Life satisfaction is a protective factor against the onset of Type 2 diabetes in men but not in women: findings from the MONICA/KORA cohort study

Hypertension in the first blood pressure reading and the risk of cardiovascular disease mortality in the general population: findings from the prospective KORA study

BACKGROUND

The risk of cardiovascular disease (CVD) mortality in individuals with an alerting reaction, assessed by hypertension in the first blood pressure (BP) reading but normal BP in further readings, remains unknown in the general population.

METHODS AND RESULTS

In a sample of 11 146 adults (51.5% men and 48.5% women) with a mean age of 47.1 years (SD ± 12.3) from a German population-based cohort, we analyzed risk factors and CVD mortality risk associated with an alerting reaction. An alerting reaction was prevalent in 10.2% of the population and associated with sociodemographic, lifestyle, and somatic CVD risk factors. Within a mean follow-up period of 22.7 years (SD ± 7.05 years; max: 32 years; 253 201 person years), 1420 (12.7%) CVD mortality cases were observed. The CVD mortality rate associated with an alerting reaction was significantly higher than in normotension (64 vs. 32 cases/10 000 person-years), but lower than hypertension (118 cases/10 000 person-years). Correspondingly, the alerting reaction was associated with a 23% higher hazard ratio of CVD mortality than normal blood pressure [hazard ratio 1.23 (95% confidence interval 1.02-1.49), P  = 0.04]. However, adjustment for antihypertensive medication use attenuated this association [1.19 (0.99-1.44), P  = 0.06].

CONCLUSION

The results may warrant monitoring of an alerting reaction as a preventive measure of CVD mortality in untreated individuals with elevated first BP readings, as well as optimized treatment in treated individuals.

Asthma Moderates the Association between the Big Five Personality Traits and Life Satisfaction

The current study aimed to examine whether asthma moderates the association between the Big Five personality traits and life satisfaction. By analyzing data from 3934 people with asthma (40.09% males) with a mean age of 49.2 (S.D. = 16.94) years old and 22,914 people without asthma (42.9% males) with a mean age of 45.62 (S.D. = 17.25) years old using a hierarchical regression and multiple regressions, the current study found that asthma significantly moderates the link between Neuroticism and life satisfaction and Openness and life satisfaction after controlling for other covariates. Specifically, Neuroticism was negatively related to life satisfaction whereas Agreeableness, Openness, Conscientiousness, and Extraversion were positively associated with life satisfaction in people with and without asthma. However, the negative association between Neuroticism and life satisfaction and the positive association between Openness and life satisfaction were stronger in people with asthma compared to people without asthma.

Explainable artificial intelligence on life satisfaction, diabetes mellitus and its comorbid condition

This study uses artificial intelligence for testing (1) whether the comorbidity of diabetes and its comorbid condition is very strong in the middle-aged or old (hypothesis 1) and (2) whether major determinants of the comorbidity are similar for different pairs of diabetes and its comorbid condition (hypothesis 2). Three pairs are considered, diabetes-cancer, diabetes-heart disease and diabetes-mental disease. Data came from the Korean Longitudinal Study of Ageing (2016-2018), with 5527 participants aged 56 or more. The evaluation of the hypotheses were based on (1) whether diabetes and its comorbid condition in 2016 were top-5 determinants of the comorbidity in 2018 (hypothesis 1) and (2) whether top-10 determinants of the comorbidity in 2018 were similar for different pairs of diabetes and its comorbid condition (hypothesis 2). Based on random forest variable importance, diabetes and its comorbid condition in 2016 were top-2 determinants of the comorbidity in 2018. Top-10 determinants of the comorbidity in 2018 were the same for different pairs of diabetes and its comorbid condition: body mass index, income, age, life satisfaction-health, life satisfaction-economic, life satisfaction-overall, subjective health and children alive in 2016. In terms of SHAP values, the probability of the comorbidity is expected to decrease by 0.02-0.03 in case life satisfaction overall is included to the model. This study supports the two hypotheses, highlighting the importance of preventive measures for body mass index, socioeconomic status, life satisfaction and family support to manage diabetes and its comorbid condition.

Life satisfaction and the risk of atherosclerotic cardiovascular disease in the general Japanese population: the Suita Study

BACKGROUND

Atherosclerotic cardiovascular disease (ASCVD) is a major cause of morbidity and mortality. Life satisfaction is a measure of mental health with a potential cardioprotective role. This study aimed to investigate the association between life satisfaction and ASCVD risk in the general Japanese population.

METHOD

We used data from 6,877 people (30-84 years) registered in the Suita Study, a Japanese population-based prospective cohort study. All participants were free from stroke and coronary heart disease (CHD) at baseline. Then, participants were followed up for incident ASCVD, including cerebral infarction and CHD. Cox proportional hazards models were used to calculate the hazard ratio (HR) and 95% confidence interval (95% CI) of incident ASCVD according to life satisfaction.

RESULTS

Within 102,545 person-years (median follow-up = 16.6 years), 482 incident ASCVD events were identified. In the age- and sex-adjusted model, being very satisfied, rather satisfied, or not sure, compared to being dissatisfied with life, showed a lower risk of ASCVD: HR (95% CI) = 0.55 (0.41, 0.74), 0.67 (0.50, 0.89), and 0.57 (0.36, 0.88), respectively (p-trend < 0.001). The associations remained consistent after adjusting for stress and unfortunate events: HR (95% CI) = 0.57 (0.42, 0.77), 0.68 (0.50, 0.91), and 0.54 (0.35, 0.84), respectively (p-trend < 0.001). The results did not vary between cerebral infarction and CHD: HR (95% CI) for being very satisfied with life = 0.58 (0.37, 0.91) and 0.55 (0.36, 0.84), respectively.

CONCLUSION

Life satisfaction was inversely associated with the risk of ASCVD in the investigated general Japanese population.

Life satisfaction and emotional distress in people living with type 2 diabetes mellitus: The mediating effect of cognitive function

AIMS AND OBJECTIVES

To explore the relationships among emotional distress, cognitive function and life satisfaction in people living with type 2 diabetes mellitus (T2DM), and to verify the mediating role of cognitive function.

BACKGROUND

People with T2DM face cognitive decline caused by age and disease complications. Emotional distress will reduce their life satisfaction, and cognitive function will also affect the life satisfaction, but whether cognitive function mediates the effect of emotional distress on life satisfaction has not been verified.

DESIGN

A cross-sectional study.

METHODS

A total of 200 people living with T2DM in the community by convenience sampling were enrolled from November-December 2018. Data collection involved a demographic and disease characteristic questionnaire, Problem Areas in Diabetes Scale, Subjective and Objective Cognitive Function Evaluation and Life Satisfaction Questionnaire. Data analysis included descriptive statistics and structural equation modelling. This report followed the STROBE guideline.

RESULTS

The emotional distress and subjective memory complaints of cognitive function had a significant positive correlation, while both emotional distress and cognitive function showed significant negative correlations with life satisfaction. In addition, cognitive function completely mediated the relationship between emotional distress and life satisfaction.

CONCLUSION

The cognitive function played a mediating role in life satisfaction and explains how emotional distress affects life satisfaction of people with T2DM. Therefore, it is suggested that diabetes nurses should early identify the decline of cognitive function, and to intervene at an early stage.

RELEVANCE TO CLINICAL PRACTICE

This study provides opinions on the mediating factors of cognitive function. Coping strategies and supporting resources to help the T2DM people to improve their life satisfaction are suggested.

Does life satisfaction reduce risk of incident hypertension and stroke? Evidence from the Whitehall II cohort

BACKGROUND

Previous studies showed life satisfaction is related to reduced risk of coronary heart disease and diabetes, but its association with other cardiometabolic endpoints including hypertension and stroke remains unexplored. This study examined life satisfaction's prospective association with incident hypertension and stroke in middle-aged adults.

METHODS

At baseline (1985-1988), 6225 healthy British civil servants aged 35-55 from the Whitehall II cohort completed the validated Satisfaction with Life Scale and provided information regarding sociodemographics, a range of health-related factors, and psychological distress. Incident hypertension was ascertained according to clinic-derived measures of systolic or diastolic blood pressure of ≥140/90 mmHg, respectively, or self-reports of either physician-diagnosed hypertension or hypertensive medication use. Incident stroke and transient ischemic attack (TIA) were ascertained by self-reported physician diagnosis. Follow-up assessments occurred every 2-5 years through 2017. Cox proportional hazards regression models estimated hazard ratios (HR) and 95% confidence intervals (CI) of hypertension and stroke/TIA risk separately.

RESULTS

Over a 31-year follow-up, 2703 cases of hypertension and 370 cases of stroke/TIA occurred. Life satisfaction was not related to risk of developing hypertension but was associated with 12% decreased risk of stroke/TIA after controlling for sociodemographics, health status, and health behaviors (HR_{per 1-SD} = 0.88; 95%CI = 0.79-0.98). However, the association was attenuated after adjustment for psychological distress.

CONCLUSIONS

No robust associations were found between life satisfaction and incident hypertension and stroke/TIA, respectively, after accounting for well-established risk factors and psychological distress. More research is needed to understand why associations of life satisfaction with cardiometabolic health seem to vary across endpoints.