THE RELATIONSHIP AMONG PSYCHOSOCIAL, BEHAVIORAL AND PHYSIOLOGICAL RISK FACTORS FOR CARDIOVASCULAR DISEASE IN CHILDREN AND ADOLESCENTS.
Contributors: University of Pennsylvania.
Published: 1995
Number of pages: 139
Subjects: Health Sciences, Nursing.; Psychology, Developmental.
Description: Despite considerable advances in research and practice over the past three decades, cardiovascular disease remains a major cause of premature morbidity and mortality in the United States. In Western and industrialized populations, atherosclerosis and essential hypertension are the major causes of cardiovascular disease. These pathological processes begin in childhood.

The purpose of this study was to examine the relationship of psychosocial and behavioral to physiological risk factors for cardiovascular disease in children and adolescents. Cardiovascular risk factors are classified as: psychosocial (Type A Behavior Pattern and components), behavioral (physical activity, cigarette smoking), and physiological (blood pressure, lipoproteins, obesity).

The sample for this cross-sectional study was composed of 91 twin pairs (n = 182 subjects) who participated in Phase 2 of the Delaware Valley Twin Study. Twin pairs were randomly assigned to one of two groups for data analysis. Data were collected during two home visits by nurse clinicians. Hierarchical regression was used to examine the relationship of the psychosocial and behavioral risk factors to the physiological risk factors for cardiovascular disease, after accounting for missing data, sex, and developmental age.

Eighteen to 20% of the variance in body mass index (p $\le$ 0.001) was explained by developmental age in both samples. After accounting for missing data, sex, and developmental age, the addition of the combination of psychosocial and behavioral variables explained 9% of the variance in high-density lipoprotein (p $\le$ 0.05) in the cross-validation sample and 12.4% of the variance in body mass index (p $\le$ 0.01) in Sample 1. Impatience-aggression, one component of the Type A Behavior Pattern, contributed significantly (t = 3.6, p $\le$ 0.001) to the regression equation for body mass index in Sample 1. Smoking contributed significantly to the regression equation for high-density lipoprotein (t = 2.3, p $\le$ 0.05) and systolic blood pressure (t = 2.0, p $\le$ 0.05) in the cross-validation sample.

Results demonstrated the importance of including developmental age in clinical practice and research focused on cardiovascular risk factors in children and adolescents. While a developmental interrelationship among cardiovascular risk factors was observed for two of the physiological variables (body mass index, high density lipoprotein), this observation was not cross-validated. Future research needs to delineate these relationships using multi-modal methods of measurement of cardiovascular risk factor variables.
Notes: Source: Dissertation Abstracts International, Volume: 56-05, Section: B, page: 2564.

Thesis (PH.D.)--UNIVERSITY OF PENNSYLVANIA, 1995.

School code: 0175.