Key result
Higher hopelessness linked to increased carotid IMT, independent of depression and traditional CVD risk factors.
Why the study?
Does hopelessness increase carotid artery intimal-medial thickening in healthy middle-aged women?
Cross-Sectional (n=559)
Yes
Does hopelessness increase carotid artery intimal-medial thickening in healthy middle-aged women?
Effect estimate: 0.0061 mm greater mean IMT per 1-point higher hopelessness score
p-value: p=0.0217
Hopelessness is independently associated with subclinical atherosclerosis in healthy middle-aged women, suggesting it may be a unique psychosocial risk factor for cardiovascular disease.
Hopelessness assessment may refine CVD risk stratification in women; leaves open causal role and need for longitudinal validation.
BACKGROUND AND PURPOSE: Depression and hopelessness are associated with increased cardiovascular disease (CVD) morbidity and mortality; however, few studies have compared these constructs early in the atherogenic process, particularly in women or minorities. METHODS: This cross-sectional study examined associations of hopelessness and depressive symptoms with carotid artery intimal-medial thickening (IMT) in 559 women (62% white, 38% black; mean+/-SD age, 50.2+/-2.8 years) without evidence of clinical CVD from the Study of Women's Health Across the Nation (SWAN) Heart Study. Hopelessness was measured by 2 questionnaire items; depressive symptoms were measured with the 20-item Center for Epidemiological Studies Depression Scale. Mean and maximum IMT were assessed by B-mode ultrasonography of the carotid arteries. RESULTS: Increasing hopelessness was significantly related to higher mean (P=0.0139) and maximum (P=0.0297) IMT in regression models adjusted for age, race, site, income, and CVD risk factors. A weaker pattern of associations was noted for depressive symptoms and mean (P=0.1056) and maximum (P=0.0691) IMT. Modeled simultaneously in a risk factor-adjusted model, hopelessness was related to greater mean IMT (P=0.0217) and maximum IMT (P=0.0409), but depressive symptoms were unrelated to either outcome (P>0.4). No interactions with race or synergistic effects of depressive symptoms and hopelessness were observed. CONCLUSIONS: Among middle-aged women, higher levels of hopelessness are associated with greater subclinical atherosclerosis independent of age, race, income, CVD risk factors, and depressive symptoms.
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Whipple et al. (2009) conducted a cross-sectional in Subclinical atherosclerosis (n=559). Hopelessness vs. Lower levels of hopelessness was evaluated on Mean carotid artery intimal-medial thickening (IMT) (0.0061 mm greater mean IMT per 1-point higher hopelessness score, p=0.0217). Higher levels of hopelessness were associated with greater mean and maximum carotid artery intimal-medial thickening, independent of depressive symptoms and CVD risk factors.
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