Race/Ethnicity, Cumulative Midlife Loss, and Carotid Atherosclerosis in Middle-Aged Women

Author:

Lewis Tené T,Van Dyke Miriam E,Matthews Karen A,Barinas-Mitchell Emma

Abstract

Abstract African-American women have elevated rates of cardiovascular disease compared with women of other races or ethnicities, and race/ethnicity–related stressors may play a role. We examined the association between a race/ethnicity–related stressor, midlife loss, and a marker of cardiovascular risk, carotid intima media thickness (IMT), in 1,410 African-American, White, Chinese, and Hispanic women from the Study of Women’s Health Across the Nation. Participants were queried about losses annually over 12 years (1996–2013), with IMT assessed in year 12–13 via ultrasound. Linear regression models were used to examine associations between cumulative upsetting losses and IMT, adjusting for covariates. In minimally adjusted models in the full cohort, 3 or more upsetting losses (vs. none) were associated with IMT (β = 0.03, 95% confidence interval (CI): 0.01, 0.05; P = 0.0003). Results were more robust among African-American women (β = 0.042, 95% CI: 0.01, 0.07; P < 0.01) than White (β = 0.014, 95% CI: –0.01, 0.03; P = 0.21), Chinese (β = 0.036, 95% CI: –0.03, 0.10; P = 0.25), or Hispanic (β = 0.036, 95% CI: –0.07, 0.14; P = 0.51) women, although associations among women from racial/ethnic minorities overall were of similar magnitude. Results persisted in fully adjusted models (P for interaction with race/ethnicity = 0.04). Midlife loss may be a pathway through which race/ethnicity influences cardiovascular risk for African-American women and, potentially, Chinese and Hispanic women.

Funder

NIH Office of Research on Women's Health

National Institutes of Health

National Heart, Lung, and Blood Institute

Publisher

Oxford University Press (OUP)

Subject

Epidemiology

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