UMMS Affiliation

Department of Medicine, Division of Cardiovascular Medicine; Department of Medicine, Division of Preventive and Behavioral Medicine

Publication Date


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Article Postprint


Women's Health; Cardiovascular Diseases; Spirituality; Postmenopause


Alternative and Complementary Medicine | Behavior and Behavior Mechanisms | Cardiology | Cardiovascular Diseases | Clinical Epidemiology | Religion | Women's Health


Purpose: Spirituality has been associated with better cardiac autonomic balance, but its association with cardiovascular risk is not well studied. We examined whether more frequent private spiritual activity was associated with reduced cardiovascular risk in postmenopausal women enrolled in the Women’s Health Initiative Observational Study.

Methods: Frequency of private spiritual activity (prayer, Bible reading, and meditation) was selfreported at year 5 of follow-up. Cardiovascular outcomes were centrally adjudicated, and cardiovascular risk was estimated from proportional hazards models.

Results: Final models included 43,708 women (mean age: 68.9±7.3; median follow-up: 7.0 years) free of cardiac disease through year 5 of follow-up. In age-adjusted models private spiritual activity was associated with increased cardiovascular risk (HR: 1.16; CI 1.02, 1.31, weekly vs. never; 1.25; CI 1.11, 1.40, daily vs. never). In multivariate models adjusted for demographics, lifestyle, risk factors, and psychosocial factors, such association remained significant only in the group with daily activity (HR 1.16; CI: 1.03, 1.30). Subgroup analyses indicate this association may be driven by the presence of severe chronic diseases.

Conclusion: In aging women, higher frequency of private spiritual activity was associated with increased cardiovascular risk, likely reflecting a mobilization of spiritual resources in order to cope with aging and illness.


women's health, cardiovascular diseases, spirituality

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This is the authors' final, peer-reviewed version of the article as prepared for publication

DOI of Published Version



Annals of Epidemiology 2013 May;23(5):239-45. doi: 10.1016/j.annepidem.2013.03.002. Link to final version of article on publisher's website

Journal/Book/Conference Title

Annals of Epidemiology

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Link to article in PubMed

PubMed ID