title: Progression of coronary artery calcification in black and white women: do the stresses and rewards of multiple roles matter?
abstract: BACKGROUND
  Black women experience higher rates of cardiovascular disease (CVD) than white women, though evidence for racial differences in subclinical CVD is mixed. Few studies have examined multiple roles (number, perceived stress, and/or reward) in relation to subclinical CVD, or whether those effects differ by race.
  
  
  OBJECTIVE
  The aim of this study was to investigate the effects of multiple roles on 2-year progression of coronary artery calcium.
  
  
  METHODS
  Subjects were 104 black and 232 white women (mean age 50.8 years). Stress and reward from four roles (spouse, parent, employee, caregiver) were assessed on five-point scales. Coronary artery calcium progression was defined as an increase of ≥10 Agatston units.
  
  
  RESULTS
  White women reported higher rewards from their multiple roles than black women, yet black women showed cardiovascular benefits from role rewards. Among black women only, higher role rewards were related significantly to lower progression of coronary artery calcium, adjusting for body mass index, blood pressure, and other known CVD risk factors. Blacks reported fewer roles but similar role stress as whites; role number and stress were unrelated to coronary artery calcium progression.
  
  
  CONCLUSIONS
  Rewarding roles may be a novel protective psychosocial factor for progression of coronary calcium among black women.
authors: Department of Preventive Medicine, Rush University Medical Center, Chicago, IL 60612, USA. Imke_Janssen@rush.edu
authors: Imke
authors: I
authors: Janssen
authors: Lynda H
authors: LH
authors: Powell
authors: Mateusz S
authors: MS
authors: Jasielec
authors: Karen A
authors: KA
authors: Matthews
authors: Steven M
authors: SM
authors: Hollenberg
authors: Kim
authors: K
authors: Sutton-Tyrrell
authors: Susan A
authors: SA
authors: Everson-Rose
mesh_terms: D001741:Black or African American; D002114:Calcinosis / Q000208:ethnology / Q000473:pathology* / Q000523:psychology; D002118:Calcium / Q000032:analysis; D003324:Coronary Artery Disease / Q000208:ethnology / Q000473:pathology* / Q000523:psychology; D003331:Coronary Vessels / Q000737:chemistry; D018450:Disease Progression; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008875:Middle Aged; D012307:Risk Factors; D012380:Role; D013315:Stress, Psychological / Q000208:ethnology / Q000503:physiopathology*; D044465:White People
chemical_list: D002118:Calcium