American Diabetes Association
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Social support, social network size, social strain, stressful life events and CHD in women with type 2 diabetes – a cohort study based on the Women’s Health Initiative

posted on 2020-06-04, 22:09 authored by Junmei Miao Jonasson, Michael Hendryx, Aladdin H. Shadyab, Erika Kelley, Karen C Johnson, Candyce H Kroenke, Lorena Garcia, Sofia Lawesson, Ailiana Santosa, Shawnita Sealy-Jefferson, Xiaochen Lin, Crystal W. Cene, Simin Liu, Carolina Valdiviezo, Juhua Luo

We studied associations between social support, social network size, social strain or stressful life events and risk of coronary heart disease (CHD) in postmenopausal women with type 2 diabetes.

Research Design and Methods

From the Women’s Health Initiative, 5,262 postmenopausal women with type 2 diabetes at baseline were included. Cox proportional hazards regression models adjusted for demographics, depressive symptom, anthropometric variables, and lifestyle factors were used to examine associations between social factors and CHD.


A total of 672 cases of CHD were observed during an average 12.79 (SD 6.29) years of follow-up. There was a significant linear trend toward higher risk of CHD as number of stressful life events increased (p for trend=0.01; HR [95% CI] for the third and fourth quartiles compared with first quartile = 1.27 [1.03-1.56] and 1.30 [1.04-1.64]). Being married or in an intimate relationship was related to decreased risk of CHD [HR and 95% CI 0.82 (0.69-0.97)].


Among postmenopausal women with type 2 diabetes, higher levels of stressful life events were associated with higher risk of CHD. Experience of stressful life events might be considered as a risk factor for CHD among women with type 2 diabetes.


The WHI program is funded by the National Heart, Lung, and Blood Institute, National Institutes of Health, U.S. Department of Health and Human Services through contracts HHSN268201600018C, HHSN268201600001C, HHSN268201600002C, HHSN268201600003C, and HHSN268201600004C.


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