Mood patterns based on momentary assessment of positive and negative moods over a day and coronary artery calcification in the CARDIA study.
OBJECTIVE
Retrospective assessments of negative mood have predicted coronary artery disease development and progression. Using momentary assessment, we evaluated associations between average positive and negative mood states and diurnal mood patterns, with prevalent and incident coronary artery calcification (CAC), a measure of calcified atherosclerosis.


METHODS
In a prospective cohort study of 669 white and African American men and women, aged 33 to 45 years, from the Coronary Artery Risk Development in Young Adults Study, mood was assessed at Year 15 examination, six times over a weekday. Prevalent, progressive, and 5-year incident CAC (any detectable CAC [score >0]) and substantial CAC (CAC score ≥ 20) were assessed at examinations at Years 15 and 20 by electron-beam tomographic scans. We employed a modified Poisson regression approach for binary data with robust error estimation to quantify relative risk.


RESULTS
In multivariate-adjusted analyses, those with high-average positive mood that improved over a day had a lower risk of prevalent CAC higher than 0 (relative risk [RR] = 0.17 [95% confidence interval {CI} = 0.04-0.67]) and substantial CAC (RR = 0.25 [95% CI = 0.06-0.95]). In contrast, those with high-average, increasingly negative mood over a day had a higher risk of prevalent CAC (RR = 1.85 [95% CI = 0.86-3.99]) and substantial CAC (RR = 3.11 [95% CI = 1.29-7.49]). Findings were similar for progressive CAC at Year 20. This pattern of high/worsening negative mood (not positive mood) during the day was also predictive of 5-year incident CAC (RR = 2.99 [95% CI = 1.00-8.93]).


CONCLUSIONS
Diurnal mood patterns were associated with the progression of calcified atherosclerosis, with negative mood predicting greater progression and positive mood predicting lower progression.
Kaiser Permanente Division of Research, Oakland, CA, USA. candyce.h.kroenke@kp.org
Candyce H
CH
Kroenke
Teresa
T
Seeman
Karen
K
Matthews
Nancy
N
Adler
Elissa
E
Epel
D000293:Adolescent; D000328:Adult; D000339:Affect; D000704:Analysis of Variance; D050197:Atherosclerosis / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000523:psychology; D044383:Black People / Q000706:statistics & numerical data; D002114:Calcinosis / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000523:psychology; D002940:Circadian Rhythm; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000473:pathology; D018450:Disease Progression; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015233:Models, Statistical; D011446:Prospective Studies; D011859:Radiography; D057566:Self Report; D017678:Sex Distribution; D044465:White People / Q000706:statistics & numerical data; D055815:Young Adult; D001741:Black or African American