Association of depressive symptoms, trait anxiety, and perceived stress with subclinical atherosclerosis: Results from the Chicago Healthy Aging Study (CHAS)

Abstract

Objective Examine the association between multiple psychological factors (depressive symptoms, trait anxiety, perceived stress) and subclinical atherosclerosis in older age. Method This cross-sectional study included 1,101 adults ages 65-84 from the Chicago Healthy Aging Study (CHAS—2007-2010). Previously validated self-report instruments were used to assess psychological factors. Noninvasive methods were used to assess subclinical atherosclerosis in two regions of the body, i.e., ankle-brachial blood pressure index (ABI) and coronary artery calcification (CAC). Multivariate logistic regression was used to examine the association between each psychological measure and subclinical atherosclerosis, after adjustment for socio-demographic factors, sleep quality, young adulthood/early middle age and late life CVD risk status, and psychological ill-being as appropriate. Results The burden of major cardiovascular disease risk factors did not significantly differ across tertiles of psychological factors. In multivariate adjusted models, trait anxiety was associated with calcification: those in the second tertile were significantly more likely to have CAC>0 compared to those in the lowest anxiety tertile [OR=1.68; 95%CI=1.09-2.58], but no significant difference was observed for Tertile III of trait anxiety [OR=1.31; 95%CI=0.75-2.27]. No association was seen between psychological measures and ABI. Conclusion Of several psychological factors, only trait anxiety was significantly associated with CAC.

Anxiety and depressive symptoms are associated with higher carotid intima-media thickness. Cross-sectional analysis from ELSA-Brasil baseline data

“…Recently, Hernandez et al [56] carried out a cross-section evaluation of 1101 individuals aged 65e84 years from the Chicago Healthy Aging Study, and did not find any consistent associations between subclinical atherosclerosis (evaluated by CAC score and ankle-brachial index) or symptoms of depressive or anxiety. The previously mentioned studies by Beutel et al [16], Chirinos et al [17], Ohira et al [20] and Paterniti et al [24] did not find significant associations either.…”

Acute and chronic psychological stress as risk factors for cardiovascular disease: Insights gained from epidemiological, clinical and experimental studies

“…work stress, job insecurity, anxiety, social isolation) and their respective effect on CVD risk Ferrie et al, 2013;Hernandez et al, 2014;Aiello et al, 2009). Furthermore, the relative new field of psychoneuroimmunology, which addresses the multi-directional interactions between the central nervous system, the endocrine system and the immune system, is now providing mechanistic insight into ways by which (perceived) stressors can be translated into physiological changes (Glaser and KiecoltGlaser, 2005).…”

The Myocardial Perfusion Scintigraphy in Predicting Risk for Coronary Artery Disease in Patients with Anxiety and Depression Symptoms

“…However, there was no difference in state anxiety levels in both study groups. Previously Hernandez et al investigated association between multiple psychological factors and subclinical atherosclerosis in older age (15). They showed that only trait anxiety was significantly associated with coronary artery calcification.…”

“…It has been reported that there was an association between chronic anxiety and endothelial dysfunction for elderly males but not for young ones (16 In the present study, we also investigated patients' perceived levels of stress over the previous month by using PSS. Some studies have found no association between perceived stress and subclinical atherosclerosis; however, recently Richardson et al published a meta-analysis and they declared that high perceived stress was associated with a risk ratio of 1.27 for incident coronary heart disease (15,(20)(21)(22)(23). The present study demonstrated no association between perceived stress and myocardial ischemia.…”