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Positive and Negative Attributes and Risk for Coronary and Aortic Calcification in Healthy Women

From the University of Pittsburgh, Department of Psychiatry (K.A.W., J.O., L.L.), Department of Medicine (D.E.), and Department of Epidemiology (L.H.K.), Pittsburgh, Pennsylvania.

Address correspondence and reprint requests to Karen A. Matthews, Department of Psychiatry, University of Pittsburgh School of Medicine, 3811 O’Hara Street, Pittsburgh, PA 15213. E-mail: matthewska{at}upmc.edu

Objective: Negative emotions predict the development of clinical coronary events, and some evidence suggests that negative emotions relate to subclinical atherosclerosis. Low levels of positive emotions and cognitions are relatively unexplored as predictors of cardiovascular risk. We tested the hypothesis that low positive and high negative affect and cognitions would be related to risk for coronary and aortic calcification in healthy women.

Methods: One hundred fifty-five healthy women had measures of positive and negative affect/cognitions obtained before or at the time of electron beam tomography scan of coronary and aortic calcification.

Results: Coronary calcification was unrelated to women’s psychosocial scores. High aortic calcification was consistently associated with low scores on the Pearlin Mastery Scale and Life Engagement Test and high scores on the CES-Depression Inventory and Negative Interactions Scale in multivariate analyses. Odds ratios (OR [95% confidence intervals (CI)]) from the multivariate binary logistic regression analyses for a SD above the mean scales scores were 0.55 (95% CI, 0.35–0.87) for Pearlin Mastery; 0.56 (95% CI, 0.36–0.86) for the Life Engagement Test; 0.63 (95% CI, 0.40–98) for Life Satisfaction; 1.57 (95% CI, 1.04–2.36) for the CES-Depression; 1.77 (95% CI, 1.15–2.74) for the Cook-Medley Hostility; 1.49 (95% CI, 0.98–2.26) for Spielberger Anger-In; and 2.35 (95% CI, 1.49–3.73) for the Negative Interaction scales.

Conclusions: Women’s psychosocial attributes were not related to coronary calcification, raising the possibility that psychosocial attributes are less important for early than late stages of coronary atherosclerosis. The observed associations of psychosocial attributes with aortic calcification may be due to somewhat different risk factors being important for atherosclerosis at different vascular beds. Positive attributes may be related to atherosclerosis and should be studied further.

Key Words: coronary atherosclerosis • aorta • women • psychosocial • emotion • longitudinal

Abbreviations: IMT = intima media thickness; EBT = electron beam tomography; HT = hormone therapy; PMBC = Pittsburgh Mind-Body Center; CES-D = Center for Epidemiological Studies-Depression scale; LET = Life Engagement Test.

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