title: Psychosocial risk factors and retinal microvascular signs: the multi-ethnic study of atherosclerosis.
abstract: The association between psychosocial risk factors and retinal microvascular signs was examined in the Multi-Ethnic Study of Atherosclerosis. Subjects were recruited from Baltimore, Maryland; Chicago, Illinois; Forsyth County, North Carolina; Los Angeles County, California; New York, New York; and St. Paul, Minnesota. Levels of depressive symptoms, trait anger, trait anxiety, chronic burdens, emotional support, and cynical distrust were assessed by questionnaire (from July 2000 to July 2002). Digital retinal images (from August 2002 to January 2004) from 6,147 participants were used to evaluate retinopathy and retinal vascular caliber. After controlling for potential confounding factors, the authors found that subjects without access to emotional support (Enriched Social Support Instrument score of <19 vs. > or = 19) had 60% greater odds of retinopathy (odds ratio = 1.6, 95% confidence interval (CI): 1.3, 2.0). Subjects with high Spielberger trait-anxiety scale scores (> or = 22 vs. < or = 14) and subjects with high depressive symptoms (Center for Epidemiology Studies Depression Scale score, > or = 16 vs. <16) were also more likely to have retinopathy (odds ratio = 1.4, 95% CI: 1.1, 1.9 and odds ratio = 1.5, 95% CI: 1.2, 1.9), respectively. In this cross-sectional study, lack of emotional support, increased trait anxiety, and more depressive symptoms were associated with retinopathy signs, independently of other known risk factors.
authors.affiliation: Department of Epidemiology, University of Washington, Seattle,Washington, USA. richaj@uw.edu
authors.forename: Richard A
authors.initials: RA
authors.lastname: Jensen
authors.forename: Steven
authors.initials: S
authors.lastname: Shea
authors.forename: Nalini
authors.initials: N
authors.lastname: Ranjit
authors.forename: Ana
authors.initials: A
authors.lastname: Diez-Roux
authors.forename: Tien Y
authors.initials: TY
authors.lastname: Wong
authors.forename: Ronald
authors.initials: R
authors.lastname: Klein
authors.forename: Barbara E K
authors.initials: BE
authors.lastname: Klein
authors.forename: Mary Frances
authors.initials: MF
authors.lastname: Cotch
authors.forename: David S
authors.initials: DS
authors.lastname: Siscovick
mesh_terms: D001741:Black or African American; D000368:Aged; D000369:Aged, 80 and over; D000786:Anger; D001007:Anxiety / Q000150:complications / Q000208:ethnology; D001213:Asian; D050197:Atherosclerosis / Q000208:ethnology; D003863:Depression / Q000150:complications; D005260:Female; D005451:Fluorescein Angiography; D006630:Hispanic or Latino; D006801:Humans; D008297:Male; D055806:Microvessels / Q000473:pathology; D008875:Middle Aged; D011584:Psychology; D012164:Retinal Diseases / Q000208:ethnology / Q000473:pathology / Q000523:psychology*; D012171:Retinal Vessels / Q000473:pathology*; D012307:Risk Factors; D011795:Surveys and Questionnaires; D014481:United States; D044465:White People