disease. Psychosom Med. 2010; 72: 556-562.CrossRefPubMed
8.
Atlantis E, Shi Z, Penninx BJWH, Wittert GA, Taylor A, Almeida OP. Chronic medical conditions mediate the association between depression and cardiovascular disease mortality. Soc Psychiatry Psychiatr Epidemiol. 2012; 47: 615-25.CrossRefPubMed
9.
Baune BT, Stuart M, Gilmour A, Wersching H, Arolt V, Bergr K. Moderators of the relationship between depression and cardiovascular disorders: A systematic review. Gen Hosp Psychiatry. 2012; 34: 478-92.CrossRefPubMed
10.
Bortman DJ, Golden SH, Wittstein IS. The cardiovascular toll of stress. Lancet. 2007; 370: 1089-1100.CrossRef
11.
Empana JP, Sykes DS, Luc G, et al. Contributions of depressive mood and circulating inflammatory markers to coronary heart disease in healthy European men: The Prospective Epidemiological Study of Myocardial Infarction (PRIME). Circulation. 2005; 111: 2299-2305.CrossRefPubMed
12.
Leung YW, Flora DB, Gravely S, Irvine J, Carney RM, Grace SL. The impact of premorbid and postmorbid depression onset on mortality and cardiac morbidity among patients with coronary heart disease: Meta-analysis. Psychosom Med. 2012; 74: 786-801.CrossRefPubMedPubMedCentral
13.
Falk Dahl CA, Dahl AA. Lifestyle and social network in individuals with high level of social phobia/anxiety symptoms: A community based study. Soc Psychiatry Psychiatr Epidemiol. 2010; 45: 309-317.CrossRefPubMed
14.
Rozanski A, Blumenthal JA, Kaplan J. Impact of psychological factors on the pathogenesis of cardiovascular disease and implications for therapy. Circulation. 1999; 99: 2912-2217.CrossRef
15.
Chida Y, Hamer M. Chronic psychosocial factors and acute physiological responses to laboratory-induced stress in healthy populations: A quantitative review of 30 years of investigations. Psychol Bull. 2008; 134: 829-885.CrossRefPubMed
16.
Howren MB, Lamkin DM, Suls J. Associations of depression with C-reactive protein, IL-1 and IL-6: A meta-analysis. Psychosom Med. 2009; 71: 171-186.CrossRefPubMed
17.
Pizzi C, Manzoli L, Mancini S, Costa GM. Analysis of potential predictors of depression among coronary heart disease risk factors including heart rate variability, markers of inflammation, and endothelial function. Eur Heart J. 2008; 29: 1110-1117.CrossRefPubMed
18.
Thomas KS, Nielsen RA, Dimsdale JE. Relationships between hostility, anger expression and blood pressure dipping in an ethically diverse sample. Psychosom Med. 2004; 66: 298-304.PubMed
19.
Guerrero C, Palmero F. Impact of defensive hostility in cardiovascular disease. Behav Med. 2010; 36: 77-84.CrossRefPubMed
20.
Holt-Lunstad J, Smith TW, Uchino BN. Can hostility interfere with the health benefits of giving and receiving social support? The impact of cynical hostility on cardiovascular reactivity during social support interactions among friends. Ann Behav Med. 2008; 35: 319-330.CrossRefPubMed
21.
Pope MK, Smith TW. Cortisol excretion in high and low cynically hostile men. Psychosom Med. 1991; 53: 386-92.CrossRefPubMed
22.
Suarez EC, Kuhn CM, Schanberg SM, Williams RB, Zimmerman EA. Neuroendocrine, cardiovascaulr and emotional responses of hostile men: The role of interpersonal challenge. Psychosom Med. 1998; 60: 78-88.CrossRefPubMed
23.
Steptoe A, Cropley M, Griffith J, Kirschbaun C. Job strain and anger expression predict early morning elevations in salivary cortisol. Psychosom Med. 2000; 62: 286-92.CrossRefPubMed
24.
Stewart JC, Janicki-Deverts D, Muldoon MF, Kamarck TW. Depressive symptoms moderate the influence of hostility on serum interleukin-6 and C-reactive protein. Psychosom Med. 2008; 70: 197-204.CrossRefPubMed
25.
Matthews KA, Zhu S, Tucker DC, Whooley MA. Blood pressure reactivity to psychological stress and coronary calcification in the Coronary Artery Risk Development in Young Adults Study. Hypertension. 2006; 47: 391-5.CrossRefPubMed
26.
Pahuja R, Kotchen TA. Salivary cortisol predicts cardiovascular mortality. Curr Hypertens Rep. 2011; 13: 404-5.CrossRefPubMed
27.
Sykes DH, Haertel U, Gostautas A, Evans AE. The Framingham type A behaviour pattern and coronary heart disease in three countries: A cross-cultural comparison. Int J Epidemiol. 1992; 21: 1081-1089.CrossRefPubMed
28.
DiMatteo MR, Lepper HS, Croghan TW. Depression is a risk factor for non-compliance with medical treatment: Meta-analysis of the effects of anxiety and depression on patient adherence. Arch Intern Med. 2000; 160: 2101-2107.CrossRefPubMed
29.
Scherwitz LW, Perkins LL, Chesney MA, Hughes GH, Sidney S, Manollo TA. Hostility and health behaviors in young adults: the CARDIA study. Am J Epidemiol. 1992; 136: 136-45.PubMed
30.
Shin C, Kim J, Yi H, Lee H, Lee J, Shin K. Relationship between trait-anger and sleep disturbances in middle-aged men and women. J Psychosom Res. 2005; 58: 183-189.CrossRefPubMed
31.
Siegler IC, Peterson BL, Barefoot JC, Williams RB. Hostility during late adolescence predicts coronary risk factors in mid-life. Am J Epidemiol. 1992; 136: 146-154.PubMed
32.
Yarnell JWG, Patterson CC, Arveiler D, et al. Contribution of lifetime smoking in France and Northern Ireland to country and socioeconomic differentials in mortality and cardiovascular incidence: The PRIME study. J Epidemiol Community Health. 2012; 66: 599-604.CrossRefPubMed
33.
Ruidavets JB, Ducimetiere P, Evans A, et al. Patterns of alcohol consumption and ischaemic heart disease in culturally divergent countries: The Prospective Epidemiological Study of Myocardial Infarction (PRIME). BMJ. 2010; 341, e6077.CrossRef
34.
Woodside JV, Yarnell JWG, Patterson CC, et al. Do lifestyle behaviours explain socioeconomic differences in all-cause mortality, and fatal and non-fatal cardiovascular events? Evidence from middle aged men in France and Northern Ireland in the PRIME Study. Prev Med. 2012; 54: 247-53.CrossRefPubMed
35.
Cohen S, Wills TA. Stress, social support and the buffering hypothesis. Psychol Bull. 1985; 98: 310-357.CrossRefPubMed
36.
Uchino BN, Cacioppo JT, Kiecolt-Glaser JK. The relationship between social support and physiological processes: A review with emphasis on underlying mechanisms and implications for health. Psychol Bull. 1996; 119: 488-531.CrossRefPubMed
37.
Rosengren A, Wilhelmsen L, Orth-Gomer K. Coronary disease in relation to social support and social class in Swedish men: A 15 year follow-up study of men born in 1933. Eur Heart J. 2004; 25: 56-63.CrossRefPubMed
38.
Krumholz HM, Butler J, Miller J, et al. Prognostic importance of emotional support for elderly patients hospitalized with heart failure. Circulation. 1998; 97: 958-64.CrossRefPubMed
39.
Lepore SJ. Cynicism, social support and cardiovascular reactivity. Health Psychol. 1995; 14: 210-216.CrossRefPubMed
40.
Kamarck TW, Manuck SB, Jennings JR. Social support reduces cardiovascular reactivity to psychological challenge: A laboratory model. Psychosom Med. 1990; 52: 42-58.CrossRefPubMed
41.
Kirschbaum C, Klauer T, Filipp S-H, Hellhammer DH. Sex-specific effects of social support on cortisol and subjective responses to acute psychological stress. Psychosom Med. 1995; 57: 23-31.CrossRefPubMed
42.
Uchino BN. Social support and health: A review of physiological processes potentially underlying links to disease outcomes. J Behav Med. 2006; 29: 377-387.CrossRefPubMed
43.
Ruberman W, Weinblatt E, Goldberg JD, Chaudhary BS. Psychosocial influences on mortality after myocardial infarction. New Eng J Med. 1984; 311: 552-9.CrossRefPubMed
44.
Gallo LC, Smith TW. Patterns of hostility and social support: conceptualizing psychosocial risk factors as characteristics of the person and the environment. J Res Pers. 1999; 33: 281-310.CrossRef
45.
The PRIME Study Group. The PRIME study: Classical risk factors do not explain the severalfold differences in risk of coronary heart disease between France and Northern Ireland. Quart J Med. 1998; 91: 667-76.CrossRef
46.
Cook WW, Medley DM. Proposed hostility and pharisaic-virtue scales for the MMPI. J Appl Psychol. 1954; 38: 414-18.CrossRef
47.
Rodda BE, Miller MC, Bruhn JG. Prediction of anxiety and depression patterns among coronary patients using a Markov process analysis. Behav Sci. 1971; 16: 482-89.CrossRefPubMed
48.
World Health Organization. MONICA Psychosocial Optional Study. Suggested measurement instruments. Copenhagen: WHO Regional Office for Europe; 1989.
49.
Sykes DH, Arveiler D, Salters CP, et al. Psychosocial risk factors for heart disease in Northern Ireland and France: The Prospective Epidemiological Study of Myocardial Infarction (PRIME). Int J Epidemiol. 2002; 31: 1227-1234.CrossRefPubMed
50.
Ducimetiere P, Ruidavets JB, Montaye M, Haas B, Yarnell J, on behalf of The PRIME Study Group. Five year incidence of angina pectoris and other forms of coronary heart disease in healthy men aged 50–59 in France and NI: The PRIME study. Int J Epidemiol. 2001; 30: 1057-62.CrossRefPubMed
51.
Whooley MA, de Jonge P, Vittinghoff E, et al. Depressive symptoms, health behaviours and risk of cardiovascular events in patients with coronary heart disease. JAMA. 2008; 300: 2379-2388.CrossRefPubMedPubMedCentral
52.
Dombrowski SU, Avenell A, Sniehott FF. Behavioural interventions for obese adults with additional risk factors for morbidity: Systematic review of effects on behaviour, weight and disease risk factors. Obes Facts. 2010; 3: 377-96.CrossRefPubMed
53.
Ledoux TA, Hingle MD, Baranowksi T. Relationship of fruit and vegetable intake with adiposity: A systematic review. Obes Rev. 2011; 12: e143-e150.CrossRefPubMed
54.
Savica V, Bellinghieri G, Kopple JD. The effect of nutrition on blood pressure. Ann Rev Nutr. 2010; 30: 365-401.CrossRef
55.
Wu Y, Zhang D, Jiang X, Jiang W. Fruit and vegetable consumption and risk of type 2 diabetes mellitus: A dose response meta-analysis of prospective cohort studies. Nutr Metab Cardiovasc Dis. 2015; 25: 140-7.CrossRefPubMed
56.
Aune D, Norat T, Leitzmann M, Tonstad S, Vatten LJ. Physical activity and the risk of type II diabetes: A systematic review and dose-response meta-analysis. Eur J Epidemiol. 2015; 30: 529-42.CrossRefPubMed
57.
Hartmann-Boyce J, Johns DJ, Jebb SA, Summerbell C, Aveyard P. Behavioural Weight Management Review Group. Behavioural weight management programmes for adults assessed by trials conducted in everyday contexts: Systematic review and meta-analysis. Obes Rev. 2014; 15: 920-32.CrossRefPubMedPubMedCentral
58.
Forey BA, Fry JS, Lee PN, Thornton AJ, Coombs KJ. The effect of quitting smoking on HDL-cholesterol - a review based on within-subject changes. Biomark Res. 2013; 1: 26.CrossRefPubMedPubMedCentral
59.
Xin X, He J, Frontini MG, Ogden LG, Motsamai OI, Whelton PK. Effects of alcohol reduction on blood pressure: A meta-analysis of randomized controlled trials. Hypertension. 2001; 38: 1112-7.CrossRefPubMed
60.
Appleton KM, Woodside JV, Yarnell JWG, et al. Depressed mood and dietary fish intake: Direct relationship or indirect relationship as a result of diet and lifestyle? J Affect Disord. 2007; 104: 217-23.CrossRefPubMed
61.
Mammen G, Faulkner G. Physical activity and the prevention of depression: A systematic review of prospective studies. Am J Prev Med. 2013; 45: 649-57.CrossRefPubMed
62.
Sanhueza C, Ryan L, Foxcroft DR. Diet and the risk of unipolar depression in adults: Systematic review of cohort studies. J Hum Nutr Diet. 2013; 26: 56-70.CrossRefPubMed
63.
Oyebode O, Gordon-Dseagu V, Walker A, Mindell JS. Fruit and vegetable consumption and all-cause, cancer and CVD mortality: Analysis of Health Survey for England data. J Epidemiol Commun Health. 2014.
64.
Wang X, Ouyang Y, Liu J, et al. Fruit and vegetable consumption and mortality from all causes, cardiovascular disease, and cancer: systematic review and dose-response meta-analysis of prospective cohort studies. BMJ. 2014; 349: g4490.CrossRefPubMedPubMedCentral
65.
Knott CS, Coombs N, Stamatakis E, Biddulph JP. All cause mortality and the case for age specific alcohol consumption guidelines: Pooled analyses of up to 10 population based cohorts. BMJ. 2015; 350: h384.CrossRefPubMedPubMedCentral
66.
Appleton KM, Woodside JV, Arveiler D, et al. Depression and mortality: Artifact of measurement and analysis? J Affect Disord. 2013; 151: 632-8.CrossRefPubMed
67.
Beekman AT, Deeg DJ, Van Limbeek J, et al. Criterion validity of the Center for Epidemiologic Studies Depression scale (CES-D): Results from a community-based sample of older subjects in The Netherlands. Psychol Med. 1997; 27: 231-5.CrossRefPubMed
68.
Cole DA, Maxwell SE. Testing meditational models with longitudinal data: Questions and tips in the use of structural equation modelling. J Abnorm Psych. 2003; 112: 558-577.CrossRef
69.
Asparouhov T, Masyn K, Muthén B. Continuous time survival in latent variable models. In Proceedings of the Joint Statistical Meeting, American Statistical Association, Biometrics Section, Seattle, Washington, 2006: 180–187.
70.
Richiardi L, Bellocco R, Zugna D. Mediation analysis in epidemiology: Methods, interpretation and bias. Int J Epidemiol. 2013; 42: 1511-9.CrossRefPubMed
Metadata
Title
A Role for Behavior in the Relationships Between Depression and Hostility and Cardiovascular Disease Incidence, Mortality, and All-Cause Mortality: the Prime Study
Authors
K. M. Appleton, PhD
J. V. Woodside, PhD
D. Arveiler, MD
B. Haas, MD
P. Amouyel, PhD
M. Montaye, MD
J. Ferrieres, MD
J. B. Ruidavets, MD
J. W. G. Yarnell, MD
F. Kee, MD
A. Evans, MD
A. Bingham, MA
P. Ducimetiere, PhD
C. C. Patterson, PhD
for the PRIME study group
Publication date
01-08-2016
Publisher
Springer US
Published in
Annals of Behavioral Medicine / Issue 4/2016
Print ISSN: 0883-6612
Electronic ISSN: 1532-4796
DOI
https://doi.org/10.1007/s12160-016-9784-x

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