TY - JOUR
T1 - Psychosocial factors may serve as additional eligibility criteria for cardiovascular risk screening in women and men in a multi-ethnic population: The HELIUS study
T2 - The HELIUS study
AU - Hummel, B.
AU - van Valkengoed, I.G.M.
AU - Harskamp, R.E.
AU - Galenkamp, H.
AU - Bolijn, R.
AU - Moll Van Charante, E.P.
AU - Mommersteeg, Paula M. C.
N1 - Funding Information: This research was supported by the Netherlands Organization for Health Research and Development Gender and Health Program [ZonMwgrant number 849200008]. The work of Bryn Hummel is further supported by the Dutch Heart Foundation [grant number 2020B004]. The HELIUS study is funded by the Dutch Heart Foundation [grant number 2010 T084], the Netherlands Organization for Health Research and Development (ZonMw [grant number 200500003]), the European Union (FP-7 [grant number 278901]), and the European Fund for the Integration of non-EU immigrants (EIF [grant number 2013EIF013]).The HELIUS study is conducted by the Amsterdam University Medical Centre, location AMC and the Public Health Service of Amsterdam. Both organizations provided core support for HELIUS. We are most grateful to the participants of the HELIUS study and the management team, research nurses, interviewers, research assistants and other staff who have taken part in gathering the data of this study. We would also like to thank dr. van Dis for providing the conversions for the SCORE-NL. Part of this work has previously been presented at the International Gender Medicine Conference in Padua, 2022. Funding Information: This research was supported by the Netherlands Organization for Health Research and Development Gender and Health Program [ZonMwgrant number 849200008 ]. The work of Bryn Hummel is further supported by the Dutch Heart Foundation [grant number 2020B004 ]. The HELIUS study is funded by the Dutch Heart Foundation [grant number 2010 T084 ], the Netherlands Organization for Health Research and Development (ZonMw [grant number 200500003 ]), the European Union (FP-7 [grant number 278901 ]), and the European Fund for the Integration of non-EU immigrants (EIF [grant number 2013EIF013 ]). Publisher Copyright: © 2023 The Authors
PY - 2023/7/1
Y1 - 2023/7/1
N2 - Cardiovascular disease (CVD) prevention strategies include identifying and managing high risk individuals. Identification primarily occurs through screening or case finding. Guidelines indicate that psychosocial factors increase CVD risk, but their use for screening is not yet recommended. We studied whether psychosocial factors may serve as additional eligibility criteria in a multi-ethnic population without prior CVD. We performed a cross-sectional analysis using baseline data of 10,226 participants of Dutch, South-Asian Surinamese, African Surinamese, Ghanaian, Turkish and Moroccan origin aged 40-70 years, living in Amsterdam, the Netherlands. Using logistic regressions and Akaike Information Criteria, we analyzed whether psychosocial factors (educational level, employment status, occupational level, financial stress, primary earner status, mental health, stress, depression, and social isolation) improved prediction of high CVD risk (SCORE-estimated fatal and non-fatal CVD risk ≥5%) beyond eligibility criteria from history taking (smoking, obesity, family history of CVD). Next, we compared the additional predictive value of psychosocial eligibility criteria in women and men across ethnic groups, using the area under the curve (AUC). Of our sample, 32.7% had a high CVD risk. Only socioeconomic eligibility criteria (employment status and educational level) improved high CVD risk prediction (p < .001 for likelihood-ratio tests). These increased AUCs in women (from 0.563 to 0.682) and men (from 0.610 to 0.664), particularly in Dutch, South-Asian Surinamese, African Surinamese and Moroccan women, and Dutch and Moroccan men. Concluding, socioeconomic eligibility criteria may be considered as additional eligibility criteria for CVD risk screening, as they improve detection of women and men at high CVD risk.
AB - Cardiovascular disease (CVD) prevention strategies include identifying and managing high risk individuals. Identification primarily occurs through screening or case finding. Guidelines indicate that psychosocial factors increase CVD risk, but their use for screening is not yet recommended. We studied whether psychosocial factors may serve as additional eligibility criteria in a multi-ethnic population without prior CVD. We performed a cross-sectional analysis using baseline data of 10,226 participants of Dutch, South-Asian Surinamese, African Surinamese, Ghanaian, Turkish and Moroccan origin aged 40-70 years, living in Amsterdam, the Netherlands. Using logistic regressions and Akaike Information Criteria, we analyzed whether psychosocial factors (educational level, employment status, occupational level, financial stress, primary earner status, mental health, stress, depression, and social isolation) improved prediction of high CVD risk (SCORE-estimated fatal and non-fatal CVD risk ≥5%) beyond eligibility criteria from history taking (smoking, obesity, family history of CVD). Next, we compared the additional predictive value of psychosocial eligibility criteria in women and men across ethnic groups, using the area under the curve (AUC). Of our sample, 32.7% had a high CVD risk. Only socioeconomic eligibility criteria (employment status and educational level) improved high CVD risk prediction (p < .001 for likelihood-ratio tests). These increased AUCs in women (from 0.563 to 0.682) and men (from 0.610 to 0.664), particularly in Dutch, South-Asian Surinamese, African Surinamese and Moroccan women, and Dutch and Moroccan men. Concluding, socioeconomic eligibility criteria may be considered as additional eligibility criteria for CVD risk screening, as they improve detection of women and men at high CVD risk.
KW - Cardiovascular risk management
KW - Cardiovascular risk screening
KW - Ethnic differences
KW - Psychosocial risk factors
KW - Sex differences
KW - The HELIUS study
UR - http://www.scopus.com/inward/record.url?scp=85153883058&partnerID=8YFLogxK
U2 - https://doi.org/10.1016/j.ypmed.2023.107515
DO - https://doi.org/10.1016/j.ypmed.2023.107515
M3 - Article
C2 - 37062519
SN - 0091-7435
VL - 172
JO - Preventive medicine
JF - Preventive medicine
IS - 107515
M1 - 107515
ER -