title: Sex differences in the combined effect of chronic stress with impaired vascular endothelium functioning and the development of early atherosclerosis: the Cardiovascular Risk in Young Finns study.
abstract: BACKGROUND
  The syndrome of vital exhaustion (VE), characterized by fatigue and irritability, may contribute to an increased risk of atherosclerosis. The aim of the study was to explore sex differences in the interactions of VE with endothelial dysfunction and VE with reduced carotid elasticity, the important contributors to the development of early atherosclerosis, on preclinical atherosclerosis.
  
  
  METHODS
  The participants were 1002 women and 719 men aged 24-39 examined in the Cardiovascular Risk in Young Finns study. Vital exhaustion was measured using the Maastricht Questionnaire. Preclinical atherosclerosis was assessed by carotid intima-media thickness (IMT), endothelial function was measured by brachial flow-mediated dilatation (FMD), and arterial elasticity by carotid artery compliance (CAC) using ultrasound techniques.
  
  
  RESULTS
  We found a significant CAC x VE interaction for IMT only for the men. Our results imply that high VE level significantly related to high IMT levels among the men with low CAC, but not among the women with low CAC or among the women or men with high CAC. No significant FMD x VE interactions for IMT for the women or men were found.
  
  
  CONCLUSIONS
  High VE may exert an effect on IMT for men with impaired arterial elasticity. The results suggest that high vitally exhausted men with reduced arterial elasticity are at increased risk of atherosclerosis in early life and imply men's decreased stress coping in relation to stressful psychological coronary risk factors.
authors.affiliation: Institute of Behavioral Sciences, University of Helsinki, PO Box 9, 00014 Helsinki, Finland.
authors.forename: Nadja
authors.initials: N
authors.lastname: Chumaeva
authors.forename: Mirka
authors.initials: M
authors.lastname: Hintsanen
authors.forename: Markus
authors.initials: M
authors.lastname: Juonala
authors.forename: Olli T
authors.initials: OT
authors.lastname: Raitakari
authors.forename: Liisa
authors.initials: L
authors.lastname: Keltikangas-Järvinen
mesh_terms: D000328:Adult; D000342:Affective Symptoms; D017668:Age of Onset; D050197:Atherosclerosis / Q000453:epidemiology* / Q000473:pathology / Q000503:physiopathology; D004548:Elasticity; D004730:Endothelium, Vascular / Q000378:metabolism* / Q000473:pathology; D005221:Fatigue; D005260:Female; D005387:Finland; D006801:Humans; D007508:Irritable Mood; D008297:Male; D012307:Risk Factors; D012737:Sex Factors; D040921:Stress Disorders, Traumatic / Q000453:epidemiology* / Q000473:pathology / Q000503:physiopathology