Key result
Depressive symptoms, anger, anxiety, and chronic stress were not associated with coronary calcification in asymptomatic adults (e.g., relative prevalence for anger in men 0.94; 95% CI 0.88-1.01).
Why the study?
Are high levels of psychosocial factors (depressive symptoms, anger, anxiety, and chronic stress) associated with increased subclinical coronary atherosclerosis in asymptomatic adults?
Cross-Sectional (n=6,789)
Are high levels of psychosocial factors (depressive symptoms, anger, anxiety, and chronic stress) associated with increased subclinical coronary atherosclerosis in asymptomatic adults?
Relative Risk: 0.94 (95% CI 0.88–1.01)
Depressive symptoms, anger, anxiety, and chronic stress burden are not associated with subclinical coronary calcification in asymptomatic adults.
No support for psychosocial screening in subclinical atherosclerosis assessment; leaves open longitudinal links to events or progression.
BACKGROUND: Psychosocial factors have been linked to coronary events, but the mechanisms underlying these associations have not been established. Evidence is mixed regarding associations of psychosocial factors with subclinical coronary atherosclerosis. OBJECTIVE: To examine associations of 4 psychosocial factors (depressive symptoms, anger, anxiety, and chronic stress) with the presence of subclinical coronary atherosclerosis. DESIGN: Cross-sectional study. SETTING: The Multiethnic Study of Atherosclerosis, a population-based study of subclinical atherosclerosis. PATIENTS: A multiethnic sample of 6789 adults, 45 to 84 years of age, with no history of clinical cardiovascular disease. MEASUREMENTS: Coronary calcium was assessed by using chest computed tomography, and psychosocial factors were assessed by using questionnaires with validated scales. RESULTS: There was no evidence that higher levels of the psychosocial measures were associated with greater prevalence of calcification or with greater amounts of calcium among persons with calcium. Age- and risk factor-adjusted relative prevalences of coronary calcification in men for the top fourth category versus the bottom fourth category of anger, anxiety, and depressive symptoms were 0.94 (95% CI, 0.88 to 1.01), 0.97 (CI, 0.90 to 1.04), and 0.97 (CI, 0.90 to 1.05), respectively; these values for women were 1.01 (CI, 0.90 to 1.15), 0.93 (CI, 0.83 to 1.05), and 0.92 (CI, 0.82 to 1.04), respectively. Relative prevalences for the top versus the bottom category of chronic stress burden were 1.02 (CI, 0.94 to 1.11) for men and 0.88 (CI, 0.79 to 0.99) for women. LIMITATIONS: Current measures of psychosocial factors may be a poor proxy for cumulative exposure during development of atherosclerosis. CONCLUSION: Depressive symptoms, anger, anxiety, and chronic stress burden were not associated with coronary calcification in a multiethnic sample of asymptomatic adults.
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Roux et al. (2006) conducted a cross-sectional in No history of clinical cardiovascular disease (n=6,789). Psychosocial factors (depressive symptoms, anger, anxiety, and chronic stress) vs. Bottom fourth category (lowest levels) was evaluated on Prevalence of coronary calcification (Relative prevalence 0.94, 95% CI 0.88-1.01). Depressive symptoms, anger, anxiety, and chronic stress were not associated with coronary calcification in asymptomatic adults (e.g., relative prevalence for anger in men 0.94; 95% CI 0.88-1.01).
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