This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Suarez, E. C. Search for Related Content PubMed PubMed Citation Articles by Suarez, E. C. Related Collections Immunology Personality Depression Other Cardiovascular Medicine

C-Reactive Protein Is Associated With Psychological Risk Factors of Cardiovascular Disease in Apparently Healthy Adults

From the Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, North Carolina.

Address correspondence and reprint requests to Dr. Suarez at Duke University Medical Center, PO Box 3328, Durham, NC 27710. E-mail: suare001{at}mc.duke.edu

OBJECTIVE: The current study examined the relation of anger, hostility, and severity of depressive symptoms, alone and in combination, to C-reactive protein (CRP) in healthy men and women.

METHODS: A high sensitivity enzyme linked immuno sorbent assay (ELISA) was used to evaluate CRP levels in a multiethnic sample of 127 healthy, nonsmoking men and women. Fasting blood samples were collected the same day the assessments were done of anger and hostility using the Buss-Perry Aggression Questionnaire (BPAQ) and depressive symptomatology using the Beck Depression Inventory (BDI). A psychological risk factor (PRF) score representing a composite summary indicator of BDI and BPAQ-anger and -hostility was generated using principal component analysis. Log-transformed CRP values were examined using univariate and multivariate analyses adjusting for control variables of age, gender, body mass index (BMI), alcohol use, exercise frequency, ratio of total to high-density lipoprotein cholesterol, and family history of premature coronary heart disease (CHD).

RESULTS: Log-normalized CRP was correlated with BDI (r = 0.21, p = .02) and BPAQ anger (r = 0.20, p = .02), but not with BPAQ hostility. After adjustment for control variables, BDI (ß = 0.05, p = .011), BPAQ anger (ß = 0.05, p = .007), and the PRF composite score (ß = 0.27, p = .005), but not BPAQ hostility (ß = 0.03, p = .11), were significantly associated with log-normalized CRP.

CONCLUSIONS: Greater anger and severity of depressive symptoms, separately and in combination with hostility, were significantly associated with elevations in CRP in apparently healthy men and women. These associations were independent of potential confounding factors.

Key Words: C-reactive protein • anger • hostility • severity of depressive symptoms • men • women

Abbreviations: BDI = Beck Depression Inventory;; BMI = body mass index;; BPAQ = Buss-Perry Aggression Questionnaire;; CHD = coronary heart disease;; CVD = cardiovascular disease;; ELISA = enzyme linked immuno sorbent assay;; hsCRP = high sensitivity C-reactive protein;; IL = interleukin;; MCP-1 = monocyte chemoattractant protein-1;; MI = myocardial infarction;; MIP-1a = monocyte inflammatory protein-1a;; NHANES III = Third National Health and Nutrition Examination Survey;; OTC = over-the-counter;; PRF = psychological risk factor;; TNF- = tumor necrosis factor-.

This article has been cited by other articles:

				M. Elovainio, J. E Ferrie, A. Singh-Manoux, D. Gimeno, R. De Vogli, M. Shipley, J. Vahtera, E. Brunner, M. G Marmot, and M. Kivimaki Organisational justice and markers of inflammation: the Whitehall II study Occup. Environ. Med., February 1, 2010; 67(2): 78 - 83. [Abstract] [Full Text] [PDF]

				M. Elovainio, A.-M. Aalto, M. Kivimaki, S. Pirkola, J. Sundvall, J. Lonnqvist, and A. Reunanen Depression and C-Reactive Protein: Population-Based Health 2000 Study Psychosom Med, May 1, 2009; 71(4): 423 - 430. [Abstract] [Full Text] [PDF]

				P. Garvin, L. Nilsson, J. Carstensen, L. Jonasson, and M. Kristenson Plasma Levels of Matrix Metalloproteinase-9 are Independently Associated With Psychosocial Factors in a Middle-Aged Normal Population Psychosom Med, April 1, 2009; 71(3): 292 - 300. [Abstract] [Full Text] [PDF]

				M. B. Howren, D. M. Lamkin, and J. Suls Associations of Depression With C-Reactive Protein, IL-1, and IL-6: A Meta-Analysis Psychosom Med, February 1, 2009; 71(2): 171 - 186. [Abstract] [Full Text] [PDF]

				J. C. Stewart, D. Janicki-Deverts, M. F. Muldoon, and T. W. Kamarck Depressive Symptoms Moderate the Influence of Hostility on Serum Interleukin-6 and C-Reactive Protein Psychosom Med, February 1, 2008; 70(2): 197 - 204. [Abstract] [Full Text] [PDF]

				A. H. Miller and C. L. Raison Immune System Contributions to the Pathophysiology of Depression Focus, January 1, 2008; 6(1): 36 - 45. [Abstract] [Full Text] [PDF]

				T. W. Smith, B. N. Uchino, C. A. Berg, P. Florsheim, G. Pearce, M. Hawkins, P. N. Hopkins, and H.-C. Yoon Hostile Personality Traits and Coronary Artery Calcification in Middle-Aged and Older Married Couples: Different Effects for Self-Reports Versus Spouse Ratings Psychosom Med, June 1, 2007; 69(5): 441 - 448. [Abstract] [Full Text] [PDF]

				S. H. Boyle, J. E. Michalek, and E. C. Suarez Covariation of Psychological Attributes and Incident Coronary Heart Disease in U.S. Air Force Veterans of the Vietnam War Psychosom Med, November 1, 2006; 68(6): 844 - 850. [Abstract] [Full Text] [PDF]