Key result
Higher role rewards linked to ~50% lower CAC progression risk per unit in Black women.
Why the study?
Does perceived stress and reward from multiple social roles affect the progression of subclinical coronary artery calcium in Black and White women?
Cohort (n=336)
Yes
Does perceived stress and reward from multiple social roles affect the progression of subclinical coronary artery calcium in Black and White women?
Rewarding social roles may serve as a protective psychosocial factor against the early progression of subclinical coronary atherosclerosis in midlife Black women.
Answers are grounded in this paper and cite their sources.
Role rewards may protect against CAC progression in Black women; hypothesis-generating and requires prospective trials before clinical adoption.
BACKGROUND: Black women experience higher rates of cardiovascular disease (CVD) than white women, though evidence for racial differences in subclinical CVD is mixed. Few studies have examined multiple roles (number, perceived stress, and/or reward) in relation to subclinical CVD, or whether those effects differ by race. PURPOSE: The aim of this study was to investigate the effects of multiple roles on 2-year progression of coronary artery calcium. METHODS: Subjects were 104 black and 232 white women (mean age 50.8 years). Stress and reward from four roles (spouse, parent, employee, caregiver) were assessed on five-point scales. Coronary artery calcium progression was defined as an increase of ≥10 Agatston units. RESULTS: White women reported higher rewards from their multiple roles than black women, yet black women showed cardiovascular benefits from role rewards. Among black women only, higher role rewards were related significantly to lower progression of coronary artery calcium, adjusting for body mass index, blood pressure, and other known CVD risk factors. Blacks reported fewer roles but similar role stress as whites; role number and stress were unrelated to coronary artery calcium progression. CONCLUSION: Rewarding roles may be a novel protective psychosocial factor for progression of coronary calcium among black women.
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Janssen et al. (2011) conducted a cohort in Healthy midlife women without cardiovascular disease (n=336). Higher perceived rewards from multiple social roles vs. Lower perceived rewards from roles was evaluated on Progression of coronary artery calcium (increase of ≥10 Agatston units) (50% risk reduction per 1-unit increase in average rewards). Among Black women, a 1-unit increase in average role rewards significantly reduced the risk of 2-year coronary artery calcium progression by 50%.
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