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Cited by 79Religion, Spirituality, and PsychologyCardiac Health and Mental HealthWorkplace Spirituality and Leadership

Burden of Cardiovascular Risk Factors, Subclinical Atherosclerosis, and Incident Cardiovascular Events Across Dimensions of Religiosity: The Multi-Ethnic Study of Atherosclerosis

Open access
Feinstein, Matthew, Liu, Kiang, Ning, Hongyan, Fitchett, George, Lloyd-Jones, Donald M.·2010·Circulation
DOI 10.1161/circulationaha.109.879973PMC PMC2871276
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Abstract

Background— Religious involvement has been associated with improved health practices and outcomes; however, no ethnically diverse community-based study has examined differences in cardiac risk factors, subclinical cardiovascular disease, and cardiovascular disease (CVD) events across levels of religiosity. Methods and Results— We included 5474 white, black, Hispanic, and Chinese participants who attended examination 2 of the National Heart, Lung, and Blood Institute’s Multi-Ethnic Study of Atherosclerosis (MESA). We compared cross-sectional differences in cardiac risk factors and subclinical CVD and longitudinal CVD event rates across self-reported levels of religious participation, prayer/meditation, and spirituality. Multivariable-adjusted regression models were fitted to assess associations of measures of religiosity with risk factors, subclinical CVD, and CVD events. MESA participants (52.4% female; mean age, 63) with greater levels of religious participation were more likely to be female and black. After adjustment for demographic covariates, participants who attended services daily, compared with never, were significantly more likely to be obese (adjusted odds ratio 1.57, 95% confidence interval [CI] 1.12 to 1.72) but less likely to smoke (adjusted odds ratio 0.39, 95% CI 0.26 to 0.58). Results were similar for those with frequent prayer/meditation or high levels of spirituality. There were no consistent patterns of association observed between measures of religiosity and presence/extent of subclinical CVD at baseline or incident CVD events during longitudinal follow-up in the course of 4 years. Conclusions— Our results do not confirm those of previous studies associating greater religiosity with overall better health risks and status, at least with regard to CVD. There was no reduction in risk for CVD events associated with greater religiosity.

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Crossref · 10.1161/circulationaha.109.879973

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  • Of the 83 methodologically most rigorous smoking studies, 75 (90%) reported inverse relationships with R/S involvement.

    “Of the 83 methodologically most rigorous studies, 75 (90%) reported inverse relationships with R/S involvement [213, 285–294].”

    From Religion, Spirituality, and Health: The Research and Clinical Implications (2012) · cites this paper as [288]

    The Introduction and Results (page numbers unavailable) report an inverse association between religious involvement and smoking. This paper is a MESA study, however, and our copy does not report an assessment of 83 rigorous smoking studies or the claimed 75 (90%) result. (LLM, conf=0.88)

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  • Two lower quality studies and five well-done studies (13%, including one at a trend level) reported higher BP in the more R/S or with religious fasting.

    “Two lower quality studies [405, 406] and five well-done studies [407–411] (13%, including one at a trend level), however, reported higher BP in the more R/S or with religious fasting.”

    From Religion, Spirituality, and Health: The Research and Clinical Implications (2012) · cites this paper as [410]

  • Among the 10 highest-quality diet studies, seven (70%) reported a better diet among those who were more R/S.

    “Among the 10 studies with the highest quality ratings, seven (70%) reported a better diet among those who were more R/S [213, 306–310].”

    From Religion, Spirituality, and Health: The Research and Clinical Implications (2012) · cites this paper as [307]

    The Results (Study Sample; page unavailable) describe smoking, blood pressure, and BMI by religiosity, but not diet. Searches for diet and for the claimed count of seven of ten high-quality studies found no passage in our copy assessing diet-study quality or reporting that result. (LLM, conf=0.76)

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  • Of the nine best cholesterol studies, five (56%) reported lower cholesterol or a lowering of cholesterol in response to an R/S intervention, whereas one found higher cholesterol but only in Mexican American men.

    “Of the nine best studies, five (56%) reported lower cholesterol [311–313] or a lowering of cholesterol in response to a R/S intervention [314, 315], whereas one found higher cholesterol (but only in Mexican American men) [316].”

    From Religion, Spirituality, and Health: The Research and Clinical Implications (2012) · cites this paper as [316]

    The Methods > Risk Factors section says cholesterol was measured, but the Results > Frequency of Religious Participation, Risk Factors and Subclinical Atherosclerosis section does not report higher cholesterol among Mexican American men. Searches for “Mexican American,” “hypercholesterolemia,” and higher cholesterol in men found no passage supporting that finding. The other cholesterol studies in the citing sentence are attached to different citations. (LLM, conf=0.77)

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  • In the WHI and MESA cohorts, point estimates showed a higher risk of CVD among the more religiously involved.

    “In both the WHI and MESA cohorts, point estimates actually showed a higher risk of CVD among the more religiously involved.”

    From Advancing our understanding of religion and spirituality in the context of behavioral medicine (2017) · cites this paper as Feinstein et al., 2010

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Authors
Feinstein, M., Liu, K., Ning, H., Fitchett, G., & Lloyd-Jones, D. M.
Affiliations
  • Northwestern University (US)
  • From the Department of Preventive Medicine (K.L., H.N., D.M.L.-J.), Feinberg School of Medicine (M.F.), Northwestern University, and Rush University Medical School (G.F.), Chicago, Illinois.
ORCID
Venue
Circulation
Publisher
Ovid Technologies (Wolters Kluwer Health)
Published
2010-02-09
Volume
121
Issue
5
Pages
659-666
ISSN
  • 0009-7322 (ISSN-L)
  • 1524-4539
DOI
10.1161/circulationaha.109.879973
PMC
PMC2871276
OpenAlex
W2082355902
Cited by
79
References
33
Citations by year
2026: 2 · 2025: 6 · 2024: 2 · 2023: 5 · 2022: 6 · 2021: 3 · 2020: 3 · 2019: 2 · 2018: 5 · 2017: 5 · 2016: 7 · 2015: 5 · 2014: 3 · 2013: 10 · 2012: 10
FWCI
8.12
Type
journal article
Language
en
Open access
Locations
  • Circulation (publishedVersion)
  • PubMed (publishedVersion)
  • Europe PMC (PubMed Central) (acceptedVersion)
  • PubMed Central (acceptedVersion)
Funders
  • National Institutes of Health (n01hc95164-17-0-1, n01hc95165-34-0-1, n01hc95161-24-0-1, n01hc095169-003, n01hc95166-21-0-1, n01hc95162-31-0-1, n01hc95168-27-0-1, n01hc95160-18-0-1, n01hc095167-000, n01hc95163-22-0-1, n01hc95159-40-0-1)
  • National Heart, Lung, and Blood Institute (N01 HC-95159, N01-HC095169, N01-HC-095165, N01 HC095163, N01-HC-095159, N01 HC095168, N01-HC-095162, N01-HC-095161, N01 HC095167, N01-HC-095160, N01 HC095166, N01 HC095164, N01 HC95169)
Topics
  • Social Sciences › Health › Religion, Spirituality, and Psychology
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Health and Mental Health
  • Social Sciences › Demography › Workplace Spirituality and Leadership
Keywords
religiosity, religious participation, prayer and meditation, spirituality, cardiovascular risk factors, subclinical atherosclerosis, incident cardiovascular events, obesity, smoking, ethnic differences, Multi-Ethnic Study of Atherosclerosis
MeSH terms
Aged, Aged, 80 and over, Cross-Sectional Studies, Female, Follow-Up Studies, Humans, Male, Middle Aged, Religion, Risk Factors, Cohort Studies, Incidence, Atherosclerosis

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