title: Cynical hostility and carotid atherosclerosis in African American and white women: the Study of Women's Health Across the Nation (SWAN) Heart Study.
abstract: BACKGROUND
  Hostility is associated with increased cardiovascular disease mortality and morbidity and may be related to subclinical atherosclerosis; less is known about this association among women and minority groups.
  
  
  METHODS
  We examined the association between hostility and intimal-medial thickening (IMT) as well as presence/absence of plaque in the carotid arteries in middle-aged white and African American women. Hostility was measured by a 13-item questionnaire and IMT and plaque were assessed by B-mode ultrasonography in 589 participants from the Chicago and Pittsburgh sites of the SWAN.
  
  
  RESULTS
  In age- and site-adjusted models, each 1-point increment in hostility score predicted a significant 0.0057-mm higher mean IMT (P < .0001) and 0.0081-mm higher maximum IMT (P < .0001)--effects that were identical in magnitude to each 1-year increment in age. Adjustments for race, education, body mass index, resting systolic blood pressure, and smoking diminished these associations, but they remained significant (P < or = .01). With hostility scores modeled in approximate tertiles, high scorers (> or = 6) had greater mean (P = .0005) and maximum (P = .0004) IMT than low scorers (0 or 1); moderate and low scorers did not differ (age-adjusted mean values for low, moderate, and high scorers were 0.657, 0.662, and 0.694 mm, respectively, for mean IMT; those for low, moderate, and high scorers were 0.855, 0.860, and 0.906 mm, respectively, for maximum IMT). Hostility was unrelated to presence of plaque and did not interact with race, education, smoking, and body mass index.
  
  
  CONCLUSIONS
  Hostility is related to small but significantly greater subclinical atherosclerosis in middle-aged women; this association is not explained by traditional risk factors.
authors.affiliation: Department of Preventive Medicine, Rush University Medical Center, Chicago, IL 60612-2391, USA.
authors.forename: Susan A
authors.initials: SA
authors.lastname: Everson-Rose
authors.forename: Tené T
authors.initials: TT
authors.lastname: Lewis
authors.forename: Kelly
authors.initials: K
authors.lastname: Karavolos
authors.forename: Karen A
authors.initials: KA
authors.lastname: Matthews
authors.forename: Kim
authors.initials: K
authors.lastname: Sutton-Tyrrell
authors.forename: Lynda H
authors.initials: LH
authors.lastname: Powell
mesh_terms: D001741:Black or African American; D015992:Body Mass Index; D002340:Carotid Artery Diseases / Q000000981:diagnostic imaging / Q000208:ethnology* / Q000523:psychology*; D004522:Educational Status; D005260:Female; D006791:Hostility; D006801:Humans; D008875:Middle Aged; D044469:Racial Groups; D012307:Risk Factors; D012737:Sex Factors; D012907:Smoking; D014463:Ultrasonography; D044465:White People