title: Psychological factors and subclinical atherosclerosis in postmenopausal Chinese women in Hong Kong.
abstract: BACKGROUND
  Substantial evidence shows that psychological factors are associated with cardiovascular diseases. However, data on the association between psychological factors and subclinical atherosclerosis is lacking in postmenopausal Chinese women.
  
  
  OBJECTIVE
  To examine the associations of perceived stress and trait anxiety with subclinical atherosclerosis in postmenopausal Chinese women in Hong Kong. Their relationships with biological and behavioral risk factors were also examined.
  
  
  METHODS
  Between 2002 and 2004, we recruited 518 postmenopausal women aged 50-64 years. Perceived stress and trait anxiety were evaluated by the perceived stress scale and the state-trait anxiety inventory, respectively. Subclinical atherosclerosis was determined by measuring carotid intima-media thickness (IMT) and plaque using B-mode ultrasonography.
  
  
  RESULTS
  Perceived stress and trait anxiety showed no significant association with IMT or plaque. Multivariate analyses showed high perceived stress scores were associated with an increased risk of elevated total cholesterol (OR=2.10; 95% CI=1.17-3.77) and elevated low-density lipoprotein cholesterol (LDL-C) (OR=2.39; 95% CI=1.36-4.21). High trait anxiety scores were associated with a 2.7-fold risk of elevated LDL-C (OR=2.74; 95% CI=1.56-4.80). Women with high perceived stress or trait anxiety scores were more likely to be physically inactive.
  
  
  CONCLUSIONS
  Perceived stress and trait anxiety were associated with atherogenic lipid levels, but not subclinical atherosclerosis. Maintaining high physical activity may help alleviate psychological stress and anxiety.
authors.affiliation: School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong.
authors.forename: Ruby H Y
authors.initials: RH
authors.lastname: Yu
authors.forename: Suzanne C
authors.initials: SC
authors.lastname: Ho
authors.forename: Christopher W K
authors.initials: CW
authors.lastname: Lam
authors.forename: Jean L F
authors.initials: JL
authors.lastname: Woo
authors.forename: Stella S Y
authors.initials: SS
authors.lastname: Ho
mesh_terms: D001007:Anxiety; D044466:Asian People; D050197:Atherosclerosis / Q000097:blood / Q000000981:diagnostic imaging / Q000523:psychology*; D002339:Carotid Arteries / Q000000981:diagnostic imaging*; D003430:Cross-Sectional Studies; D005260:Female; D015438:Health Behavior; D006723:Hong Kong / Q000453:epidemiology; D006801:Humans; D008055:Lipids / Q000097:blood; D016015:Logistic Models; D008875:Middle Aged; D058226:Plaque, Atherosclerotic / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000523:psychology*; D015995:Prevalence; D012307:Risk Factors; D013315:Stress, Psychological; D017539:Tunica Intima / Q000000981:diagnostic imaging*; D014463:Ultrasonography
chemical_list: D008055:Lipids