A Network Analysis of Cardiovascular Risk Factors in Patients With Heart Disease

The Role of Socioeconomic Status and Sex

Bibliographic Data

ID19309423
AuthorsSophie C M van den Houdt (0000-0002-4808-0869, Everson Museum of Art), Paula Mc Mommersteeg (0000-0002-8458-866X, Everson Museum of Art), Paula M C Mommersteeg, Jos Widdershoven (0000-0002-7090-3980, Everson Museum of Art), Nina Kupper (0000-0001-8721-5239, Tilburg University, corresponding author)
Year2023
Volume85
Issue5
Pages417-430
Publication date2023-06-01
Peer ReviewedYes
Open AccessNo
TypeARTICLE
VenuePsychosomatic Medicine (JOURNAL)
Journal identifiersISSN: 0033-3174 • E-ISSN: 1534-7796
PublisherOvid Technologies (Wolters Kluwer Health) (PUBLISHER)
DOI10.1097/psy.0000000000001196
PMID37010207
OpenAlexW4362505968
LanguageEN
Citations received1
References cited99

OBJECTIVE: Diverse risk factors influence the development and prognosis of coronary heart disease (CHD) independently and mutually. Low socioeconomic status (SES) seems to exacerbate these risk factors' influences. In addition, sex differences have been identified for individual risk factors. Network analysis could provide in-depth insight into the interrelatedness of the risk factors, their predictability, and the moderating role of sex, to ultimately contribute to more refinement in prevention and cardiac rehabilitation. METHODS: A total of 1682 participants (78% male; mean [standard deviation] age = 69.2 [10.6] years) with CHD completed questionnaires on psychosocial factors and health behaviors. Cardiometabolic data were retrieved through medical records. An SES index was created based on self-reported occupation, education, and area (i.e., postal code)-based median family income. Using R, we conducted a mixed graphical model network analysis on all risk factors combined with and without the moderating role of sex. RESULTS: SES belonged to the more influential risk factors with moderate to high levels of expected influence and degree centrality, indicating that it plays a considerable role in the risk factor network. When considering the moderating role of sex, relationships between SES and most risk factors were found to be stronger for women ( b = 0.06-0.48). CONCLUSIONS: The current study provided an insight into an interrelated network of psychosocial and medical risk factors among CHD patients. With SES belonging to the more influential risk factors and female sex influencing the strength of all the SES-risk factor relationships, cardiac rehabilitation and prevention techniques could be more refined by accounting for both influences

Disease · Environmental health · Population · Socioeconomic status · Sociology · Cardiac Health and Mental Health · Chronic Disease Management Strategies · Demography · Internal Medicine · Medicine · Mental Health Research Topics · Psychology · Gerontology