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Adverse Impact of Mood on Flow-Mediated Dilation

From the Departments of Psychiatry (D.C.C., J.R.T., P.J.M., W.A.B., J.E.D.) and Medicine (M.S.M., M.G.Z.), University of California, San Diego, La Jolla, California; and University of California, San Diego Moores Cancer Center (W.A.B.), La Jolla, California.

Address correspondence and reprint requests to Denise C. Cooper, PhD, Department of Psychiatry, University of California, San Diego, 9500 Gilman Dr., #0804, La Jolla, CA 92093-0804. E-mail: dccooper{at}ucsd.edu

Objective: To examine the impact of mood states on endothelial function, as measured noninvasively by brachial artery flow-mediated dilation (FMD). Substantial literature indicates that negative mood is linked to cardiovascular disease (CVD). However, the mechanisms underlying this relationship are not well defined. CVD is often preceded by dysfunction of the endothelium.

Methods: Healthy adults (n = 70; mean age, 36 years) completed the Profile of Mood States (POMS), which contains six subscales (depression/dejection; tension/anxiety; anger/hostility; confusion/bewilderment; fatigue/inertia; vigor/activity) that are used to compute a total mood disturbance score for overall psychological distress. FMD was calculated (maximum percentage change in brachial artery diameter) from ultrasound assessment of arterial diameter at baseline and for 10 minutes after occlusion.

Results: Regressions showed that increases in POMS total mood disturbance scores were associated with decreases in endothelial function. Mood disturbance explained 10% of the variance in FMD (p < .01), after controlling for age, sex, mean arterial pressure, body mass index, and socially desirable response bias. An exploratory set of separate regressions conducted to decompose the link between FMD and total mood disturbance revealed that the following POMS subscales were inversely correlated with FMD: depression/dejection, tension/anxiety, anger/hostility, fatigue/inertia (p’s < .05), and confusion/bewilderment (p < .01).

Conclusions: Mood disturbance could contribute to CVD via impaired vasodilation. These preliminary results show that even mild levels of adverse psychological states, particularly depressed, anxious, angry, confused, and fatigued states, might be linked to increased cardiovascular risk.

Key Words: endothelial function • vasodilation • mood • depression • anxiety • fatigue

Abbreviations: FMD = flow-mediated dilation; POMS = Profile of Mood States; TMD = total mood disturbance; MAP = mean arterial pressure; BMI = body mass index; CVD = cardiovascular disease.

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