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Exploring the Role of Irrational Beliefs, Lifestyle Behaviors, and Educational Status in 10-Year Cardiovascular Disease Risk: the ATTICA Epidemiological Study

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Abstract

Background

Irrational beliefs, maladaptive emotions, and unhealthy lifestyle behaviors can adversely affect health status. However, limited research has examined the association between irrational beliefs and cardiovascular disease (CVD). The aim of this study was to evaluate the association between irrational beliefs and the 10-year CVD incidence among apparently healthy adults, considering the potential moderating or mediating role of particular social and lifestyle factors.

Methods

The ATTICA study is a population-based, prospective cohort (2002–2012), in which 853 participants without a history of CVD [453 men (aged 45 ± 13 years) and 400 women (aged 44 ± 18 years)] underwent psychological evaluations. Among other tools, participants completed the irrational beliefs inventory (IBI, range 0–88), a self-reported measure consistent with the Ellis model of psychological disturbance. Demographic characteristics, detailed medical history, dietary, and other lifestyle habits were also evaluated. Incidence of CVD (i.e., coronary heart disease, acute coronary syndromes, stroke, or other CVD) was defined according to the International Coding Diseases (ICD)-10 criteria.

Results

Mean IBI score was 53 ± 2 in men and 53 ± 3 in women (p = 0.88). IBI score was positively associated with 10-year CVD risk (hazard ratio 1.07, 95%CI 1.04, 1.13), in both men and women, and more prominently among those with less healthy dietary habits and lower education status; specifically, higher educational status leads to lower IBI score, and in conjunction they lead to lower 10-year CVD risk (HR for interaction 0.98, 95%CI 0.97, 0.99).

Conclusions

The findings of this study underline the need to build new, holistic approaches in order to better understand the inter-relationships between irrational beliefs, lifestyle behaviors, social determinants, and CVD risk in individuals.

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Acknowledgements

Authors would like to thank the ATTICA study investigators: Yannis Skoumas, Natassa Katinioti, Labros Papadimitriou, Constantina Masoura, Spiros Vellas, Yannis Lentzas, Manolis Kambaxis, Konstadina Palliou, Vassiliki Metaxa, Agathi Ntzouvani, Dimitris Mpougatsas, Nikolaos Skourlis, Christina Papanikolaou, Georgia-Maria Kouli, Aimilia Christou, Adella Zana, Maria Ntertimani, Aikaterini Kalogeropoulou, Evangelia Pitaraki, Alexandros Laskaris, Mihail Hatzigeorgiou, and Athanasios Grekas for their assistance in the initial physical examination and follow-up evaluation, Efi Tsetsekou for her assistance in psychological evaluations, and the laboratory team: Carmen Vassiliadou and George Dedoussis (genetic analysis), Marina Toutouza-Giotsa, Constadina Tselika, and Sia Poulopoulou (biochemical analysis), and Maria Toutouza for the database management.

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Authors and Affiliations

  1. Department of Nutrition and Dietetics, School of Health Sciences and Education, Harokopio University, 70 Eleftheriou Venizelou Ave, 176 76, Kallithea, Athens, Greece

    Christina Vassou, Mary Yannakoulia & Demosthenes B. Panagiotakos

  2. School of Medicine Sydney, University of Notre Dame, Sydney, Australia

    Ekavi N. Georgousopoulou

  3. First Cardiology Clinic, School of Medicine, University of Athens, Athens, Greece

    Christina Chrysohoou & Christos Pitsavos

  4. Department of Psychiatry, School of Medicine, University of Athens, Athens, Greece

    Charalabos Papageorgiou

  5. School of Psychology, University of Surrey, Guildford, UK

    Mark Cropley

  6. Faculty of Health, University of Canberra, Canberra, Australia

    Demosthenes B. Panagiotakos

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  1. Christina Vassou
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Correspondence to Demosthenes B. Panagiotakos.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional ethics committee (#017/1.5.2001) and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Vassou, C., Georgousopoulou, E.N., Yannakoulia, M. et al. Exploring the Role of Irrational Beliefs, Lifestyle Behaviors, and Educational Status in 10-Year Cardiovascular Disease Risk: the ATTICA Epidemiological Study. Int.J. Behav. Med. 30, 279–288 (2023). https://doi.org/10.1007/s12529-022-10091-9

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