Social Support and Subclinical Coronary Artery Disease in Middle-Aged Men and Women: Findings from the Pilot of Swedish CArdioPulmonary bioImage Study

Demir Djekic, Erika Fagman, Oskar Angerås, George Lappas, Kjell Torén, Göran Bergström and Annika Rosengren
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Demir Djekic: Department of Cardiology, School of Medical Sciences, Örebro University, Örebro University Hospital, 701 85 Örebro, Sweden
Erika Fagman: Department of Radiology, Institute of Clinical Sciences, The Sahlgrenska Academy at University of Gothenburg, Sahlgrenska University Hospital, 413 90 Gothenburg, Sweden
Oskar Angerås: Department of Molecular and Clinical Medicine, The Sahlgrenska Academy at University of Gothenburg, Sahlgrenska University Hospital, 416 85 Gothenburg, Sweden
George Lappas: Department of Molecular and Clinical Medicine, The Sahlgrenska Academy at University of Gothenburg, Sahlgrenska University Hospital, 416 85 Gothenburg, Sweden
Kjell Torén: Section of Occupational and Environmental Medicine, Sahlgrenska Academy, University of Gothenburg, 413 90 Gothenburg, Sweden
Göran Bergström: Department of Molecular and Clinical Medicine, The Sahlgrenska Academy at University of Gothenburg, Sahlgrenska University Hospital, 416 85 Gothenburg, Sweden
Annika Rosengren: Department of Molecular and Clinical Medicine, The Sahlgrenska Academy at University of Gothenburg, Sahlgrenska University Hospital, 416 85 Gothenburg, Sweden

IJERPH, 2020, vol. 17, issue 3, 1-16

Abstract: Social support has been associated with coronary artery disease (CAD), particularly in individuals who have sustained a cardiovascular event. This study investigated the relationship between social support and subclinical CAD among 1067 healthy middle-aged men and women. Social support was assessed with validated social integration and emotional attachment measures. Subclinical CAD was assessed as a coronary artery calcium score (CACS) using computed tomography. There was no association between social support and CACS in men. In women, low social support was strongly linked to cardiovascular risk factors, high levels of inflammatory markers, and CACS > 0. In a logistic regression model, after adjustment for 12 cardiovascular risk factors, the odds ratio (95% confidence intervals) for CACS > 0 in women with the lowest social integration, emotional attachment, and social support groups (reference: highest corresponding group) were 2.47 (1.23–5.12), 1.87 (0.93–3.59), and 4.28 (1.52–12.28), respectively. Using a machine learning approach (random forest), social integration was the fourth (out of 12) most important risk factor for CACS > 0 in women. Women with lower compared to higher or moderate social integration levels were about 14 years older in “vascular age”. This study showed an association between lack of social support and subclinical CAD in middle-aged women, but not in men. Lack of social support may affect the atherosclerotic process and identify individuals vulnerable to CAD events.

Keywords: Social support; women; coronary artery calcium; coronary artery calcification; subclinical coronary artery disease; inflammation (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2020
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