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 prior to two electron beam tomography 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, 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 three years (β = .16, p = .035, ΔR2 = .03) while the Psychosocial Resources index was not predictive of CAC progression (β = -.08, p = .30, ΔR2 = .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 =.20, p = .01, ΔR2 = .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 represent potential targets for psychological interventions to reduce cardiovascular risk.

Self-Esteem and the Acute Effect of Anxiety on Ambulatory Blood Pressure

“…As part of the questionnaire battery completed by participants, trait self-esteem was measured using a 4-item short form 26 of the Rosenberg Self-Esteem Scale (I feel that I have a number of good qualities; I am able to do things as well as most other people; I feel that I am a person of worth, or at least on an equal basis as others; I take a positive attitude toward myself), rated on a scale of 0 “Strongly Disagree” to 3 “Strongly Agree” (α = 0.85). The self-esteem scores have a bimodal distribution (see Figure 1), with a modal score of 8 but more than 25% had the maximum possible score.…”

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

“…Several have reported a positive association between subclinical atherosclerosis and the psychological attributes of depression (Agatisa et al, 2005; Janssen et al, 2011; Lewis et al, 2009; Tiemeier et al, 2004), anxiety (Paterniti et al, 2001; Seldenrijk et al, 2010), and stress (Troxel et al, 2003), while others document null findings (Low et al, 2011; Low et al, 2009; Matthews et al, 1998; O’Malley et al, 2000a; Ohira et al, 2012; Roux et al, 2006; Rozanski et al, 2011; Seldenrijk et al, 2011; Stewart et al, 2007; Yu et al, 2010). Select evidence indicates up to a three-fold higher risk for atherosclerosis among those with psychological ill-being (e.g., major depression) (Agatisa et al, 2005; Paterniti et al, 2001).…”

Multisystem resiliency moderates the major depression–Telomere length association: Findings from the Heart and Soul Study

“…Resiliency comes in many intrapersonal and interpersonal forms, including ways of coping and responding to emotions, health behaviors such as physical activity, sleep, and diet, and social features of connections with others (Ryff et al, 2012). These factors tend to cluster together naturally in people (Low et al, 2011; Sun et al, in press; Taylor and Seeman, 1999), which makes the cluster perhaps more phenotypically representative. There is growing interest in examining a combination of psychosocial and lifestyle factors as resiliency that decreases disease risk (Agrigoroaei and Lachman, 2011; Low et al, 2011; Taylor et al, 2000).…”