title: Psychosocial predictors of coronary artery calcification progression in postmenopausal women.
abstract: OBJECTIVE
  Coronary artery calcification (CAC) has been associated with psychosocial factors in some but not all cross-sectional analyses. The goal of this study was to determine whether positive and negative psychosocial factors prospectively predict CAC progression in postmenopausal women.
  
  
  METHODS
  Participants from the Healthy Women Study who also participated in the Pittsburgh Mind-Body Center protocol (n = 149) completed self-report psychosocial measures before two electron beam computed tomographic scans of CAC separated by an average of 3.3 years. Results of exploratory factor analysis were used to create aggregate psychosocial indices: psychological risk (depressive symptoms, perceived stress, cynicism, and anger-in) and psychosocial resources (optimism, purpose in life, mastery, self-esteem, and social support).
  
  
  RESULTS
  The psychological risk index predicted significantly greater CAC progression over 3 years (β = 0.16, p = .035, ΔR(2) = 0.03), whereas the psychosocial resources index was not predictive of CAC progression (β = -0.08, p = .30, ΔR(2) = 0.01). On individual scales, higher scores on cynicism emerged as a significant predictor of CAC progression, along with a trend linking anger-in to atherosclerosis progression. A post hoc analysis showed a significant interaction between cynicism and anger-in (β = 0.20, p = .01, ΔR(2) = 0.03), such that women reporting high levels of both cynicism and anger suppression exhibited the most CAC progression.
  
  
  CONCLUSIONS
  These findings highlight psychosocial risk factors that may accelerate the progression of subclinical atherosclerosis in older women, suggest the potential importance of examining combinations of psychosocial risk factors, and identify potential targets for psychological interventions to reduce cardiovascular risk.
authors: Department of Psychiatry, University of Pittsburgh, Pittsburgh, Pennsylvania 15213, USA. lowca@upmc.edu
authors: Carissa A
authors: CA
authors: Low
authors: Karen A
authors: KA
authors: Matthews
authors: Lewis H
authors: LH
authors: Kuller
authors: Daniel
authors: D
authors: Edmundowicz
mesh_terms: D000328:Adult; D002114:Calcinosis / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000503:physiopathology / Q000523:psychology; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000503:physiopathology / Q000523:psychology; D003863:Depression / Q000453:epidemiology; D018450:Disease Progression; D004644:Emotions; D004812:Epidemiologic Methods; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017698:Postmenopause / Q000502:physiology* / Q000523:psychology; D012649:Self Concept; D013315:Stress, Psychological / Q000453:epidemiology; D014057:Tomography, X-Ray Computed