November 1, 2011Open Access
Psychosocial Predictors of Coronary Artery Calcification Progression in Postmenopausal Women
Resultado clave
A psychological risk index including depressive symptoms, perceived stress, cynicism, and anger-in predicted significantly greater coronary artery calcification progression over 3 years (β=0.16, p=0.035).
Diseño del estudio
Tipo
Cohort (n=149)
PICO estructurado
Do positive and negative psychosocial factors prospectively predict CAC progression in postmenopausal women?
P
Población
149 postmenopausal women followed for an average of 3.3 years to evaluate psychosocial predictors of coronary artery calcification progression.
E
Exposición
Self-reported psychosocial measures (psychological risk index and psychosocial resources index)
O
Resultado
Coronary artery calcification (CAC) progression measured by two electron beam computed tomographic scans separated by an average of 3.3 yearssurrogate
Psychological risk factors, particularly the combination of cynicism and anger suppression, prospectively predict the progression of coronary artery calcification in postmenopausal women.
Resultado numérico
Estimación del efecto: β = 0.16
valor p: p=0.035
Resumen
OBJECTIVE: Coronary artery calcification (CAC) has been associated with psychosocial factors in some but not all cross-sectional analyses. The goal of this study was to determine whether positive and negative psychosocial factors prospectively predict CAC progression in postmenopausal women. METHODS: Participants from the Healthy Women Study who also participated in the Pittsburgh Mind-Body Center protocol (n = 149) completed self-report psychosocial measures before two electron beam computed tomographic scans of CAC separated by an average of 3.3 years. Results of exploratory factor analysis were used to create aggregate psychosocial indices: psychological risk (depressive symptoms, perceived stress, cynicism, and anger-in) and psychosocial resources (optimism, purpose in life, mastery, self-esteem, and social support). RESULTS: The psychological risk index predicted significantly greater CAC progression over 3 years (β = 0.16, p = .035, ΔR(2) = 0.03), whereas the psychosocial resources index was not predictive of CAC progression (β = -0.08, p = .30, ΔR(2) = 0.01). On individual scales, higher scores on cynicism emerged as a significant predictor of CAC progression, along with a trend linking anger-in to atherosclerosis progression. A post hoc analysis showed a significant interaction between cynicism and anger-in (β = 0.20, p = .01, ΔR(2) = 0.03), such that women reporting high levels of both cynicism and anger suppression exhibited the most CAC progression. CONCLUSIONS: These findings highlight psychosocial risk factors that may accelerate the progression of subclinical atherosclerosis in older women, suggest the potential importance of examining combinations of psychosocial risk factors, and identify potential targets for psychological interventions to reduce cardiovascular risk.