title: Psychological strains, salivary biomarkers, and risks for coronary heart disease among hurricane survivors.
abstract: OBJECTIVE
  To examine the associations of psychological strains, salivary biomarkers, and coronary heart disease (CHD) risks in hurricane survivors 2 years after Hurricane Ike in the United States.
  
  
  BACKGROUND
  Hurricane survivors often suffer from long-lasting posttraumatic stress disorder (PTSD) and other forms of psychological strain related to surviving a natural disaster and dealing with its aftermath. Psychological strains may be associated with biomarkers, which, in turn, may be associated with a higher incidence of CHD risks.
  
  
  METHODS
  Structured interviews were conducted with 19 hurricane survivors to assess psychological strains (PTSD, perceived stress, depression, and anxiety) and measure CHD risks. Saliva samples were collected by the passive drool method and analyzed for inflammatory cytokine (interleukin [IL]-1β, IL-6, and IL-10) and chemokine (monocyte chemotactic protein [MCP]-1) biomarkers.
  
  
  RESULTS
  The salivary level of MCP-1 was significantly associated with PTSD symptoms, depression (both p < .01), and anxiety (p < .05). There were significant associations between anxiety and hypertension (p < .01), perceived stress and blood glucose level (p < .05), and perceived stress and obesity (p < .05).
  
  
  CONCLUSIONS
  Our findings that long-lasting psychological strains are associated with major CHD risks and salivary MCP-1 levels suggest that the mechanism by which such strains play a role in the development of CHD involves recruitment of monocyte cells in response to chronic endothelial inflammation. Further studies are needed to advance our understanding of the underlying mechanisms by which the PTSD and other psychological strains contribute to the development of CHD.
authors.affiliation: Virginia Commonwealth University, School of Nursing, Richmond, VA, USA kan@vcu.edu.
authors.forename: Kyungeh
authors.initials: K
authors.lastname: An
authors.affiliation: Virginia Commonwealth University, School of Nursing, Richmond, VA, USA.
authors.forename: Jeanne
authors.initials: J
authors.lastname: Salyer
authors.affiliation: The University of Texas at El Paso, School of Nursing, El Paso, TX, USA.
authors.forename: Hsueh-Fen Sabrina
authors.initials: HF
authors.lastname: Kao
mesh_terms: D015415:Biomarkers / Q000032:analysis*; D003327:Coronary Disease / Q000209:etiology*; D055867:Cyclonic Storms; D005260:Female; D006801:Humans; D016753:Interleukin-10 / Q000032:analysis; D053583:Interleukin-1beta / Q000032:analysis; D015850:Interleukin-6 / Q000032:analysis; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D018945:Monocyte Chemoattractant Proteins / Q000032:analysis; D010446:Peptide Fragments / Q000032:analysis; D012307:Risk Factors; D012463:Saliva / Q000737:chemistry*; D013313:Stress Disorders, Post-Traumatic / Q000150:complications; D013315:Stress, Psychological / Q000150:complications*
chemical_list: D015415:Biomarkers; D053583:Interleukin-1beta; D015850:Interleukin-6; D018945:Monocyte Chemoattractant Proteins; D010446:Peptide Fragments; C052994:interleukin-1beta (163-171); D016753:Interleukin-10
keywords: anxiety; coronary heart disease; depression; perceived stress; posttraumatic stress disorder (PTSD); salivary MCP-1; salivary cytokines