Influência dos aspectos psicossociais no autorrelato de doenças cardiovasculares

Abstract

Cardiovascular diseases (CVDs) are the leading cause of death from chronic non-communicable diseases, accounting for about 17.2 million deaths worldwide in 2012. The World Health Organization estimates that this number can reach 23.3 million in 2030.Among the main risk factors for CVD are behavioral aspects such as smoking, physical inactivity and inadequate feeding, as well as clinical aspects such as overweight, hypertension and dyslipidemia. In addition to such factors, it has been suggested that psychosocial aspects may play an important role directly or indirectly in the development of CVDs. The main objective of the present study was to evaluate the influence of psychosocial aspects on self-report of CVDs. The hypotheses were that psychosocial aspects have a direct influence on health behaviors, risk factors for cardiovascular diseases (RFCVD) and CVD. Such aspects would also have an indirect effect on CVDs that is mediated by health-related behaviors. A cross-sectional population-based study was conducted with a representative sample of adults living in the urban area of a medium-sized municipality in the state of Rio Grande do Sul, Brazil. Data were collected through structured interviews conducted in the homes using a standardized and pre-tested questionnaire composed of demographic, socioeconomic, behavioral, psychosocial, and health-related variables. Data collection occurred in 2006 and resulted in a total of 1100 individuals in 36 census sections. A latent variable was created for the psychosocial aspects which included scales of: resilience, life quality, sense of coherence and social support. The outcomes were CVDs and RFCVDs measured by unit items inquiring participants if a physician had said they had heart disease, high blood pressure and high cholesterol / triglycerides, as well as being overweight (BMI ≥ 25kg/=m²).Data analysis was performed in the Stata 12 program and structural equation models were used. The final model presented a good fit in all indexes: (χ²[57]=155, p=<0.001; RMSEA=0.042; CFI=0.902 e SRMR=0.042).Consistent with our direct effect hypothesis, favorable psychosocial aspects were inversely associated with risk for CVDs (β=-0.15; p=0.011) and with CVDs (β=-0.10; p=0.048). The indirect effect through health behaviors was not confirmed. The findings suggest that psychosocial aspects may influence the presence of CVDs or their risk factors.