Abstract
BackgroundGender influences cardiovascular disease (CVD) through norms, social relations, roles and behaviours. This study identified gender-specific aspects of socialisation associated with CVD.MethodsA longitudinal study was conducted, involving 9936 (5,231 women and 4705 men) initially healthy, community-dwelling Australians aged 70 years or more from the ASPirin in Reducing Events in the Elderly (ASPREE) study and ASPREE Longitudinal Study of Older Persons, with a median follow-up time of 6.4 years. Variable categorisation, variable selection (using machine learning (ML) models; Elastic Net and extreme gradient boosting) and Cox-regression were employed separately by binary gender to identity socialisation factors (n=25 considered) associated with CVD.ResultsDifferent socialisation factors were identified using the ML models. In the Cox model, for both genders, being married/partnered was associated with a reduced risk of CVD (men: HR 0.76, 95% CI 0.60 to 0.96; women: HR 0.67, 95% CI 0.58 to 0.95). For men, having 3–8 relatives they felt close to and could call on for help (HR 0.76, 95% CI 0.58 to 0.99; reference <3 relatives), having 3–8 relatives they felt at ease talking with about private matters (HR 0.70, 95% CI 0.55 to 0.90; reference <3 relatives) or playing games such as chess or cards (HR 0.82, 95% CI 0.67 to 1.00) was associated with reduced risk of CVD. For women, living with others (HR 0.71, 95% CI 0.55 to 0.91) or having ≥3 friends they felt at ease talking with about private matters (HR 0.74, 95% CI 0.58 to 0.95; reference <3 friends) was associated with a lower risk of CVD.ConclusionsThis study demonstrates the need to prioritise gender-specific social factors to improve cardiovascular health in older adults.
Funder
National Heart Foundation of Australia
a NHMRC Senior Principal Research Fellowship and Leadership 3 Investigator grant
Monash University, ANZ Trustees, the Wicking Trust, and the Mason Foundation
NHMRC Senior Principal Research Fellowship and Leadership 3 Investigator grant
NHMRC Investigator Grant Leadership Level 1
National Institute on Aging and the National Cancer Institute at the U.S. National Institutes of Health
Victorian Cancer Agency
National Health and Medical Research Council of Australia
Monash International Tuition Scholarship and Monash Graduate Scholarship.
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