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From the Department of Psychology (K.F.H.), University of Pittsburgh; Department of Psychiatry (K.A.M.), University of Pittsburgh School of Medicine; and Department of Epidemiology (K.S.T., L.H.K.), University of Pittsburgh Graduate School of Public Health, Pittsburgh, Pennsylvania.
Address reprint requests to: Karen Matthews, Department of Psychiatry, University of Pittsburgh, 3811 O’Hara St., Pittsburgh, PA 15213. Email: matthewska{at}msx.upmc.edu
OBJECTIVE: The objective of this study was to determine whether psychosocial risk factors for cardiovascular disease (CVD) are associated with impairments in endothelial function and to determine whether use of hormone replacement therapy (HRT) can moderate observed associations among women without prior CVD.
METHODS: Flow-mediated dilation was assessed by brachial ultrasound after reactive hyperemia in 193 postmenopausal women enrolled in the prospective Healthy Women Study. Measures of psychosocial characteristics had been completed at study entry, when the women were premenopausal (mean = 13.6 years earlier), and at a separate postmenopausal follow-up exam near the time of the ultrasound (mean = 1.5 years earlier).
RESULTS: Factor analyses of the psychosocial characteristics yielded two factors: Type A/anger and anxiety/depression. Anxiety/depression scores at the study entry and follow-up exams and Type A/anger scores at the study entry exam were associated with less vasodilation (p values < 0.05). Type A/anger scores at the follow-up exam were associated with less vasodilation among women not using HRT (p < .05).
CONCLUSIONS: Psychosocial risk factors for CVD are associated with impaired brachial artery dilation among postmenopausal women. HRT use may mask some associations between psychosocial risk factors and endothelial dysfunction among postmenopausal women.
Key Words: endothelial function, • psychosocial characteristics, • hormone replacement therapy, • menopause, • atherosclerosis.
Abbreviations: BMI = body mass index;; CVD = cardiovascular disease;; HRT = hormone replacement therapy;; ISEL = Interpersonal Support Evaluation List.
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