Social Support, Social Network Size, Social Strain, Stressful Life Events, and Coronary Heart Disease in Women With Type 2 Diabetes: A Cohort Study Based on the Women's Health Initiative

Diabetes Care. 2020 Aug;43(8):1759-1766. doi: 10.2337/dc19-2065. Epub 2020 Jun 4.

Abstract

Objective: We studied associations between social support, social network size, social strain, or stressful life events and risk of coronary heart disease (CHD) in postmenopausal women with type 2 diabetes.

Research design and methods: From the Women's Health Initiative, 5,262 postmenopausal women with type 2 diabetes at baseline were included. Cox proportional hazards regression models adjusted for demographics, depressive symptoms, anthropometric variables, and lifestyle factors were used to examine associations between social factors and CHD.

Results: A total of 672 case subjects with CHD were observed during an average 12.79 (SD 6.29) years of follow-up. There was a significant linear trend toward higher risk of CHD as the number of stressful life events increased (P for trend = 0.01; hazard ratio [HR] [95% CI] for the third and fourth quartiles compared with first quartile: 1.27 [1.03-1.56] and 1.30 [1.04-1.64]). Being married or in an intimate relationship was related to decreased risk of CHD (HR 0.82 [95% CI 0.69-0.97]).

Conclusions: Among postmenopausal women with type 2 diabetes, higher levels of stressful life events were associated with higher risk of CHD. Experience of stressful life events might be considered as a risk factor for CHD among women with type 2 diabetes.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Aged
  • Cohort Studies
  • Coronary Disease / epidemiology*
  • Coronary Disease / etiology
  • Diabetes Mellitus, Type 2 / complications
  • Diabetes Mellitus, Type 2 / epidemiology*
  • Diabetic Angiopathies / epidemiology
  • Diabetic Angiopathies / etiology
  • Female
  • Humans
  • Life Change Events
  • Middle Aged
  • Risk Factors
  • Sex Factors
  • Social Environment
  • Social Networking*
  • Social Support*
  • Stress, Psychological / epidemiology*
  • Stress, Psychological / etiology
  • Women's Health

Associated data

  • figshare/10.2337/figshare.12200195