Table 3.
Vascular Responses to Stress and Risk of Major Adverse Cardiovascular Events (MACE).
| Total Sample | Women | Men | |||||
|---|---|---|---|---|---|---|---|
| HR (95% CI) | p | HR (95% CI) | p | HR (95% CI) | p | p-value Sex Interaction | |
| Per Standard Deviation Decrease in Microvascular Response to Stress Measured by RHI * | |||||||
| Model 1 | 1.35 (1.11, 1.63) | 0.003 | 1.85 (1.37, 2.48) | <.0001 | 1.10 (0.85, 1.42) | 0.47 | 0.01 |
| Model 2 | 1.28(1.05, 1.58) | 0.02 | 1.80 (1.33, 2.45) | 0.0002 | 0.99 (0.76, 1.30) | 0.95 | 0.002 |
| Model 3 | 1.06 (0.86, 1.32) | 0.57 | 1.41 (1.02, 1.94) | 0.04 | 0.85 (0.64, 1.33) | 0.25 | 0.01 |
| Model 4 | 1.06 (0.86, 1.32) | 0.58 | 1.44 (1.03, 2.02) | 0.03 | 0.83 (0.62, 1.11) | 0.21 | 0.01 |
| Model 5 | 1.08 (0.87, 1.35) | 0.49 | 1.41 (1.01, 1.96) | 0.046 | 0.87 (0.64, 1.17) | 0.34 | 0.02 |
| Model 6 | 1.14 (0.91, 1.44) | 0.26 | 1.50 (1.05, 2.13) | 0.03 | 0.93 (0.69, 1.26) | 0.66 | 0.03 |
| Per Standard Deviation Decrease in Transient Endothelial Response to Stress Measured by FMD † | |||||||
| Model 1 | 1.50 (1.22, 1.84) | 0.0001 | 1.30 (0.98, 1.73) | 0.07 | 1.64 (1.30, 2.06) | <.0001 | 0.14 |
| Model 2 | 1.54 (1.24, 1.91) | 0.0001 | 1.30 (0.95, 1.79) | 0.10 | 1.66 (1.31, 2.12) | <.0001 | 0.15 |
| Model 3 | 1.47 (1.17, 1.84) | 0.001 | 1.61 (1.13, 2.29) | 0.01 | 1.42 (1.11, 1.81) | 0.005 | 0.49 |
| Model 4 | 1.41 (1.12, 1.78) | 0.004 | 1.49 (1.03, 2.16) | 0.03 | 1.39 (1.09, 1.77) | 0.01 | 0.69 |
| Model 5 | 1.41 (1.11, 1.78) | 0.005 | 1.54 (1.05, 2.26) | 0.03 | 1.38 (1.08, 1.76) | 0.01 | 0.55 |
| Model 6 | 1.35 (1.07, 1.71) | 0.01 | 1.66 (1.12, 2.48) | 0.01 | 1.29 (1.01, 1.65) | 0.04 | 0.22 |
Model 1: Includes vascular measure; Sex specific models includes vascular measure, sex, and their interaction.
Model 2: Model 1 + age, sex, race, and education
Model 3: Model 2 covariates + clinical risk factors (ever smoking, BMI, hypertension, diabetes, dyslipidemia, ejection fraction)
Model 4: Model 3 covariates + medications (beta-blockers, statins, ACE inhibitors, and aspirin).
Model 5: Model 4 covariates + psychological risk factors (beck depression inventory, PTSD symptoms)
Model 6: Model 5 covariates + mental stress induced myocardial ischemia
All models adjusted for baseline RHI
All models also adjusted for brachial artery diameter and baseline FMD
Abbreviations: ACE: Angiotensin-converting enzyme; BMI: Body mass index; FMD: Flow mediated dilation; PTSD: Post-traumatic stress disorder; RHI: Reactive hyperemia index.