Objective: To study the effect of individual and cumulative psychosocial stressors on the risk of incident IHD and MI among men and women. Material: In 1991-3 a random sample of 9,599 participants, 57 % women, from the Copenhagen City Heart Study answered a range of questions on major life events (LE) in childhood, adulthood and at work, vital exhaustion, lack of social network and daily use of psychotropic medication and were followed in a nationwide hospital discharge register until 2007. Results: During follow-up 257 experienced an event of MI and 714 an event of IHD. The hazard ratio of IHD among those exposed to life events both in adulthood and at work was HR 1.25 (CI 95% 0.9-1.7), whereas no association was found between life events in childhood, adulthood or work-related, respectively, nor for all three types of LE accumulated. The association between Vital Exhaustion ≥10 and IHD was HR 1.79 (1.3-2.4), and people lacking a close confident had a HR of IHD of 1.73 (1.0-2.9). We found no association with MI. By means of logistic regression we found an association between accumulated LE in child-, adulthood and work-related and Vital Exhaustion ≥10 with an OR 11.9 (CI 95% 7.8-18). The association between accumulated LE and lack of a close confident was OR 4.52 (2.2-9.2). We were unable to elucidate any gender difference. Conclusion: In this population-based cohort study we found that neither Individual nor accumulated LE are associated with IHD/MI, but are associated with other psychosocial risk factors of IHD/MI. Objectives: To test if health beliefs mediate the relation between family history of coronary heart disease (CHD) and 10-year CHD incidence in a large population-based sample of Canadians (n= 2,688), controlling for established CHD risk factors. Background: CHD is the leading cause of death in the United States today, with family history (FH) long known as an important risk factor. We tested the hypothesis that those who believe that CHD is not preventable, possibly because they have a positive FH, do not alter their health behavior (in this case exercise) to be cardioprotective. Methods: Cox proportional hazards models were used to estimate the adjusted hazard ratios (HR) of FH, preventability belief, and exercise for incident CHD. We first constructed a baseline Cox proportional hazards regression model of the association between incident CHD and FH controlling for age at baseline and Framingham risk score (an index of standard CHD risk factors). We then constructed a second Cox proportional hazards regression model to test if preventability belief was related to FH and a third model to test if belief could be viewed as a mediator of the FH-CHD relation. Finally we evaluated if the preventability belief-CHD relation was itself mediated by exercise .Results: Preventability belief was correlated with family history for both genders (β=.724, 95% confidence interval [CI] .592-.885, p<.005), with those that had a family history of heart disease less likely to believe that heart disease can be prevented. Preventability belief was also found to be a mediator between family history and CHD, but for women only (β=2.51, 95% CI 1.65-3.80, p<.001). Finally exercise mediated this relation, again for women only (β=− .868, HR=.420, 95% CI (HR) 0.770 -0.907, p<.001) Conclusion: Health belief in the preventability of CHD was found to be an important mediator in the relation between family history of CHD and incident CHD in women because of its effect on exercise. Heart failure (HF) affects millions of individuals and is increasing in prevalence. Close to a third of HF patients exhibit clinical levels of depressive symptoms. In turn, depression is associated with greater morbidity and mortality in HF. The mechanisms linking depression and worse outcome in HF are unclear. One suggested pathway links depression with heightened inflammation that may then be related to undesirable cardiac remodeling in HF. However, there have been mixed results in the literature connecting depression with inflammation in cardiac patients. Methods: The present study attempts to further delineate relations between depression and inflammatory markers in HF patients by using an exercise task to unmask group differences. Further, components of depression were examined separately to determine if inflammatory markers were differentially associated with somatic or cognitive depression symptoms. 40 NYHA II-IV HF patients and 35 healthy controls performed a moderate 20-min bicycle exercise task and completed the Beck Depression Inventory (BDI), sub-categorized into somatic (BDI-s) and cognitive (BDI-c) symptoms. Plasma levels of IL-6 were measured at baseline, 10 min and 30 min after exercise. Repeated measures ANCOVA were performed, controlling for age, gender, body mass index and physical function. Results: Both HF patients and controls with elevated BDI-s exhibited higher plasma levels of IL-6 at baseline, which remained elevated until 30 min post-exercise task (time x BDI-s effect, F(8, 65)=4.16, p=.045). Meanwhile, those with lower BDI-s had reduced IL-6 levels across the entire period. In contrast, elevated BDI-c symptoms were associated with low IL-6 at baseline in both HF and non-HF groups, but then an increase in IL-6 in the non-HF controls by 30 min post-exercise (group x time x BDI-c effect, F(8,65) = 7.6, p=.007). Conclusions: Elevated IL-6 levels until 30-min post task were associated with heightened somatic symptoms of depression, whereas HF patients with elevated cognitive symptoms had lower levels of IL-6 through 30 minpost exercise. By further understanding the components of depression associated with elevated inflammatory markers, interventions may be developed to specifically address symptoms of depression that may worsen cardiac outcomes. Psychosocial factors are independently related to cardiovascular disease outcomes, but less is known about the effect of these factors on stroke risk. The purpose of this study was to determine the effect of multiple psychosocial factors on stroke mortality in older adults. Participants included 3,656 adults (59.9% African American, 40.1% non-Hispanic white; 61.2% female) with a mean (SD) age of 77.0 (6.2) years from the Chicago Health and Aging Project (CHAP). CHAP is an ongoing, longitudinal study of risk for Alzheimer's Disease and other chronic conditions of the elderly. Mortality was ascertained through 12/31/05 and verified by data from the National Death Index; over 7.7 years of followup, 76 fatal strokes were identified. Prior principal component analysis on nine psychosocial questionnaires revealed three primary factors related to distress (depression, neuroticism, perceived stress, life satisfaction), social connectivity (social engagement, spirituality, social networks), and unfair treatment (hostility, perceived discrimination). Factor scores were computed by summing individual z-scores for each questionnaire loading on the factor. Cox models were conducted for each factor score adjusting for age, race, sex, education, systolic blood pressure, body mass index, physical activity, smoking and chronic conditions. Each 1-point higher distress score related to a significant 10% increase in stroke mortality [HR=1.10; 95% CI=1.03-1.18; p<.008]. Results were unchanged further controlling for history of stroke. There were no main effects of social connectivity and unfair treatment on stroke mortality. In this cohort of elderly African American and non-Hispanic white adults, higher levels of distress contributed significantly to greater risk of dying from stroke over nearly 8 years of follow-up. Additional research is needed to identify mechanisms underlying the association between distress and stroke mortality. There is an increasing research interest on the positive psychosocial factors that are assumed to maintain and enhance health. However, there is discussion whether positive and negative constructs are separate or bipolar opposites of the same phenomenon. High sense of coherence (SOC) refers to a dispositional orientation that includes flexible and adaptive coping with stressors. We examine the relationships between SOC and cardiovascular disease (CVD) and compare these results with a negative construct, depressive symptoms. Participants included men (N=3850) and women (N=4083) aged 25-74 years who had participated in risk factor surveys (The FINRISK Study) conducted in 1992 and 1997. SOC was measures with a 13-item scale. Depressive symptoms were measured with the 21-item Beck Depression Inventory (BDI) and had correlation of -0.60 with SOC. Incident CVD and IHD were derived from hospital records/death certificates. Subjects with a history of CVD or IHD at baseline were excluded. During a ten-to 15-year follow-up there were 397 nonfatal and fatal CVD and 219 IHD events. The 2nd SOC tertile had a higher risk of CVD (RR 1.32; 95% CI 1.03-1.69) than the highest SOC tertile after adjustment for age, gender, education, smoking, body mass index, blood pressure, cholesterol and alcohol consumption. The highest BDI tertile (RR 1.31; 1.01-1.70) had a higher risk for CVD compared to the lowest BDI tertile after adjustment for age, gender, education, and smoking. The second SOC tertile had a higher risk of CVD (RR 1.34; 1.04-1.72) in the age-adjusted model but BDI tertiles in the same model did not differ significantly. Neither SOC nor BDI were related to IHD events. Sense of coherence was related to CVD events but not to IHD events. However, the association was not linear as was the case with depressive symptoms. Further studies on psychosocial factors in CVD could benefit from parallel comparisons of positive and negative constructs. Objective: Besides general accepted complications, diabetesrelated symptom distress is an important outcome measure to understand the total burden of diabetes. Besides, diabetes-distress severity contributes to the variation in different aspects of quality of life (QOL). We investigated the longitudinal relationship of diabetes-related symptom distress among elderly with type 2 diabetes over a 7-year period.