Psychosocial Factors and Cardiovascular Disease Risk
An Opportunity in Women’s Health
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The reduction in cardiovascular disease (CVD) burden during the past half-century is one of the greatest public health successes in history.1 However, the gains in cardiovascular health have not been experienced equally across all groups. In addition to disparities by socioeconomic status, age, and race/ethnicity,1 differences by sex are also apparent.2 Overall reductions in CVD risk, as well as potential for benefit from existing cardioprotective strategies, seem greater among men than women.2 In addition, the clinical presentations of and several risk factors for CVD demonstrate sexual dimorphism.2 Therefore, ongoing work in CVD risk research has focused on potential paths to achieving better outcomes for women. A promising area is the domain of psychosocial factors, which have been associated with multiple biological processes that may be directly relevant to development of CVD. In this issue of Circulation Research, Chang et al3 report on the association between a key psychosocial factor—social integration—with incidence of coronary heart disease (CHD) among midlife and older women. They report that women with the highest levels of social integration (measured by an index of both content and frequency of social interactions) had ≈50% lower risk of CHD when compared with those with the lowest levels of social integration. Interestingly, the differences were significant for both …