March 15, 2007Open Access
View Full PaperRace-Gender Differences in the Association of Trait Anger with Subclinical Carotid Artery Atherosclerosis: The Atherosclerosis Risk in Communities Study
Key Result
High trait anger was significantly associated with increased carotid intimal-medial thickness, with the strongest independent association in Black men (MD 67 microm; 95% CI 23-110; p=0.004).
Study Design
Type
Cohort (n=14,098)
Multicenter
Yes
Structured PICO
Is trait anger associated with subclinical carotid artery atherosclerosis in Black or White men and women?
P
Population
14,098 Black or White men and women, aged 48-67 years, evaluated for the association between trait anger and subclinical carotid artery atherosclerosis.
E
Exposure
Trait anger (assessed using the 10-item Spielberger Trait Anger Scale)
O
Outcome
Subclinical carotid artery atherosclerosis determined by an averaged measure of the wall intimal-medial thickness (IMT) of the carotid bifurcation and of the internal and common carotids, measured by high-resolution B-mode ultrasoundsurrogate
Trait anger is independently associated with increased subclinical carotid atherosclerosis specifically in Black men, highlighting important race-gender differences in psychosocial cardiovascular risk factors.
Main Result
Mean Difference: 67 (95% CI 23–110)
p-value: p=0.004
Abstract
This paper examines the association between trait anger and subclinical carotid artery atherosclerosis among 14,098 Black or White men and women, aged 48-67 years, in the Atherosclerosis Risk in Communities Study cohort, 1990-1992. Trait anger was assessed using the 10-item Spielberger Trait Anger Scale. Carotid atherosclerosis was determined by an averaged measure of the wall intimal-medial thickness (IMT) of the carotid bifurcation and of the internal and common carotids, measured by high-resolution B-mode ultrasound. In the full study cohort, trait anger and carotid IMT were significantly and positively associated (p = 0.04). In race-gender stratified analysis, the association was strongest and independent only in Black men, among whom a significant trait anger-carotid IMT relation was observed for both the overall trait anger measure (p = 0.004) and the anger reaction dimension (p = 0.001). In Black men, carotid IMT levels increased across categories of overall trait anger and anger reaction, resulting in clinically significant differences (67 microm (95% confidence interval: 23, 110) and 82 microm (95% confidence interval: 40, 125), respectively) from low to high anger. Sociodemographic, lifestyle, anthropometric, and biologic cardiovascular disease risk factors appear to mediate the relation in Black women, White men, and White women. In conclusion, these findings document disparate race-gender patterns in the association of trait anger with subclinical carotid artery atherosclerosis.