Psychosocial factors and coronary calcium in adults without clinical cardiovascular disease.
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.


METHODS
Cross-sectional study.


METHODS
The Multiethnic Study of Atherosclerosis, a population-based study of subclinical atherosclerosis.


METHODS
A multiethnic sample of 6789 adults, 45 to 84 years of age, with no history of clinical cardiovascular disease.


METHODS
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.


CONCLUSIONS
Current measures of psychosocial factors may be a poor proxy for cumulative exposure during development of atherosclerosis.


CONCLUSIONS
Depressive symptoms, anger, anxiety, and chronic stress burden were not associated with coronary calcification in a multiethnic sample of asymptomatic adults.
Diez Roux
Ana V
AV
Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, Michigan 48103, USA. adiezrou@umich.edu
Ranjit
Nalini
N
Powell
Lynda
L
Jackson
Sharon
S
Lewis
Tené T
TT
Shea
Steven
S
Wu
Colin
C
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000786:Anger; D001007:Anxiety / Q000150:complications; D002114:Calcinosis / Q000208:ethnology / Q000473:pathology* / Q000523:psychology*; D003324:Coronary Artery Disease / Q000208:ethnology / Q000473:pathology / Q000523:psychology; D003331:Coronary Vessels / Q000473:pathology*; D003430:Cross-Sectional Studies; D003863:Depression / Q000150:complications; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D012737:Sex Factors; D013315:Stress, Psychological / Q000150:complications