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Huang TY, Chen LC, Li XP, Li WH, Xu SX, Nagy C, Ibrahim P, Nie ZW, Yang NY, Zeng L, Huang HW, Turecki G, Xie XH. Elevated triglycerides and low triiodothyronine: Key risk factors for coronary artery calcification in patients with schizophrenia. Schizophr Res 2024; 264:113-121. [PMID: 38128342 DOI: 10.1016/j.schres.2023.12.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2023] [Revised: 11/04/2023] [Accepted: 12/10/2023] [Indexed: 12/23/2023]
Abstract
OBJECTIVE Coronary artery calcification (CAC) is a well-established independent predictor of coronary heart disease, and patients with schizophrenia have significantly higher rates compared to the general population. We performed this study to examine the population-specific risk factors associated with CAC in patients with schizophrenia. METHODS In this cross-sectional study, patients with schizophrenia who underwent low-dose chest CT scans between January 2020 and December 2021 were analyzed. Ordinary CAC scores and results of routine blood tests were obtained. Logistic regression was used to calculate the odds ratio (OR) for potential risk factors in patients with and without CAC, while the negative binomial additive model was used to explore the dose-response relationship between risk factors and CAC score. RESULTS Of the 916 patients, 233 (25.4 %) had CAC, while 683 (74.6 %) did not. After adjusting for confounding factors, higher triglyceride levels (OR = 1.20, 95 % confidence interval (CI): 1.04 to 1.38, p = 0.013) and low triiodothyronine levels (OR = 0.50, 95 % CI: 0.29 to 0.84; p = 0.010) were identified as risk factors for CAC. Both triglycerides (p = 0.021) and triiodothyronine (p = 0.010) were also found to have significant dose-response relationships with CAC scores according to the negative binomial additive model in the exploratory analysis. CONCLUSIONS This study highlights elevated serum triglycerides and decreased triiodothyronine levels as population-specific risk factors for CAC in patients with schizophrenia, suggest the need for close monitoring of CAC in patients with schizophrenia and further prospective trials to provide additional evidence on this topic.
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Affiliation(s)
- Tan-Yu Huang
- Department of Radiology, Second People's Hospital of Huizhou, Huizhou, China
| | - Li-Chang Chen
- Department of Medical Statistics, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Xiao-Ping Li
- Department of Psychiatry, Second People's Hospital of Huizhou, Huizhou, China
| | - Wu-Hao Li
- Department of Radiology, Second People's Hospital of Huizhou, Huizhou, China
| | - Shu-Xian Xu
- Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan, China
| | - Corina Nagy
- Department of Psychiatry, McGill University, Montreal, QC, Canada; McGill Group for Suicide Studies, Douglas Mental Health University Institute, McGill University, Montreal, QC, Canada
| | - Pascal Ibrahim
- Department of Psychiatry, McGill University, Montreal, QC, Canada; McGill Group for Suicide Studies, Douglas Mental Health University Institute, McGill University, Montreal, QC, Canada
| | - Zhao-Wen Nie
- Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan, China
| | - Nai-Yan Yang
- Department of Psychiatry, Second People's Hospital of Huizhou, Huizhou, China
| | - Lun Zeng
- Department of Psychiatry, Second People's Hospital of Huizhou, Huizhou, China
| | - Hua-Wei Huang
- Department of Psychiatry, Second People's Hospital of Huizhou, Huizhou, China
| | - Gustavo Turecki
- Department of Psychiatry, McGill University, Montreal, QC, Canada; McGill Group for Suicide Studies, Douglas Mental Health University Institute, McGill University, Montreal, QC, Canada
| | - Xin-Hui Xie
- Brain Function and Psychosomatic Medicine Institute, Second People's Hospital of Huizhou, Huizhou, China; Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan, China.
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Matta J, Wiernik E, Robineau O, Severi G, Touvier M, Gouraud C, Ouazana-Vedrines C, Pitron V, Ranque B, Hoertel N, Van den Bergh O, Witthöft M, Kab S, Goldberg M, Zins M, Lemogne C. Trust in sources of information on COVID-19 at the beginning of the pandemic's first wave and incident persistent symptoms in the population-based CONSTANCES cohort: A prospective study. J Psychosom Res 2023; 169:111326. [PMID: 37037155 PMCID: PMC10072983 DOI: 10.1016/j.jpsychores.2023.111326] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Revised: 03/20/2023] [Accepted: 04/02/2023] [Indexed: 04/12/2023]
Abstract
OBJECTIVE To examine the association between trust in different sources of information on COVID-19 at the beginning of the pandemic and the burden of incident persistent symptoms. METHODS This prospective study used data from the SAPRIS and SAPRIS-Sérologie surveys nested in the French CONSTANCES population-based cohort. Trust in different information sources was measured between April 6 and May 4, 2020. Persistent symptoms that emerged afterwards were self-reported between December 2020 and January 2021. The associated psychological burden was measured with the somatic symptom disorder B criteria scale (SSD-12). The analyses were adjusted for gender, age, education, income, self-rated health, SARS-CoV-2 serology tests, and self-reported COVID-19. RESULTS Among 20,985 participants [mean age (SD), 49.0 years (12.7); 50.2% women], those with higher trust in government/journalists at baseline had fewer incident persistent symptoms at follow-up (estimate (SE) for one IQR increase: -0.21 (0.03), p < 0.001). Participants with higher trust in government/journalists and medical doctors/scientists were less likely to have ≥1 symptom (odds ratio (95% confidence interval) for one IQR increase: 0.87 (0.82-0.91) and 0.91 (0.85-0.98), respectively). Among 3372 participants (16.1%) who reported ≥1 symptom, higher trust in government/journalists and medical doctors/scientists predicted lower SSD-12 scores (-0.39 (0.17), p = 0.02 and - 0.85 (0.24), p < 0.001, respectively), whereas higher trust in social media predicted higher scores in those with lower trust in government/journalists (0.90 (0.34), p = 0.008). These associations did not depend upon surrogate markers of infection with SARS-CoV-2. CONCLUSIONS Trust in information sources on COVID-19 may be associated with incident persistent symptoms and associated psychological burden, regardless of infection with SARS-CoV-2.
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Affiliation(s)
- Joane Matta
- Université Paris Cité, « Population-based Cohorts Unit », INSERM, Paris Saclay University, UVSQ, UMS 011, Paris, France
| | - Emmanuel Wiernik
- Université Paris Cité, « Population-based Cohorts Unit », INSERM, Paris Saclay University, UVSQ, UMS 011, Paris, France
| | - Olivier Robineau
- Sorbonne Université, Inserm, Institut Pierre-Louis d'Epidémiologie et de Santé Publique, Paris, France; EA2694, Univ Lille, Centre Hospitalier de Tourcoing, France
| | - Gianluca Severi
- Université Paris-Saclay, UVSQ, INSERM, CESP U1018, Gustave Roussy, Villejuif, France; Department of Statistics, Computer Science, Applications "G. Parenti", University of Florence, Florence, Italy
| | - Mathilde Touvier
- Sorbonne Paris Nord University, Inserm U1153, Inrae U1125, Cnam, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center - Université Paris Cité (CRESS), Bobigny, France
| | - Clément Gouraud
- Service de Psychiatrie de l'adulte, AP-HP, Hôpital Hôtel-Dieu, F-75004 Paris, France
| | - Charles Ouazana-Vedrines
- Service de Psychiatrie de l'adulte, AP-HP, Hôpital Hôtel-Dieu, F-75004 Paris, France; Université Paris Cité, INSERM U1266, Institut de Psychiatrie et Neuroscience de Paris, F-75014 Paris, France
| | - Victor Pitron
- Université Paris Cité, VIFASOM (Vigilance Fatigue Sommeil et Santé Publique), Paris, France; Centre du Sommeil et de la Vigilance-Pathologie professionnelle, APHP, Hôtel-Dieu, F-75004 Paris, France
| | - Brigitte Ranque
- Université Paris Cité, Service de Médecine interne, AP-HP, Hôpital européen Georges-Pompidou, Paris, France
| | - Nicolas Hoertel
- Université Paris Cité, INSERM U1266, Institut de Psychiatrie et Neuroscience de Paris, F-75014 Paris, France; Service de Psychiatrie et Addictologie, AP-HP, Hôpital Corentin-Celton, DMU Psychiatrie et Addictologie, F-92130 Issy-les-Moulineaux, France
| | - Omer Van den Bergh
- Health Psychology, Faculty of Psychology & Educational Sciences, University of Leuven, 3000 Leuven, Belgium
| | - Michael Witthöft
- Department of Clinical Psychology, Psychotherapy and Experimental Psychopathology, Johannes Gutenberg-University, 55122 Mainz, Germany
| | - Sofiane Kab
- Université Paris Cité, « Population-based Cohorts Unit », INSERM, Paris Saclay University, UVSQ, UMS 011, Paris, France
| | - Marcel Goldberg
- Université Paris Cité, « Population-based Cohorts Unit », INSERM, Paris Saclay University, UVSQ, UMS 011, Paris, France
| | - Marie Zins
- Université Paris Cité, « Population-based Cohorts Unit », INSERM, Paris Saclay University, UVSQ, UMS 011, Paris, France
| | - Cédric Lemogne
- Service de Psychiatrie de l'adulte, AP-HP, Hôpital Hôtel-Dieu, F-75004 Paris, France; Université Paris Cité, INSERM U1266, Institut de Psychiatrie et Neuroscience de Paris, F-75014 Paris, France.
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Dabiri AE, Kassab GS. Effects of Cannabis on Cardiovascular System: The Good, the Bad, and the Many Unknowns. Med Cannabis Cannabinoids 2021; 4:75-85. [PMID: 35224427 PMCID: PMC8832198 DOI: 10.1159/000519775] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Accepted: 09/20/2021] [Indexed: 09/29/2023] Open
Abstract
Cannabis is currently the most consumed illicit substance in the world, and gradual legalization in the USA makes it important to understand the health consequences of the use of this substance. With growing body of evidence that some cannabis ingredients may be beneficial in various aspects of hemostasis, additional research is clearly needed in various clinical areas. In addition to understanding the efficacy, research efforts should also include studies that address any harmful effects of the compounds or administration methods that may result in adverse effects. This review is focused on the cardiometabolic effects of cannabis use. Cardiometabolic diseases are among the leading causes of death in the USA and around the world. The purpose of this review was to provide an overview of the known medicinal benefits of selected cannabis cannabinoids and the known side effects or contraindications. More importantly, we have proposed new questions and signposts in cannabis research to uncover additional medicinal benefits and identify the health hazards with focus on cardiovascular disease.
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Affiliation(s)
- Ali E. Dabiri
- California Medical Innovation Institute, San Diego, California, USA
- 3DTholdings, San Diego, California, USA
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4
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Physical Aggression and Coronary Artery Calcification: A North Texas Healthy Heart Study. Int J Behav Med 2021; 29:14-24. [PMID: 33880713 DOI: 10.1007/s12529-021-09989-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/08/2021] [Indexed: 10/21/2022]
Abstract
BACKGROUND The purpose of this study was to determine the association between aspects of hostility and coronary artery calcification (CAC) scores. Specifically, analyses differentiated between subtypes of hostility and their relation to CAC. METHODS A sample of 571 patients aged 45 or older with no history of cardiovascular disease completed assessments of demographic, psychosocial, and medical history, along with a radiological CAC determination. Logistic regression was used to determine the association between hostility and CAC. Hostility was measured using the Aggression Questionnaire, which measured total aggression and how aggression is manifested on four scales: Physical, Verbal, Anger, and Hostility Aggression. RESULTS Regression analyses indicated that only the physical aggression parameter was related to CAC: a 5% increase in odds of CAC presence was indicated for every point increase in physical aggression. The association remained significant in adjusted analyses. Other factors associated with CAC in adjusted analyses included: age, gender, race/ethnicity, BMI, and dyslipidemia. CONCLUSIONS Psychosocial factors, such as physical aggression, are emerging factors that need to be considered in cardiovascular risk stratification.
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Dougherty DD, Chou T, Buhlmann U, Rauch SL, Deckersbach T. Early Amygdala Activation and Later Ventromedial Prefrontal Cortex Activation During Anger Induction and Imagery. ACTA ACUST UNITED AC 2020. [DOI: 10.3233/jmp-160002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Background: Neurobiological studies implicate the amygdala and related limbic/paralimbic structures, such as the ventromedial prefrontal cortex (VMPFC), in anger and aggression. Previous studies of self-generated anger using Positron Emission Tomography (PET) have consistently documented a lack of amygdala activation during anger. Objective: We investigated the hypothesis that a lack of amygdala activation during anger is due to differences in the time course of amygdala and VMPFC activation. Specifically, we explored whether the amygdala is involved in the early phases of anger experience which is later followed by increased VMPFC activation. Methods: Eighteen healthy control participants underwent fMRI. We adapted an anger induction paradigm previously used in our PET study, in which neutral and angry states were induced using autobiographical scripts. The hypothesized time course of amygdala and VMPFC activation during acute anger induction and imagery were modeled. Region of interest (ROI) analyses were used to identify significant a priori region activation, and correlations were run between signal values and VAS anger ratings. Results: Amygdala activation increased during the acute phase of anger induction and decreased during the later phase of anger imagery, whereas VMPFC activation decreased during anger induction and increased during anger imagery, compared to the neutral conditions. In addition, negative correlations were found between self-ratings of anger and bilateral VMPFC activation. Conclusions: Overall, our results suggest that the amygdala may be active at the initial onset of anger while the VMPFC is activated over time as the individual sustains and perhaps regulates that emotional state.
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Affiliation(s)
| | - Tina Chou
- Massachusetts General Hospital/Harvard Medical School, Boston, MA, USA
- Harvard University, Cambridge, MA, USA
| | - Ulrike Buhlmann
- Massachusetts General Hospital/Harvard Medical School, Boston, MA, USA
| | - Scott L. Rauch
- Massachusetts General Hospital/Harvard Medical School, Boston, MA, USA
| | - Thilo Deckersbach
- Massachusetts General Hospital/Harvard Medical School, Boston, MA, USA
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Tyra AT, Brindle RC, Hughes BM, Ginty AT. Cynical hostility relates to a lack of habituation of the cardiovascular response to repeated acute stress. Psychophysiology 2020; 57:e13681. [DOI: 10.1111/psyp.13681] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2019] [Revised: 07/13/2020] [Accepted: 08/08/2020] [Indexed: 01/23/2023]
Affiliation(s)
- Alexandra T. Tyra
- Department of Psychology and Neuroscience Baylor University Waco TX USA
| | - Ryan C. Brindle
- Department of Cognitive and Behavioral Science and Neuroscience Program Washington and Lee University Lexington VA USA
| | - Brian M. Hughes
- School of Psychology National University of Ireland Galway Ireland
| | - Annie T. Ginty
- Department of Psychology and Neuroscience Baylor University Waco TX USA
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Abdulla AG, Buzkova P, Nakanishi R, Budoff MJ. Association of psychosocial traits with coronary artery calcium development and progression: The Multi-Ethnic Study of Atherosclerosis. J Cardiovasc Comput Tomogr 2020; 15:56-64. [PMID: 32280016 DOI: 10.1016/j.jcct.2020.03.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2019] [Revised: 02/16/2020] [Accepted: 03/22/2020] [Indexed: 11/29/2022]
Abstract
BACKGROUND Coronary artery calcium (CAC) is a well-established quantifiable risk factor for cardiovascular disease (CVD). We examined the association of anger, hostility, anxiety, and depression with the development and progression of CAC. METHODS We studied the association of these psychosocial traits with CAC among participants in the Multi-Ethnic Study of Atherosclerosis (MESA). Anger was measured using the Spielberger Trait Anger questionnaire, hostility using a modified Cook-Medley Hostility questionnaire, anxiety using the Spielberger Trait Scale, and depression using the Center for Epidemiological Studies Depression Scale (CES-D). Among the subsample of participants with CAC = 0 at the beginning of the study period, Poisson regression models were used to determine the relative risk of developing CAC>0 over the study period. In the subsample that developed CAC>0, we used linear regression models to estimate the average increase in CAC associated with a unit increase in psychosocial trait. RESULTS Median time of follow-up was 9.4 years (range 8.0-11.4 years). Cross-sectional analyses at baseline revealed no association of any of the psychosocial traits with the presence or magnitude of CAC (anger: RR 0.98, p < 0.01; hostility: RR 1.01, p = 0.25; anxiety: RR 0.99, p < 0.01; depression: RR 0.99, p < 0.01 [not statistically significant after adjustment for covariates]). No association was detected between the traits and development of CAC (anger: RR 0.99, p = 0.23; hostility: RR 1.01, p = 0.68, anxiety: RR 1.00, p = 0.49; depression: RR 1.00, p = 0.51). We also found no association between any of the traits and progression of CAC (anger: beta -3.21, p = 0.08; hostility: beta 2.28, p = 0.43; anxiety: 3.45, p = 0.02 [not statistically significant after adjustment for covariates]; depression: beta -1.46, p = 0.11). CONCLUSIONS We found no association between anger, hostility, anxiety, or depression and CAC, suggesting these personality traits are not independent risk factors for CVD.
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Affiliation(s)
- Amer G Abdulla
- Department of Cardiology, Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, Torrance, CA, USA
| | - Petra Buzkova
- Department of Biostatistics, University of Washington School of Public Health, Seattle, WA, USA
| | - Rine Nakanishi
- Department of Cardiology, Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, Torrance, CA, USA
| | - Matthew J Budoff
- Department of Cardiology, Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, Torrance, CA, USA.
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O'Keefe EL, O'Keefe JH, Lavie CJ. Exercise Counteracts the Cardiotoxicity of Psychosocial Stress. Mayo Clin Proc 2019; 94:1852-1864. [PMID: 31451292 DOI: 10.1016/j.mayocp.2019.02.022] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2018] [Revised: 01/15/2019] [Accepted: 02/19/2019] [Indexed: 12/12/2022]
Abstract
Physical inactivity and psychosocial stress are prevalent in residents of the United States. The purpose of this article is to review the interaction between these 2 conditions and examine the effects of exercise on stress and cardiovascular (CV) health. A query of scientific references between 1974 to 2018 was performed using the PubMed search engine accessing the MEDLINE database using the search terms psychosocial stress, CV disease (CVD), physical activity, exercise, cardiac rehabilitation, and team sports. Psychosocial stress is a strong independent risk factor for adverse CV events. Conversely, people who experience CV events subsequently have drastically elevated rates of new-onset mental health disorders, including depression and anxiety. Psychosocial stress and CVD often trigger self-reinforcing feedback loops that can worsen mental health and cardiac prognosis. Exercise predictably improves CV health and prognosis and also is effective at lowering levels of psychosocial stress. Group exercise in particular seems to provide social support while at the same time boosting fitness levels and, thus, may be the single most important intervention for patients with concomitant CVD and emotional stress. Collaborative physical activity, such as group exercise, team sports, interactive physical play, and cardiac rehabilitation programs, have the potential to improve mental health and CV prognosis.
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Affiliation(s)
- Evan L O'Keefe
- Ochsner Clinical School, The University of Queensland School of Medicine, New Orleans, LA
| | - James H O'Keefe
- University of Missouri-Kansas City and Saint Luke's Mid America Heart Institute, New Orleans, LA
| | - Carl J Lavie
- Ochsner Clinical School, The University of Queensland School of Medicine, New Orleans, LA; Department of Cardiovascular Diseases, John Ochsner Heart and Vascular Institute, New Orleans, LA.
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Garshick MS, Vaidean GD, Vani A, Underberg JA, Newman JD, Berger JS, Fisher EA, Gianos E. Cardiovascular Risk Factor Control and Lifestyle Factors in Young to Middle-Aged Adults with Newly Diagnosed Obstructive Coronary Artery Disease. Cardiology 2019; 142:83-90. [PMID: 31079098 DOI: 10.1159/000498891] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2018] [Accepted: 02/11/2019] [Indexed: 12/25/2022]
Abstract
BACKGROUND While progress in the prevention of cardiovascular disease (CVD) has been noted over the past several decades, there are still those who develop CVD earlier in life than others. OBJECTIVE We investigated traditional and lifestyle CVD risk factors in young to middle-aged patients compared to older ones with obstructive coronary artery disease (CAD). METHODS A retrospective analysis of patients with a new diagnosis of obstructive CAD undergoing coronary intervention was performed. Young to middle-aged patients were defined as those in the youngest quartile (n = 281, mean age 50 ± 6 years, 81% male) compared to the other three older quartiles combined (n = 799, mean age 69 ± 7.5 years, 71% male). Obstructive CAD was determined by angiography. RESULTS Young to middle-aged patients compared to older ones were more likely to be male (p < 0.01), smokers (21 vs. 9%, p < 0.001), and have a higher body mass index (31 ± 6 vs. 29 ± 6 kg/m2, p < 0.001). Younger patients were less likely to eat fruits, vegetables, and fish and had fewer controlled CVD risk factors (2.7 ± 1.2 vs. 3.0 ± 1.0, p < 0.001). Compared to older patients, higher levels of psychological stress (aOR 1.6, 95% CI 1.1-2.4), financial stress (aOR 1.8, 95% CI 1.3-2.5), and low functional capacity (aOR 3.3, 95% CI 2.4-4.5) were noted in the young to middle-aged population as well. CONCLUSION Lifestyle in addition to traditional CVD risk factors should be taken into account when evaluating risk for development of CVD in a younger population.
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Affiliation(s)
- Michael S Garshick
- Center for the Prevention of Cardiovascular Disease, New York University Langone Health, New York City, New York, USA,
| | - Georgeta D Vaidean
- Center for the Prevention of Cardiovascular Disease, New York University Langone Health, New York City, New York, USA.,Fairleigh Dickinson University School of Pharmacy and Health Sciences, Florham Park, New Jersey, USA
| | - Anish Vani
- Center for the Prevention of Cardiovascular Disease, New York University Langone Health, New York City, New York, USA
| | - James A Underberg
- Center for the Prevention of Cardiovascular Disease, New York University Langone Health, New York City, New York, USA
| | - Jonathan D Newman
- Center for the Prevention of Cardiovascular Disease, New York University Langone Health, New York City, New York, USA
| | - Jeffrey S Berger
- Center for the Prevention of Cardiovascular Disease, New York University Langone Health, New York City, New York, USA
| | - Edward A Fisher
- Center for the Prevention of Cardiovascular Disease, New York University Langone Health, New York City, New York, USA
| | - Eugenia Gianos
- Department of Cardiology, Lenox Hill Hospital, Northwell Health, New York, New York, USA
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Psychological Traits, Heart Rate Variability, and Risk of Coronary Heart Disease in Healthy Aging Women-The Women's Health Initiative. Psychosom Med 2019; 81:256-264. [PMID: 30688770 PMCID: PMC6443472 DOI: 10.1097/psy.0000000000000672] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
OBJECTIVE Psychological traits such as optimism and hostility affect coronary heart disease (CHD) risk, but mechanisms for this association are unclear. We hypothesized that optimism and hostility may affect CHD risk via changes in heart rate variability (HRV). METHODS We conducted a longitudinal analysis using data from the Women's Health Initiative Myocardial Ischemia and Migraine Study. Participants underwent 24-hour ambulatory electrocardiogram monitoring 3 years after enrollment. Optimism (Life Orientation Test-Revised), cynical hostility (Cook-Medley), demographics, and coronary risk factors were assessed at baseline. HRV measures included standard deviation of average N-N intervals (SDNN); standard deviation of average N-N intervals for 5 minutes (SDANN); and average heart rate (HR). CHD was defined as the first occurrence of myocardial infarction, angina, coronary angioplasty, and bypass grafting. Linear and Cox regression models adjusted for CHD risk factors were used to examine, respectively, associations between optimism, hostility, and HRV and between HRV and CHD risk. RESULTS Final analyses included 2655 women. Although optimism was not associated with HRV, hostility was inversely associated with HRV 3 years later (SDANN: adjusted β = -0.54; 95% CI = -0.97 to -0.11; SDNN: -0.49; 95% CI = -0.93 to -0.05). HRV was inversely associated with CHD risk; for each 10-millisecond increase in SDNN or SDANN, there was a decrease in CHD risk of 9% (p = .023) and 12% (p = .006), respectively. CONCLUSIONS HRV did not play a major role in explaining why more optimistic women seem to be somewhat protected from CHD risk. Although hostility was inversely associated with HRV, its role in explaining the association between hostility and CHD risk remains to be established.
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Bugiardini R, Manfrini O, Cenko E. Female sex as a biological variable: A review on younger patients with acute coronary syndrome. Trends Cardiovasc Med 2019; 29:50-55. [DOI: 10.1016/j.tcm.2018.06.002] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2018] [Revised: 06/06/2018] [Accepted: 06/07/2018] [Indexed: 01/12/2023]
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Kahler CW, Surace A, Gordon REF, Cioe PA, Spillane NS, Parks A, Bock BC, Brown RA. Positive psychotherapy for smoking cessation enhanced with text messaging: Protocol for a randomized controlled trial. Contemp Clin Trials 2018; 71:146-153. [PMID: 29936125 PMCID: PMC6484849 DOI: 10.1016/j.cct.2018.06.013] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2018] [Revised: 06/13/2018] [Accepted: 06/20/2018] [Indexed: 11/22/2022]
Abstract
BACKGROUND Despite reductions in cigarette smoking in the U.S., improvements in the efficacy of smoking cessation treatments are needed, as rates of sustained abstinence remain disappointingly low. Both low positive affect and high negative affect contribute to smoking relapse and constitute viable targets for smoking cessation interventions. Although some clinical trials have evaluated interventions to address depression as a smoking relapse risk factor, very few have focused on positive affect. Recently, we developed and conducted a preliminary clinical trial of a smoking cessation treatment that targets positive affect and cognitions by incorporating interventions rooted in positive psychology. The current randomized controlled trial will expand upon this preliminary trial to test whether this positive psychology-informed approach results in higher smoking cessation rates compared to a time-matched standard smoking cessation treatment control. METHODS Three hundred and forty adult daily smokers will be randomly assigned to either positive psychotherapy for smoking cessation or standard behavioral smoking cessation counseling. Participants will meet weekly with a study counselor for 6 weeks and will receive transdermal nicotine patch and text messaging smoking cessation support. Additionally, text messaging in the positive psychotherapy condition will encourage engagement in positive psychology-specific strategies for boosting mood and staying smoke free. Smoking cessation outcomes will be measured at 12, 26, and 52 weeks following target quit date. CONCLUSION Results from this study will provide evidence on whether incorporating positive psychology interventions into smoking cessation treatment can improve smoking cessation outcomes relative to standard behavioral counseling with nicotine patch and text messaging.
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Affiliation(s)
- Christopher W Kahler
- Center for Alcohol and Addiction Studies and the Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, RI, United States.
| | - Anthony Surace
- Center for Alcohol and Addiction Studies and the Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, RI, United States
| | - Rebecca E F Gordon
- Center for Alcohol and Addiction Studies and the Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, RI, United States
| | - Patricia A Cioe
- Center for Alcohol and Addiction Studies and the Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, RI, United States
| | - Nichea S Spillane
- Department of Psychology, University of Rhode Island, Kingston, RI, United States
| | | | - Beth C Bock
- Alpert Medical School of Brown University and The Miriam Hospital, Providence, RI, United States
| | - Richard A Brown
- School of Nursing, University of Texas, Austin, TX, United States
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Tindle HA, Duncan MS, Liu S, Kuller LH, Fugate Woods N, Rapp SR, Kroenke CH, Coday M, Loucks EB, Lamonte MJ, Progovac AM, Salmoirago-Blotcher E, Walitt BT, Yuo NCY, Freiberg MS. Optimism, pessimism, cynical hostility, and biomarkers of metabolic function in the Women's Health Initiative. J Diabetes 2018; 10:512-523. [PMID: 28703425 PMCID: PMC8835287 DOI: 10.1111/1753-0407.12584] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2016] [Revised: 06/20/2017] [Accepted: 07/05/2017] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Psychological attitudes reflecting expectations about the future (optimism, pessimism) and people (cynical hostility) independently predict incident cardiovascular disease and possibly diabetes, but underlying biologic pathways are incompletely understood. Herein we examined the cross-sectional relationship between optimism, pessimism, and cynicism and biomarkers of metabolic function in the Women's Health Initiative. METHODS Among 3443 postmenopausal women, biomarkers of metabolic function (fasting insulin [FINS] and glucose) were measured at baseline and used to calculate insulin resistance (homeostasis model assessment of insulin resistance [HOMA-IR]) and pancreatic β-cell activity (homeostasis model assessment of β-cell function [HOMA-B]). Psychological attitudes were assessed by the Life Orientation Test, Revised (full scale, and optimism and pessimism subscales) and the Cook-Medley cynicism subscale. Multivariable linear regression modeled the association of psychological attitudes with biomarker levels, adjusting for sociodemographics, health conditions, and health behaviors. Because obesity promotes insulin resistance and obese individuals tend to report higher levels of pessimism and cynical hostility, an interaction with body mass index (BMI) was explored. RESULTS In fully adjusted models, only pessimism remained independently associated with higher FINS and insulin resistance (HOMA-IR). Scoring 1 point higher on the pessimism subscale was associated with a 1.2% higher FINS, whereas scoring 1 SD higher was associated with a 2.7% higher FINS (P = 0.03); results were similar for HOMA-IR. An interaction term with BMI was not significant. CONCLUSIONS In multivariable models, higher dispositional pessimism was associated with worse metabolic function; these findings were not modified by obesity status. Results extend prior work by linking pessimism to an objective biomarker of insulin resistance in elderly women.
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Affiliation(s)
- Hilary A Tindle
- Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | | | - Simin Liu
- Brown University, Providence, Rhode Island, USA
| | | | | | - Steve R Rapp
- Wake Forest Baptist Medical Center, Medical Center Boulevard, Winston-Salem, North Carolina, USA
| | | | - Mace Coday
- University of Tennessee Health Science Center, Memphis, Tennessee, USA
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Vonder M, van der Aalst CM, Vliegenthart R, van Ooijen PMA, Kuijpers D, Gratama JW, de Koning HJ, Oudkerk M. Coronary Artery Calcium Imaging in the ROBINSCA Trial: Rationale, Design, and Technical Background. Acad Radiol 2018; 25:118-128. [PMID: 28843465 DOI: 10.1016/j.acra.2017.07.010] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2017] [Revised: 07/18/2017] [Accepted: 07/20/2017] [Indexed: 01/20/2023]
Abstract
RATIONALE AND OBJECTIVES To describe the rationale, design, and technical background of coronary artery calcium (CAC) imaging in the large-scale population-based cardiovascular disease screening trial (Risk Or Benefit IN Screening for CArdiovascular Diseases [ROBINSCA]). MATERIALS AND METHODS First, literature search was performed to review the logistics, setup, and settings of previously performed CAC imaging studies, and current clinical CAC imaging protocols of participating centers in the ROBINSCA trial were evaluated. A second literature search was performed to evaluate the impact of computed tomography parameter settings on CAC score. RESULTS Based on literature reviews and experts opinion an imaging protocol accompanied by data management protocol was created for ROBINSCA. The imaging protocol should consist of a fixed tube voltage, individually tailored tube current setting, mid-diastolic electrocardiography-triggering, fixed field-of-view, fixed reconstruction kernel, fixed slice thickness, overlapping reconstruction and without iterative reconstruction. The analysis of scans is performed with one type and version of CAC scoring software, by two dedicated and experienced researchers. The data management protocol describes the organization of data handling between the coordinating center, participating centers, and core analysis center. CONCLUSION In this paper we describe the rationale and technical considerations to be taken in developing CAC imaging protocol, and we present a detailed protocol that can be implemented for CAC screening purposes.
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Affiliation(s)
- Marleen Vonder
- University of Groningen, University Medical Center Groningen, Center for Medical Imaging North-East Netherlands (CMI-NEN), Groningen, The Netherlands
| | - Carlijn M van der Aalst
- Erasmus MC-University Medical Centre, Department of Public Health, Rotterdam, The Netherlands
| | - Rozemarijn Vliegenthart
- University of Groningen, University Medical Center Groningen, Center for Medical Imaging North-East Netherlands (CMI-NEN), Groningen, The Netherlands
| | - Peter M A van Ooijen
- University of Groningen, University Medical Center Groningen, Center for Medical Imaging North-East Netherlands (CMI-NEN), Groningen, The Netherlands; University of Groningen, University Medical Center Groningen, Department of Radiology, Groningen, The Netherlands
| | - Dirkjan Kuijpers
- University of Groningen, University Medical Center Groningen, Center for Medical Imaging North-East Netherlands (CMI-NEN), Groningen, The Netherlands; Department of Radiology, Haaglanden Medical Center Bronovo, The Hague, The Netherlands
| | - Jan Willem Gratama
- University of Groningen, University Medical Center Groningen, Center for Medical Imaging North-East Netherlands (CMI-NEN), Groningen, The Netherlands; Department of Radiology, Gelre Hospital, Apeldoorn, The Netherlands
| | - Harry J de Koning
- Erasmus MC-University Medical Centre, Department of Public Health, Rotterdam, The Netherlands
| | - Matthijs Oudkerk
- University of Groningen, University Medical Center Groningen, Center for Medical Imaging North-East Netherlands (CMI-NEN), Groningen, The Netherlands.
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15
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Progovac AM, Donohue JM, Matthews KA, Chang CCH, Habermann EB, Kuller LH, Saquib J, LaMonte MJ, Salmoirago-Blotcher E, Zaslavsky O, Tindle HA. Optimism predicts sustained vigorous physical activity in postmenopausal women. Prev Med Rep 2017; 8:286-293. [PMID: 29255664 PMCID: PMC5723377 DOI: 10.1016/j.pmedr.2017.10.008] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2017] [Accepted: 10/16/2017] [Indexed: 01/10/2023] Open
Abstract
Optimism and cynical hostility are associated with health behaviors and health outcomes, including morbidity and mortality. This analysis assesses their association with longitudinal vigorous physical activity (PA) in postmenopausal women of the Women's Health Initiative (WHI). Subjects include 73,485 women nationwide without history of cancer or cardiovascular disease (CVD), and no missing baseline optimism, cynical hostility, or PA data. The Life Orientation Test-Revised Scale measured optimism. A Cook Medley questionnaire subscale measured cynical hostility. Scale scores were divided into quartiles. Vigorous PA three times or more per week was assessed via self-report at study baseline (1994–1998) and through follow-up year 6. Descriptive analysis mapped lifetime trajectories of vigorous PA (recalled at ages 18, 25, 50; prospectively assessed at baseline, and 3 and 6 years later). Hierarchical generalized linear mixed models examined the prospective association between optimism, cynical hostility, and vigorous PA over 6 years. Models adjusted for baseline sociodemographic variables, psychosocial characteristics, and health conditions and behaviors. Vigorous PA rates were highest for most optimistic women, but fell for all women by approximately 60% between age 50 and study baseline. In adjusted models from baseline through year 6, most vs. least optimistic women were 15% more likely to exercise vigorously (p < 0.001). Cynical hostility was not associated with lower odds of longitudinal vigorous PA after adjustment. Results did not differ by race/ethnicity or socioeconomic status. Higher optimism is associated with maintaining vigorous PA over time in post-menopausal women, and may protect women's health over the lifespan.
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Affiliation(s)
- Ana M Progovac
- Health Equity Research Lab, Department of Psychiatry, Cambridge Health Alliance, Cambridge, MA, United States.,Department of Psychiatry, Harvard Medical School, Boston, MA, United States
| | - Julie M Donohue
- Department of Health Policy & Management, University of Pittsburgh Graduate School of Public Health, Pittsburgh, PA, United States
| | - Karen A Matthews
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, United States
| | - Chung-Chou H Chang
- Department of Biostatistics, University of Pittsburgh, Pittsburgh, PA, United States.,Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, United States
| | - Elizabeth B Habermann
- Mayo Clinic Robert D and Patricia E Kern Center for the Science of Health Care Delivery, Surgical Outcomes Program, Rochester, MN, United States
| | - Lewis H Kuller
- Department of Epidemiology, University of Pittsburgh Graduate School of Public Health, Pittsburgh, PA, United States
| | - Juliann Saquib
- Department of Family and Community Medicine, College of Medicine, Qassim University, Saudi Arabia
| | - Michael J LaMonte
- Department of Epidemiology and Environmental Health, School of Public Health and Health Professions, University at Buffalo, Buffalo, NY, United States
| | - Elena Salmoirago-Blotcher
- Department of Medicine, Warren Alpert School of Medicine, Brown University, Providence, RI, United States.,Department of Epidemiology, Brown University School of Public Health, Providence, RI, United States.,Centers for Behavioral and Preventive Medicine, The Miriam Hospital Providence, RI, United States
| | - Oleg Zaslavsky
- Department of Biobehavioral Nursing and Health Informatics, University of Washington School of Nursing, Seattle, WA, United States
| | - Hilary A Tindle
- Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, United States
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16
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Nicoll R, Henein M. Arterial calcification: A new perspective? Int J Cardiol 2017; 228:11-22. [DOI: 10.1016/j.ijcard.2016.11.099] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2016] [Accepted: 11/06/2016] [Indexed: 12/19/2022]
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17
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Jennings JR, Pardini DA, Matthews KA. Heart rate, health, and hurtful behavior. Psychophysiology 2016; 54:399-408. [PMID: 28026867 DOI: 10.1111/psyp.12802] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2016] [Accepted: 11/02/2016] [Indexed: 01/02/2023]
Abstract
Hostility is a risk factor for cardiovascular events. When challenged, individuals high on hostility exhibit a hyperreactive psychophysiological response to stressors, thereby increasing risk for developing cardiovascular disease. However, low resting heart rate (HR) is associated with physical aggression and hostility in children, adolescents, and adults. Based on a community sample of 296 men (mean age = 32.0), we (a) address whether aggression/hostility relates to physical health through relationships with cardiovascular levels at rest and in response to stressors, and (b) determine how relations between aggression and health are altered by including psychophysiological indices in statistical models. The Cook-Medley cynical/hostile attitudes and the Buss-Perry physical aggression and hostility measures assessed aggression. Health was assessed as systolic blood pressure (SBP), report of medical conditions, and a metabolic composite. Reactivity to stressors was assessed with HR, SBP, and diastolic blood pressure. Aggression was negatively related to both resting HR and reactivity. High resting HR and reactivity were, however, positively related to poor health. Thus, the relationship between aggression and HR and reactivity suppressed an overall relationship between high aggression/hostility and poor health. In the presence of covariates for socioeconomic status, race, health behaviors, and medications, the relationship between aggression and health was significantly strengthened when HR level and reactivity were included in models. In sum, at early midlife, low HR among aggressive and hostile individuals is related to less health risk. Aggression and hostility have a deleterious influence on health, but primarily among individuals with higher HR and possibly greater cardiovascular reactivity.
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Affiliation(s)
- J Richard Jennings
- Departments of Psychiatry and Psychology, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Dustin A Pardini
- School of Criminology and Criminal Justice, Arizona State University, Phoenix, Arizona, USA
| | - Karen A Matthews
- Departments of Psychiatry and Psychology, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
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18
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Walters RP, Harrison PK, Campbell RW, Harrison DW. Frontal lobe regulation of blood glucose levels: support for the limited capacity model in hostile violence-prone men. Brain Inform 2016; 3:221-231. [PMID: 27747812 PMCID: PMC5106403 DOI: 10.1007/s40708-016-0034-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2015] [Accepted: 01/16/2016] [Indexed: 12/18/2022] Open
Abstract
Hostile men have reliably displayed an exaggerated sympathetic stress response across multiple experimental settings, with cardiovascular reactivity for blood pressure and heart rate concurrent with lateralized right frontal lobe stress (Trajanoski et al., in Diabetes Care 19(12):1412-1415, 1996; see Heilman et al., in J Neurol Neurosurg Psychiatry 38(1):69-72, 1975). The current experiment examined frontal lobe regulatory control of glucose in high and low hostile men with concurrent left frontal lobe (Control Oral Word Association Test [verbal]) or right frontal lobe (Ruff Figural Fluency Test [nonverbal]) stress. A significant interaction was found for Group × Condition, F (1,22) = 4.16, p ≤ .05 with glucose levels (mg/dl) of high hostile men significantly elevated as a function of the right frontal stressor (M = 101.37, SD = 13.75) when compared to the verbal stressor (M = 95.79, SD = 11.20). Glucose levels in the low hostile group remained stable for both types of stress. High hostile men made significantly more errors on the right frontal but not the left frontal stressor (M = 17.18, SD = 19.88) when compared to the low hostile men (M = 5.81, SD = 4.33). These findings support our existing frontal capacity model of hostility (Iribarren et al., in J Am Med Assoc 17(19):2546-2551, 2000; McCrimmon et al., in Physiol Behav 67(1):35-39, 1999; Brunner et al., in Diabetes Care 21(4):585-590, 1998), extending the role of the right frontal lobe to regulatory control over glucose mobilization.
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Affiliation(s)
- Robert P Walters
- Neuroscience Laboratory, Department of Psychology, Virginia Polytechnic Institute & State University, Williams Hall, Virginia Tech, Blacksburg, VA, 24061, USA
| | - Patti Kelly Harrison
- Neuroscience Laboratory, Department of Psychology, Virginia Polytechnic Institute & State University, Williams Hall, Virginia Tech, Blacksburg, VA, 24061, USA
| | - Ransom W Campbell
- Neuroscience Laboratory, Department of Psychology, Virginia Polytechnic Institute & State University, Williams Hall, Virginia Tech, Blacksburg, VA, 24061, USA
| | - David W Harrison
- Neuroscience Laboratory, Department of Psychology, Virginia Polytechnic Institute & State University, Williams Hall, Virginia Tech, Blacksburg, VA, 24061, USA.
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19
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Howell BA, Long JB, Edelman EJ, McGinnis KA, Rimland D, Fiellin DA, Justice AC, Wang EA. Incarceration History and Uncontrolled Blood Pressure in a Multi-Site Cohort. J Gen Intern Med 2016; 31:1496-1502. [PMID: 27619934 PMCID: PMC5130961 DOI: 10.1007/s11606-016-3857-1] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2015] [Revised: 06/02/2016] [Accepted: 08/18/2016] [Indexed: 12/20/2022]
Abstract
BACKGROUND Incarceration is associated with increased risk of hypertension and cardiovascular disease mortality. We used data from the Veterans Aging Cohort Study (VACS) to explore the impact of incarceration on blood pressure (BP) control. METHODS Among hypertensive VACS participants, we measured the association between self-reported recent incarceration or past (not recent) history of incarceration and BP control in the year following the survey. To analyze the association between incarceration and BP control, we used logistic regression models adjusted for sociodemographic characteristics, clinical factors (HIV status and body mass index), and behavioral factors (history of smoking, unhealthy alcohol use, illicit drug use). We explored potential mediators including post-traumatic stress disorder (PTSD), depression, primary care engagement, and adherence to antihypertensive medications. RESULTS Among the 3515 eligible VACS participants, 2304 participants met the inclusion criteria. Of these, 163 (7 %) reported recent incarceration, and 904 (39 %) reported a past history of incarceration. Participants with recent or past history of incarceration were more likely to have uncontrolled BP than those without a history of incarceration (67 % vs. 56 % vs. 51 %, p < 0.001). In multivariable analysis, recent incarceration (adjusted odds ratio [AOR] = 1.57 95 % confidence interval [CI]: 1.09-2.26), but not a past history of incarceration (AOR = 1.08 95 % CI: 0.90-1.30), was associated with uncontrolled BP compared with those who were never incarcerated. CONCLUSIONS Among patients with a history of hypertension, recent incarceration is associated with having uncontrolled BP following release. Interventions are needed for recently released individuals to improve hypertension outcomes.
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Affiliation(s)
- Benjamin A Howell
- Department of Internal Medicine, Yale University School of Medicine, P.O. Box 208030, New Haven, CT, 06520, USA.
| | - Jessica B Long
- Department of Internal Medicine, Yale University School of Medicine, P.O. Box 208030, New Haven, CT, 06520, USA
| | - E Jennifer Edelman
- Department of Internal Medicine, Yale University School of Medicine, P.O. Box 208030, New Haven, CT, 06520, USA
- Center for Interdisciplinary Research on AIDS, Yale University School of Public Health, New Haven, CT, USA
| | | | - David Rimland
- Atlanta VA Medical Center, Atlanta, GA, USA
- Emory University School of Medicine, Atlanta, GA, USA
| | - David A Fiellin
- Department of Internal Medicine, Yale University School of Medicine, P.O. Box 208030, New Haven, CT, 06520, USA
- Center for Interdisciplinary Research on AIDS, Yale University School of Public Health, New Haven, CT, USA
| | - Amy C Justice
- Department of Internal Medicine, Yale University School of Medicine, P.O. Box 208030, New Haven, CT, 06520, USA
- Center for Interdisciplinary Research on AIDS, Yale University School of Public Health, New Haven, CT, USA
- Veterans Administration Connecticut Healthcare System, West Haven, CT, USA
| | - Emily A Wang
- Department of Internal Medicine, Yale University School of Medicine, P.O. Box 208030, New Haven, CT, 06520, USA
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Abstract
Although it is known that hostility precedes coronary heart disease (CHD), little is known about factors that influence the development and progression of hostile characteristics. The relations among hostility, self-esteem, self-concept, and psychosocial residual were conceptualized within the modeling and role-modeling theoretical framework and examined in a sample of 85 persons with CHD. There were significant associations between all variables. Regression analyses revealed that self-esteem, mistrust residual, isolation residual, and self-concept contributed significantly, accounting for 31% of the variation in hostility scores. These findings provide support for the belief that the development of hostility in persons with CHD is related to beliefs and attitudes about the self and others. Persons with self-esteem need deficits, and a subsequent build up of negative psychosocial residual, have poor self-concepts. This poor self-concept is hostile in nature and reflects a mistrust of others and a deep sense of isolation.
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21
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Albanese E, Matthews KA, Zhang J, Jacobs DR, Whitmer RA, Wadley VG, Yaffe K, Sidney S, Launer LJ. Hostile attitudes and effortful coping in young adulthood predict cognition 25 years later. Neurology 2016; 86:1227-34. [PMID: 26935891 DOI: 10.1212/wnl.0000000000002517] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2015] [Accepted: 12/14/2015] [Indexed: 12/19/2022] Open
Abstract
OBJECTIVE We studied the relation of early-life (mean age 25 years) and mid-life (mean age 50 years) cognitive function to early measures of hostile attitudes and effortful coping. METHODS In 3,126 black and white men and women (born in 1955-1968) from the Coronary Artery Risk Development in Young Adults Study (CARDIA), we used linear regression to examine the association of hostile attitudes (Cook-Medley questionnaire) and effortful coping assessed at baseline (1985-1986) to cognitive ability measured in 1987 and to a composite cognitive Z score of tests of verbal memory, psychomotor speed, and executive function ascertained in midlife (2010-2011). RESULTS Baseline hostility and effortful coping were prospectively associated with lower cognitive function 25 years later, controlling for age, sex, race, education, long-term exposure to depression, discrimination, negative life events, and baseline cognitive ability. Compared to the lowest quartile, those in the highest quartile of hostility performed 0.21 SD units lower (95% confidence interval [CI] -0.39, -0.02). Those in the highest quartile of effortful coping performed 0.30 SD units lower (95% CI -0.48, -0.12) compared to those in the lowest quartile. Further adjustment for cumulative exposure to cardiovascular risk factors attenuated the association with the cognitive composite Z score for hostility. CONCLUSIONS Worse cognition in midlife was independently associated with 2 psychological characteristics measured in young adulthood. This suggests that interventions that promote positive social interactions may have a role in reducing risk of late-age cognitive impairment.
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Affiliation(s)
- Emiliano Albanese
- From the Laboratory of Epidemiology and Population Sciences (E.A., J.Z., L.J.L.), National Institute on Aging, NIH, Bethesda, MD; Department of Psychiatry (E.A.), University of Geneva, School of Medicine, Switzerland; Department of Psychiatry and Psychology (K.A.M.), University of Pittsburgh, PA; Division of Epidemiology School of Public Health (D.R.J.), University of Minnesota, Minneapolis; Kaiser Permanente (R.A.W., S.S.), Division of Research, Oakland, CA; Department of Medicine (V.G.W.), University of Alabama at Birmingham; and Department of Psychiatry, Neurology, and Epidemiology and Biostatistics (K.Y.), University of California, San Francisco
| | - Karen A Matthews
- From the Laboratory of Epidemiology and Population Sciences (E.A., J.Z., L.J.L.), National Institute on Aging, NIH, Bethesda, MD; Department of Psychiatry (E.A.), University of Geneva, School of Medicine, Switzerland; Department of Psychiatry and Psychology (K.A.M.), University of Pittsburgh, PA; Division of Epidemiology School of Public Health (D.R.J.), University of Minnesota, Minneapolis; Kaiser Permanente (R.A.W., S.S.), Division of Research, Oakland, CA; Department of Medicine (V.G.W.), University of Alabama at Birmingham; and Department of Psychiatry, Neurology, and Epidemiology and Biostatistics (K.Y.), University of California, San Francisco
| | - Julia Zhang
- From the Laboratory of Epidemiology and Population Sciences (E.A., J.Z., L.J.L.), National Institute on Aging, NIH, Bethesda, MD; Department of Psychiatry (E.A.), University of Geneva, School of Medicine, Switzerland; Department of Psychiatry and Psychology (K.A.M.), University of Pittsburgh, PA; Division of Epidemiology School of Public Health (D.R.J.), University of Minnesota, Minneapolis; Kaiser Permanente (R.A.W., S.S.), Division of Research, Oakland, CA; Department of Medicine (V.G.W.), University of Alabama at Birmingham; and Department of Psychiatry, Neurology, and Epidemiology and Biostatistics (K.Y.), University of California, San Francisco
| | - David R Jacobs
- From the Laboratory of Epidemiology and Population Sciences (E.A., J.Z., L.J.L.), National Institute on Aging, NIH, Bethesda, MD; Department of Psychiatry (E.A.), University of Geneva, School of Medicine, Switzerland; Department of Psychiatry and Psychology (K.A.M.), University of Pittsburgh, PA; Division of Epidemiology School of Public Health (D.R.J.), University of Minnesota, Minneapolis; Kaiser Permanente (R.A.W., S.S.), Division of Research, Oakland, CA; Department of Medicine (V.G.W.), University of Alabama at Birmingham; and Department of Psychiatry, Neurology, and Epidemiology and Biostatistics (K.Y.), University of California, San Francisco
| | - Rachel A Whitmer
- From the Laboratory of Epidemiology and Population Sciences (E.A., J.Z., L.J.L.), National Institute on Aging, NIH, Bethesda, MD; Department of Psychiatry (E.A.), University of Geneva, School of Medicine, Switzerland; Department of Psychiatry and Psychology (K.A.M.), University of Pittsburgh, PA; Division of Epidemiology School of Public Health (D.R.J.), University of Minnesota, Minneapolis; Kaiser Permanente (R.A.W., S.S.), Division of Research, Oakland, CA; Department of Medicine (V.G.W.), University of Alabama at Birmingham; and Department of Psychiatry, Neurology, and Epidemiology and Biostatistics (K.Y.), University of California, San Francisco
| | - Virginia G Wadley
- From the Laboratory of Epidemiology and Population Sciences (E.A., J.Z., L.J.L.), National Institute on Aging, NIH, Bethesda, MD; Department of Psychiatry (E.A.), University of Geneva, School of Medicine, Switzerland; Department of Psychiatry and Psychology (K.A.M.), University of Pittsburgh, PA; Division of Epidemiology School of Public Health (D.R.J.), University of Minnesota, Minneapolis; Kaiser Permanente (R.A.W., S.S.), Division of Research, Oakland, CA; Department of Medicine (V.G.W.), University of Alabama at Birmingham; and Department of Psychiatry, Neurology, and Epidemiology and Biostatistics (K.Y.), University of California, San Francisco
| | - Kristine Yaffe
- From the Laboratory of Epidemiology and Population Sciences (E.A., J.Z., L.J.L.), National Institute on Aging, NIH, Bethesda, MD; Department of Psychiatry (E.A.), University of Geneva, School of Medicine, Switzerland; Department of Psychiatry and Psychology (K.A.M.), University of Pittsburgh, PA; Division of Epidemiology School of Public Health (D.R.J.), University of Minnesota, Minneapolis; Kaiser Permanente (R.A.W., S.S.), Division of Research, Oakland, CA; Department of Medicine (V.G.W.), University of Alabama at Birmingham; and Department of Psychiatry, Neurology, and Epidemiology and Biostatistics (K.Y.), University of California, San Francisco
| | - Stephen Sidney
- From the Laboratory of Epidemiology and Population Sciences (E.A., J.Z., L.J.L.), National Institute on Aging, NIH, Bethesda, MD; Department of Psychiatry (E.A.), University of Geneva, School of Medicine, Switzerland; Department of Psychiatry and Psychology (K.A.M.), University of Pittsburgh, PA; Division of Epidemiology School of Public Health (D.R.J.), University of Minnesota, Minneapolis; Kaiser Permanente (R.A.W., S.S.), Division of Research, Oakland, CA; Department of Medicine (V.G.W.), University of Alabama at Birmingham; and Department of Psychiatry, Neurology, and Epidemiology and Biostatistics (K.Y.), University of California, San Francisco
| | - Lenore J Launer
- From the Laboratory of Epidemiology and Population Sciences (E.A., J.Z., L.J.L.), National Institute on Aging, NIH, Bethesda, MD; Department of Psychiatry (E.A.), University of Geneva, School of Medicine, Switzerland; Department of Psychiatry and Psychology (K.A.M.), University of Pittsburgh, PA; Division of Epidemiology School of Public Health (D.R.J.), University of Minnesota, Minneapolis; Kaiser Permanente (R.A.W., S.S.), Division of Research, Oakland, CA; Department of Medicine (V.G.W.), University of Alabama at Birmingham; and Department of Psychiatry, Neurology, and Epidemiology and Biostatistics (K.Y.), University of California, San Francisco.
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Abstract
Coronary heart disease (CHD) sustains a significant negative impact on hospital admissions and deaths worldwide. The prevalence of CHD in young adults is difficult to establish accurately, as these asymptomatic patients typically do not undergo diagnostic studies. In this article, the authors will focus on young adults with CHD emphasizing common and uncommon risk factors, current management and review of previous studies.
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Wu SI, Chen SC, Liu SI, Sun FJ, Juang JJM, Lee HC, Kao KL, Dewey ME, Prince M, Stewart R. Relative Risk of Acute Myocardial Infarction in People with Schizophrenia and Bipolar Disorder: A Population-Based Cohort Study. PLoS One 2015; 10:e0134763. [PMID: 26270347 PMCID: PMC4536090 DOI: 10.1371/journal.pone.0134763] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2015] [Accepted: 07/13/2015] [Indexed: 02/04/2023] Open
Abstract
OBJECTIVE Despite high mortality associated with serious mental illness, risk of acute myocardial infarction (AMI) remains unclear, especially for patients with bipolar disorder. The main objective was to investigate the relative risk of AMI associated with schizophrenia and bipolar disorders in a national sample. METHOD Using nationwide administrative data, an 11-year historic cohort study was assembled, comprised of cases aged 18 and above who had received a diagnosis of schizophrenia or bipolar disorder, compared to a random sample of all other adults excluding those with diagnoses of serious mental illness. Incident AMI as a primary diagnosis was ascertained. Hazard ratios stratified by age and gender were calculated and Cox regression models were used to adjust for other covariates. RESULTS A total of 70,225 people with schizophrenia or bipolar disorder and 207,592 people without serious mental illness were compared. Hazard ratios in men adjusted for age, income and urbanization were 1.15 (95% CI 1.01~1.32) for schizophrenia and 1.37 (1.08~1.73)for bipolar disorder, and in women, 1.85 (1.58~2.18) and 1.88(1.47~2.41) respectively. Further adjustment for treated hypertension, diabetes and hyperlipidaemia attenuated the hazard ratio for men with schizophrenia but not the other comparison groups. Hazard ratios were significantly stronger in women than men and were stronger in younger compared to older age groups for both disorders; however, gender modification was only significant in people with schizophrenia, and age modification only significant in people with bipolar disorder. CONCLUSIONS In this large national sample, schizophrenia and bipolar disorder were associated with raised risk of AMI in women and in the younger age groups although showed differences in potential confounding and modifying factors.
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Affiliation(s)
- Shu-I Wu
- Mackay Memorial Hospital, Department of Psychiatry, Taipei, Taiwan
- Mackay Medical College, Department of Audiology and Speech Language Pathology, Taipei, Taiwan
| | - Su-Chiu Chen
- National Taipei University of Nursing and Health Sciences, Department of Health Care Management, Taipei, Taiwan
| | - Shen-Ing Liu
- Mackay Memorial Hospital, Department of Psychiatry, Taipei, Taiwan
- Mackay Junior College of Nursing, Taipei, Taiwan
- Mackay Memorial Hospital, Department of Medical Research, Taipei, Taiwan
| | - Fang-Ju Sun
- Mackay Junior College of Nursing, Taipei, Taiwan
- Mackay Memorial Hospital, Department of Medical Research, Taipei, Taiwan
| | - Jimmy J. M. Juang
- Cardiovascular Center and Division of Cardiology, Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
| | - Hsin-Chien Lee
- Department of Psychiatry, Shuang Ho Hospital, Taipei, Taiwan
- Department of Psychiatry, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Kai-Liang Kao
- Far Eastern Memorial Hospital, Department of Pediatrics, Taipei, Taiwan
- * E-mail:
| | - Michael E. Dewey
- King’s College London, (Institute of Psychiatry, Psychology & Neuroscience), Health Service and Population Research Department, London, United Kingdom
| | - Martin Prince
- King’s College London, (Institute of Psychiatry, Psychology & Neuroscience), Health Service and Population Research Department, London, United Kingdom
| | - Robert Stewart
- King’s College London, (Institute of Psychiatry, Psychology & Neuroscience), Health Service and Population Research Department, London, United Kingdom
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Sararoudi RB, Kheirabadi GR, Kousha M, Toghani F, Hashemi M, Maracy MR. Is there any association of personality traits with vascular endothelial function or systemic inflammation? Adv Biomed Res 2014; 3:210. [PMID: 25371867 PMCID: PMC4219206 DOI: 10.4103/2277-9175.143254] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2013] [Accepted: 05/15/2013] [Indexed: 11/19/2022] Open
Abstract
Background: Evidences showed association of some personality traits with increased risk of cardiovascular diseases, but mediated mechanisms are not entirely described. In this study, we investigated the association of different personality traits with systemic inflammation and endothelial function as probable mediators. Methods: This cross-sectional study was conducted in 2011 on 40-60 years old employees of an industrial company located in Isfahan city (central Iran). Participants were selected through simple random sampling. Personality types were evaluated using the neuroticism-extroversion-openness personality inventory and systemic inflammatory status was determined with high sensitive C-reactive protein (hs-CRP) level. To evaluate endothelial function flow mediated dilation (FMD) were measured. The obtained data were analyzed with univariate correlation and multiple linear regression tests. Results: A total of 254 cases with mean age of 51.4 ± 6.1 years were evaluated. There was no significant relationship between hs-CRP level and FMD with the personality traits in univariate analysis. In multivariate analysis, no association was found between the scores of personality traits and FMD with controlling the factors such as age, body mass index dyslipidemia, hypertension and diabetes. Only there was an inverse association between conscientiousness score and hs-CRP (β = −0.241, P = 0.013). Conclusions: In our population who were the employees of an industrial company, no relationship was found between specific personality trait and endothelial dysfunction. However, we found that the personality trait of responsibility (conscientiousness) is negatively associated with inflammation. Further multi-center studies and also cohort studies are recommended in this regard.
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Affiliation(s)
- Reza Bagherian Sararoudi
- Department of Psychiatry, Behavioral Sciences Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Gholam Reza Kheirabadi
- Department of Psychiatry, Behavioral Sciences Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Marjan Kousha
- Department of Psychiatry, Behavioral Sciences Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Fateme Toghani
- Department of Psychiatry, Behavioral Sciences Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mohammad Hashemi
- Department of Internal Medicine, Cardiovascular Disease Research Center, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mohammad Reza Maracy
- Department of Epidemiology, Isfahan University of Medical Sciences, Isfahan, Iran
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Namdar H, Taban Sadeghi M, Sabourimoghaddam H, Sadeghi B, Ezzati D. Effects of music on cardiovascular responses in men with essential hypertension compared with healthy men based on introversion and extraversion. J Cardiovasc Thorac Res 2014; 6:185-9. [PMID: 25320667 PMCID: PMC4195970 DOI: 10.15171/jcvtr.2014.009] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2014] [Accepted: 09/05/2014] [Indexed: 11/20/2022] Open
Abstract
Introduction: The present research investigated the effects of two different types of music on cardiovascular responses in essential hypertensive men in comparison with healthy men based on introversion and extraversion.
Methods: One hundred and thirteen hypertensive men referred to Madani Heart Hospital in Tabriz completed the NEO-FFI Questionnaire and after obtaining acceptable scores were classified in four groups: introvert patients, extravert patients, introvert healthy subjects, and extravert healthy subjects (each group with 25 samples with age range 31-50). Baseline blood pressure and heart rate of each subject was recorded without any stimulus. Then subjects were exposed to slow-beat music and blood pressure and heart rate were recorded. After15 minute break, and a little cognitive task for distraction, subjects were exposed to fast-beat music and blood pressure and heart rate were recorded again.
Results: Multivariate analysis of covariance (MANCOVA) test showed that extravert patient subjects obtained greater reduction in systolic blood pressure and heart rate after presenting slow-beat music compared with introvert patients (P= 0.035, and P= 0.033 respectively). And extravert healthy subjects obtained greater reduction in heart rate after presenting slow-beat music compared with introvert healthy subjects (P= 0.036). However, there are no significant differences between introvert and extravert groups in systolic and diastolic blood pressure and heart rate after presenting fast-beat music.
Conclusion: Based on our results, introvert subjects experience negative emotions more than extravert subjects and negative emotions cause less change in blood pressure in these subjects compared with extravert subjects.
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Affiliation(s)
- Hossein Namdar
- Cardiovascular Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | | | - Hassan Sabourimoghaddam
- Department of Psychology, Faculty of Educational Sciences and Psychology, University of Tabriz, Iran
| | - Babak Sadeghi
- Department of Psychology, Faculty of Educational Sciences and Psychology, University of Tabriz, Iran
| | - Davoud Ezzati
- Department of Psychology, Faculty of Educational Sciences and Psychology, University of Tabriz, Iran
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Wang EA, Aminawung JA, Wildeman C, Ross JS, Krumholz HM. High incarceration rates among black men enrolled in clinical studies may compromise ability to identify disparities. Health Aff (Millwood) 2014; 33:848-55. [PMID: 24799583 PMCID: PMC4065793 DOI: 10.1377/hlthaff.2013.1325] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
In 1978 the federal government restricted research on prison and jail inmates in medical studies, the result of decades of unethical research in correctional institutions. We evaluated the impact this policy has had on studies of health outcomes in minority populations, particularly studies involving black men, who are disproportionately incarcerated. Specifically, we explored the effect of incarceration on follow-up rates of fourteen prospective clinical studies funded by the National Heart, Lung, and Blood Institute. We estimated that during the past three decades high rates of incarceration of black men may have accounted for up to 65 percent of the loss to follow-up among black men in these studies. The impact of incarceration was far less among white men, black women, and white women. These estimates suggest that the ability of those studies to examine racial disparities in health outcomes, as well as to understand the experience of this group, could be compromised. We believe that community-recruited subjects who are incarcerated should be allowed to continue participating in observational clinical research that poses minimal risk to participants.
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Affiliation(s)
- Emily A. Wang
- General internal medicine, Yale University School of Medicine, in New Haven, Connecticut
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Compare A, Mommersteeg PMC, Faletra F, Grossi E, Pasotti E, Moccetti T, Auricchio A. Personality traits, cardiac risk factors, and their association with presence and severity of coronary artery plaque in people with no history of cardiovascular disease. J Cardiovasc Med (Hagerstown) 2014; 15:423-30. [PMID: 24572339 DOI: 10.2459/jcm.0b013e328365cd8c] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
BACKGROUND Coronary artery disease (CAD) is a multifactorial complex disease. The aim of the present study is to verify whether the personality traits in CAD are associated with coronary artery plaque (CAP) presence and severity in people with no history of cardiovascular disease. DESIGN A cross-sectional monocenter study. METHODS Seventy five individuals with no history of CAD underwent 64-slice computed tomography coronary angiography (CTCA) and were screened for traditional cardiac risk factors and for hostility, anger, and type D personality traits. RESULTS In total, 48 patients (64%) had evidence of CAP, with mild (31%), moderate (33%), and severe (35%) coronary stenosis. Male sex, hypertension, being overweight, and number of cardiovascular risk factors increased the likelihood of CAP presence. Findings showed a significant difference between CAP presence vs. CAP absence for anger (26 vs. 30%, χ2 = 6.82) and type D personality (23 vs. 35%; χ2 = 8.23, P = 0.03), but not hostility (P > 0.05). Anger personality, and the type D subscale social inhibition, but not negative affectivity, were associated with an increased prevalence and severity of CAP. Univariate analysis confirms anger (odds ratio, OR = 1.38, 95% confidence interval, CI = 1.12-2.31), social inhibition (OR = 2.01, 95% CI = 1.81-2.93), 'negative affectivity by social inhibition' (OR = 1.24, 95% CI = 1.12-2.14), and type D personality (OR = 1.9, 95% CI = 1.11-2.03) as predictors of CAP presence. Moreover, multivariate analysis suggests social inhibition as also a unique CAP predictor (OR = 2.14, 95% CI = 1.89-2.96) after adjustment for having cardiac risk factors as a covariate. CONCLUSION The present data confirm the core role of traditional risk factors and suggest the primacy of social inhibition and anger personality traits in association with CAP presence and severity.
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Affiliation(s)
- Angelo Compare
- aHuman Factors and Technologies in Health Care Centre, University of Bergamo, Bergamo, Italy bCentre of Research on Psychology in Somatic Diseases, Tilburg University, Tilburg, the Netherlands cDivision of Cardiology, Cardiocentro Lugano, Lugano, Switzerland dVilla Santa Maria Institute, Tavernerio, Italy
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Haagensen AMJ, Sørensen DB, Sandøe P, Matthews LR, Birck MM, Fels JJ, Astrup A. High fat, low carbohydrate diet limit fear and aggression in Göttingen minipigs. PLoS One 2014; 9:e93821. [PMID: 24740321 PMCID: PMC3989186 DOI: 10.1371/journal.pone.0093821] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2014] [Accepted: 03/06/2014] [Indexed: 01/15/2023] Open
Abstract
High fat, low carbohydrate diets have become popular, as short-term studies show that such diets are effective for reducing body weight, and lowering the risk of diabetes and cardiovascular disease. There is growing evidence from both humans and other animals that diet affects behaviour and intake of fat has been linked, positively and negatively, with traits such as exploration, social interaction, anxiety and fear. Animal models with high translational value can help provide relevant and important information in elucidating potential effects of high fat, low carbohydrate diets on human behaviour. Twenty four young, male Göttingen minipigs were fed either a high fat/cholesterol, low carbohydrate diet or a low fat, high carbohydrate/sucrose diet in contrast to a standard low fat, high carbohydrate minipig diet. Spontaneous behaviour was observed through video recordings of home pens and test-related behaviours were recorded during tests involving animal-human contact and reaction towards a novel object. We showed that the minipigs fed a high fat/cholesterol, low carbohydrate diet were less aggressive, showed more non-agonistic social contact and had fewer and less severe skin lesions and were less fearful of a novel object than minipigs fed low fat, high carbohydrate diets. These results found in a porcine model could have important implications for general health and wellbeing of humans and show the potential for using dietary manipulations to reduce aggression in human society.
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Affiliation(s)
- Annika Maria Juul Haagensen
- Department of Veterinary Disease Biology, Section of Experimental Animal Models, Faculty of Health and Medical Sciences, University of Copenhagen, Frederiksberg, Denmark
| | - Dorte Bratbo Sørensen
- Department of Veterinary Disease Biology, Section of Experimental Animal Models, Faculty of Health and Medical Sciences, University of Copenhagen, Frederiksberg, Denmark
| | - Peter Sandøe
- Department of Food and Resource Economics and Department of Large Animal Sciences, University of Copenhagen, Frederiksberg, Denmark
| | - Lindsay R. Matthews
- Lindsay R Matthews & Associates Research International, Scerne Di Pineto, Italy
- Psychology Department, The University of Auckland, Auckland, New Zealand
| | - Malene Muusfeldt Birck
- Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Frederiksberg, Denmark
| | | | - Arne Astrup
- Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Frederiksberg, Denmark
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Mick E, McGough J, Deutsch CK, Frazier JA, Kennedy D, Goldberg RJ. Genome-wide association study of proneness to anger. PLoS One 2014; 9:e87257. [PMID: 24489884 PMCID: PMC3905014 DOI: 10.1371/journal.pone.0087257] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2013] [Accepted: 12/27/2013] [Indexed: 11/19/2022] Open
Abstract
Background Community samples suggest that approximately 1 in 20 children and adults exhibit clinically significant anger, hostility, and aggression. Individuals with dysregulated emotional control have a greater lifetime burden of psychiatric morbidity, severe impairment in role functioning, and premature mortality due to cardiovascular disease. Methods With publically available data secured from dbGaP, we conducted a genome-wide association study of proneness to anger using the Spielberger State-Trait Anger Scale in the Atherosclerosis Risk in Communities (ARIC) study (n = 8,747). Results Subjects were, on average, 54 (range 45–64) years old at baseline enrollment, 47% (n = 4,117) were male, and all were of European descent by self-report. The mean Angry Temperament and Angry Reaction scores were 5.8±1.8 and 7.6±2.2. We observed a nominally significant finding (p = 2.9E-08, λ = 1.027 - corrected pgc = 2.2E-07, λ = 1.0015) on chromosome 6q21 in the gene coding for the non-receptor protein-tyrosine kinase, Fyn. Conclusions Fyn interacts with NDMA receptors and inositol-1,4,5-trisphosphate (IP3)-gated channels to regulate calcium influx and intracellular release in the post-synaptic density. These results suggest that signaling pathways regulating intracellular calcium homeostasis, which are relevant to memory, learning, and neuronal survival, may in part underlie the expression of Angry Temperament.
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Affiliation(s)
- Eric Mick
- Department of Quantitative Health Sciences and the Department of Psychiatry, University of Massachusetts Medical School, Worcester, Massachusetts, United States of America
- * E-mail:
| | - James McGough
- Division of Child and Adolescent Psychiatry, University of California, Los Angeles Semel Institute for Neuroscience and Human Behavior, David Geffen School of Medicine, Los Angeles California, United States of America
| | - Curtis K. Deutsch
- Eunice Kennedy Shriver Center, University of Massachusetts Medical School, Worcester, Massachusetts, United States of America
| | - Jean A. Frazier
- Psychiatry Department, Division of Child and Adolescent Psychiatry, University of Massachusetts Medical School, Worcester, Massachusetts, United States of America
| | - David Kennedy
- Psychiatry Department, Division of Neuroinformatics and the Child and Adolescent NeuroDevelopment Initiative, University of Massachusetts Medical School, Worcester, Massachusetts, United States of America
| | - Robert J. Goldberg
- Department of Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, Massachusetts, United States of America
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Fabio A, Chen CY, Kim KH, Erickson D, Jacobs DR, Zgibor JC, Chung T, Matthews KA, Sidney S, Iribarren C, Pereira MA. Hostility modifies the association between TV viewing and cardiometabolic risk. J Obes 2014; 2014:784594. [PMID: 25050178 PMCID: PMC4094870 DOI: 10.1155/2014/784594] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2014] [Revised: 05/05/2014] [Accepted: 05/06/2014] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND It was hypothesized that television viewing is predictive of cardiometabolic risk. Moreover, people with hostile personality type may be more susceptible to TV-induced negative emotions and harmful health habits which increase occurrence of cardiometabolic risk. PURPOSE The prospective association of TV viewing on cardiometabolic risk was examined along with whether hostile personality trait was a modifier. METHODS A total of 3,269 Black and White participants in the coronary artery risk development in young adults (CARDIA) study were assessed from age 23 to age 35. A cross-lagged panel model at exam years 5, 10, 15, and 20, covering 15 years, was used to test whether hours of daily TV viewing predicted cardiometabolic risk, controlling confounding variables. Multiple group analysis of additional cross-lagged panel models stratified by high and low levels of hostility was used to evaluate whether the association was modified by the hostile personality trait. RESULTS The cross-lagged association of TV viewing at years 5 and 15 on clustered cardiometabolic risk score at years 10 and 20 was significant (B = 0.058 and 0.051), but not at 10 to 15 years. This association was significant for those with high hostility (B = 0.068 for exam years 5 to 10 and 0.057 for exam years 15 to 20) but not low hostility. CONCLUSION These findings indicate that TV viewing is positively associated with cardiometabolic risk. Further, they indicate that hostility might be a modifier for the association between TV viewing and cardiometabolic risk.
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Affiliation(s)
- Anthony Fabio
- Department of Epidemiology, Graduate School of Public Health, Epidemiology Data Coordinating Center, University of Pittsburgh, 130 DeSoto Street, 127 Parran Hall, Pittsburgh, PA 15261, USA
- *Anthony Fabio:
| | - Chung-Yu Chen
- Department of Epidemiology, Graduate School of Public Health, Epidemiology Data Coordinating Center, University of Pittsburgh, 130 DeSoto Street, 127 Parran Hall, Pittsburgh, PA 15261, USA
| | - Kevin H. Kim
- Department of Psychology in Education, School of Education, University of Pittsburgh, Pittsburgh, PA 15261, USA
| | - Darin Erickson
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN 55454, USA
| | - David R. Jacobs
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN 55454, USA
| | - Janice C. Zgibor
- Department of Epidemiology, Graduate School of Public Health, Epidemiology Data Coordinating Center, University of Pittsburgh, 130 DeSoto Street, 127 Parran Hall, Pittsburgh, PA 15261, USA
| | - Tammy Chung
- Departments of Psychiatry and Epidemiology, School of Medicine, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA 15261, USA
| | - Karen A. Matthews
- Departments of Psychiatry and Epidemiology, School of Medicine, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA 15261, USA
| | - Steven Sidney
- Division of Research, Kaiser Permanente Northern California, Oakland, CA, USA
| | - Carlos Iribarren
- Division of Research, Kaiser Permanente Northern California, Oakland, CA, USA
| | - Mark A. Pereira
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN 55454, USA
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Hou L, Lloyd-Jones DM, Ning H, Huffman MD, Fornage M, He K, Zhang X, Jacobs DR, Goff DC, Sidney S, Carr JJ, Liu K. White blood cell count in young adulthood and coronary artery calcification in early middle age: coronary artery risk development in young adults (CARDIA) study. Eur J Epidemiol 2013; 28:735-42. [PMID: 24030512 PMCID: PMC6614872 DOI: 10.1007/s10654-013-9842-7] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2013] [Accepted: 08/13/2013] [Indexed: 01/19/2023]
Abstract
White blood cell (WBC) count is associated with incident coronary heart disease (CHD). Data are sparse regarding its association in young adults with future coronary artery calcification (CAC). Our study was conducted among coronary artery risk development in young adults (CARDIA) participants (n=3,094). We examined the association between baseline (Y0) WBC counts and CHD risk factors using linear regression models. We further assessed prospective associations between Y0 WBC and inflammatory biomarkers during the follow-up, and the presence of CAC 15 and 20 years later. In total, 272 and 566 subjects had CAC scores>0 at year (Y) 15 and Y20, respectively. Baseline total WBC counts were cross-sectionally associated with SBP, BMI, and smoking, or HDL-cholesterol (p≤0.01) at Y0, and prospectively associated with C-reactive protein at Y7, Y15, and Y20, and fibrinogen at Y5 and Y20 (p<0.01). After adjustment for potential confounding factors, baseline neutrophil count was borderline associated with CAC presence 15 years later (OR=1.18 per unit, 95% CI 1.00-1.44) and total WBC (OR=1.07, 95% CI 0.96-1.19) or eosinophil (OR=1.12, 95%CI 1.00-1.25) was borderline associated with CAC presence at Y20. Baseline total WBC counts in young adults was associated prospectively with CAC presence 20 years later after adjusting for age, sex, and race. Results are attenuated when other risk factors are accounted for. Our results suggest the possible early involvement of WBC, particularly eosinophils, in the early stages of atherosclerosis.
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Affiliation(s)
- Lifang Hou
- Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, 680 N. Lake Shore Dr. suite 1400, Chicago, IL, 60611, USA,
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Abstract
In the popular imagination, anger has long been linked to cardiovascular diseases (CVD), but empirical validation from case-control and prospective studies emerged only in the 1970's. After describing the multidimensional nature of anger and its assessment (via self-report or observed in structured interviews), this paper selectively reviews evidence in (a) behavioral epidemiology, (b) stress and biological processes with implications for cardiopathogenesis, and (c) behavioral/pharmacological interventions for anger/hostility reduction. Although evidence is inconsistent, chronic feelings of anger, cynical distrust and antagonistic behavior are at least modestly associated with risk of both initiation and progression of CVD. Anger/hostility also is linked to stress exposure and reactivity, exaggerated autonomic function, reduced heart rate variability, platelet aggregation and inflammation. Clinical and pharmacologic treatment of anger/hostility has the potential to reduce anger and its health-damaging effects. Limitations, including third-variable explanations and overlap among the negative emotions, and implications for cardiology and behavioral medicine research and practice are discussed.
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Kermott CA, Cha SS, Hagen PT, Behrenbeck T. Self-rated stress is noncontributory to coronary artery disease in higher socioeconomic strata. Popul Health Manag 2013; 16:332-40. [PMID: 23537158 DOI: 10.1089/pop.2012.0105] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Stress and its attendant psychosocial and lifestyle variables have been associated with coronary artery disease (CAD), yet the contribution of socioeconomic status (SES) has not been addressed. The aim of this study is to determine if stress assessment is associated with CAD independent of SES, and is incremental to the Framingham Score. The study group consisted of 325 executive patients undergoing comprehensive health assessment. Stress was assessed utilizing the validated "Self-Rated Stress" (SRS) instrument. Coronary artery calcification (CAC) served to assess the degree of atherosclerosis, a CAD equivalent and risk assessment tool. The relationship between SRS and CAC was assessed, with adjustment by potential confounders. CAC was modeled by a variety of cut points (>0, ≥5, ≥100, ≥200) for the test of trend across stress levels per Mantel-Haenszel chi-square (1 df) with nonsignificant P values of 0.9960, 0.5242, 0.1692, 0.3233, respectively. A logistic regression model with SRS as a categorically ranked and continuous variable to predict binary outcome of calcification yielded P values of 0.2366 and 0.9644; this relationship, further adjusted by age, fruit and vegetable consumption, exercise, and education, yielded no statistically significant association. No improvement of fit was observed for the established Framingham Score to CAC relation utilizing SRS. The study concluded that SRS did not play a role in early CAD when focusing on a population in higher socioeconomic strata, and SRS did not add predictive value beyond patient age or calculated Framingham risk. Future studies should focus on additional validated instruments of stress to differentiate between subtypes of stress for varying SES strata.
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Affiliation(s)
- Cindy A Kermott
- 1 Division of Preventive Medicine, Mayo Clinic , Rochester, Minnesota
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Improving the Cardiovascular Health of the Population through Standard and Novel Strategies. CURRENT CARDIOVASCULAR RISK REPORTS 2012. [DOI: 10.1007/s12170-012-0276-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Marano G, Traversi G, Romagnoli E, Catalano V, Lotrionte M, Abbate A, Biondi-Zoccai G, Mazza M. Cardiologic side effects of psychotropic drugs. J Geriatr Cardiol 2012; 8:243-53. [PMID: 22783311 PMCID: PMC3390089 DOI: 10.3724/sp.j.1263.2011.00243] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2011] [Revised: 09/22/2011] [Accepted: 09/29/2011] [Indexed: 02/05/2023] Open
Abstract
Psychotropic drugs can produce cardiovascular side effects associated with a degree of cardiotoxicity. The coexistence of a heart disease complicates the management of mental illness, can contribute to a reduced quality of life and a worse illness course. The co-occurrence of psychiatric disorders in cardiac patients might affect the clinical outcome and morbidity. Moreover, the complex underlying mechanism that links these two conditions remains unclear. This paper discusses the known cardiovascular complications of psychotropic drugs and analyzes the important implications of antidepressive treatment in patients with previous cardiac history.
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Affiliation(s)
- Giuseppe Marano
- Department of Neurosciences, Institute of Psychiatry, Università Cattolica del Sacro Cuore, Rome 00168, Italy
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Everage NJ, Gjelsvik A, McGarvey ST, Linkletter CD, Loucks EB. Inverse associations between perceived racism and coronary artery calcification. Ann Epidemiol 2012; 22:183-90. [PMID: 22365645 DOI: 10.1016/j.annepidem.2012.01.005] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2011] [Revised: 12/22/2011] [Accepted: 01/19/2012] [Indexed: 10/28/2022]
Abstract
PURPOSE To evaluate whether racial discrimination is associated with coronary artery calcification (CAC) in African-American participants of the Coronary Artery Risk Development in Young Adults (CARDIA) study. METHODS The study included American Black men (n = 571) and women (n = 791) aged 33 to 45 years in the CARDIA study. Perceived racial discrimination was assessed based on the Experiences of Discrimination scale (range, 1-35). CAC was evaluated using computed tomography. Primary analyses assessed associations between perceived racial discrimination and presence of CAC using multivariable-adjusted logistic regression analysis, adjusted for age, gender, socioeconomic position (SEP), psychosocial variables, and coronary heart disease (CHD) risk factors. RESULTS In age- and gender-adjusted logistic regression models, odds of CAC decreased as the perceived racial discrimination score increased (odds ratio [OR], 0.94; 95% confidence interval [CI], 0.90-0.98 per 1-unit increase in Experiences of Discrimination scale). The relationship did not markedly change after further adjustment for SEP, psychosocial variables, or CHD risk factors (OR, 0.93; 95% CI, 0.87-0.99). CONCLUSIONS Perceived racial discrimination was negatively associated with CAC in this study. Estimation of more forms of racial discrimination as well as replication of analyses in other samples will help to confirm or refute these findings.
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Affiliation(s)
- Nicholas J Everage
- Department of Epidemiology, Brown University, Providence, RI 02912, USA.
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Kroenke CH, Seeman T, Matthews K, Adler N, Epel E. Mood patterns based on momentary assessment of positive and negative moods over a day and coronary artery calcification in the CARDIA study. Psychosom Med 2012; 74:526-34. [PMID: 22685242 DOI: 10.1097/psy.0b013e3182583e68] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
OBJECTIVE Retrospective assessments of negative mood have predicted coronary artery disease development and progression. Using momentary assessment, we evaluated associations between average positive and negative mood states and diurnal mood patterns, with prevalent and incident coronary artery calcification (CAC), a measure of calcified atherosclerosis. METHODS In a prospective cohort study of 669 white and African American men and women, aged 33 to 45 years, from the Coronary Artery Risk Development in Young Adults Study, mood was assessed at Year 15 examination, six times over a weekday. Prevalent, progressive, and 5-year incident CAC (any detectable CAC [score >0]) and substantial CAC (CAC score ≥ 20) were assessed at examinations at Years 15 and 20 by electron-beam tomographic scans. We employed a modified Poisson regression approach for binary data with robust error estimation to quantify relative risk. RESULTS In multivariate-adjusted analyses, those with high-average positive mood that improved over a day had a lower risk of prevalent CAC higher than 0 (relative risk [RR] = 0.17 [95% confidence interval {CI} = 0.04-0.67]) and substantial CAC (RR = 0.25 [95% CI = 0.06-0.95]). In contrast, those with high-average, increasingly negative mood over a day had a higher risk of prevalent CAC (RR = 1.85 [95% CI = 0.86-3.99]) and substantial CAC (RR = 3.11 [95% CI = 1.29-7.49]). Findings were similar for progressive CAC at Year 20. This pattern of high/worsening negative mood (not positive mood) during the day was also predictive of 5-year incident CAC (RR = 2.99 [95% CI = 1.00-8.93]). CONCLUSIONS Diurnal mood patterns were associated with the progression of calcified atherosclerosis, with negative mood predicting greater progression and positive mood predicting lower progression.
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Kahler CW, McHugh RK, Leventhal AM, Colby SM, Gwaltney CJ, Monti PM. High Hostility Among Smokers Predicts Slower Recognition of Positive Facial Emotion. PERSONALITY AND INDIVIDUAL DIFFERENCES 2012; 52:444-448. [PMID: 22223928 DOI: 10.1016/j.paid.2011.11.009] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
High levels of trait hostility are associated with wide-ranging interpersonal deficits and heightened physiological response to social stressors. These deficits may be attributable in part to individual differences in the perception of social cues. The present study evaluated the ability to recognize facial emotion among 48 high hostile (HH) and 48 low hostile (LH) smokers and whether experimentally-manipulated acute nicotine deprivation moderated relations between hostility and facial emotion recognition. A computer program presented series of pictures of faces that morphed from a neutral emotion into increasing intensities of happiness, sadness, fear, or anger, and participants were asked to identify the emotion displayed as quickly as possible. Results indicated that HH smokers, relative to LH smokers, required a significantly greater intensity of emotion expression to recognize happiness. No differences were found for other emotions across HH and LH individuals, nor did nicotine deprivation moderate relations between hostility and emotion recognition. This is the first study to show that HH individuals are slower to recognize happy facial expressions and that this occurs regardless of recent tobacco abstinence. Difficulty recognizing happiness in others may impact the degree to which HH individuals are able to identify social approach signals and to receive social reinforcement.
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Gender as a moderator in the relationship between anxiety and carotid intima-media thickness: The PREVENCION study. Artery Res 2012. [DOI: 10.1016/j.artres.2012.11.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Menezes AR, Lavie CJ, Milani RV, O'Keefe J, Lavie TJ. Psychological risk factors and cardiovascular disease: is it all in your head? Postgrad Med 2011; 123:165-76. [PMID: 21904099 DOI: 10.3810/pgm.2011.09.2472] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Psychological stress has been shown to be associated with cardiovascular disease. Over the past few decades, there has been an increasing interest in this relationship, leading to a growing pool of clinical and epidemiological data on the subject. Psychological stress has multiple etiologies, which include behavioral causes, acute events or stressors, and/or chronic stress. Cardiac rehabilitation and exercise therapy have been shown to provide protection in primary and secondary coronary heart disease prevention, as well as improve overall morbidity and mortality. In this article, we review the available data regarding the association between psychological stress and cardiovascular disease, as well as the impact of cardiac rehabilitation and exercise therapy on psychological stress-related cardiovascular events.
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Affiliation(s)
- Arthur R Menezes
- Department of Cardiovascular Diseases, John Ochsner Heart and Vascular Institute Ochsner Clinical School-The University of Queensland School of Medicine, New Orleans, LA 70121-2483, USA
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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 before two electron beam computed tomographic 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, and 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 3 years (β = 0.16, p = .035, ΔR(2) = 0.03), whereas the psychosocial resources index was not predictive of CAC progression (β = -0.08, p = .30, ΔR(2) = 0.01). 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 = 0.20, p = .01, ΔR(2) = 0.03), 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 identify potential targets for psychological interventions to reduce cardiovascular risk.
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Newman JD, Davidson KW, Shaffer JA, Schwartz JE, Chaplin W, Kirkland S, Shimbo D. Observed hostility and the risk of incident ischemic heart disease: a prospective population study from the 1995 Canadian Nova Scotia Health Survey. J Am Coll Cardiol 2011; 58:1222-8. [PMID: 21903054 DOI: 10.1016/j.jacc.2011.04.044] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2010] [Revised: 04/19/2011] [Accepted: 04/21/2011] [Indexed: 11/13/2022]
Abstract
OBJECTIVES The aim of this study was to examine the relation between hostility and incident ischemic heart disease (IHD) and to determine whether observed hostility is superior to patient-reported hostility for the prediction of IHD in a large, prospective observational study. BACKGROUND Some studies have found that hostile patients have an increased risk of incident IHD. However, no studies have compared methods of hostility assessment or considered important psychosocial and cardiovascular risk factors as confounders. Furthermore, it is unknown whether all expressions of hostility carry equal risk or whether certain manifestations are more cardiotoxic. METHODS We assessed the independent relationship between baseline observed hostility and 10-year incident IHD in 1,749 adults of the population-based Canadian Nova Scotia Health Survey. RESULTS There were 149 (8.5%) incident IHD events (140 nonfatal, 9 fatal) during the 15,295 person-years of observation (9.74 events/1,000 person-years). Participants with any observed hostility had a greater risk of incident IHD than those without (p = 0.02); no such relation was found for patient-reported hostility. Those with any observed hostility had a significantly greater risk of incident IHD (hazard ratio: 2.06, 95% confidence interval: 1.04 to 4.08, p = 0.04), after adjusting for cardiovascular (age, sex, Framingham Risk Score) and psychosocial (depression, positive affect, patient-reported hostility, and anger) risk factors. CONCLUSIONS The presence of any observed hostility at baseline was associated with a 2-fold increased risk of incident IHD over 10 years of follow-up. Compared with patient-reported measures, observed hostility is a superior predictor of IHD.
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Affiliation(s)
- Jonathan D Newman
- Department of Medicine, Columbia University Medical Center, New York, New York 10032, USA
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Panduranga P, Sulaiman K, Al-Zakwani I, Abdelrahman S. Acute coronary syndrome in young adults from oman: results from the gulf registry of acute coronary events. Heart Views 2011; 11:93-8. [PMID: 21577375 PMCID: PMC3089825 DOI: 10.4103/1995-705x.76799] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVE To assess the prevalence, risk factors, presenting features, and in-hospital outcomes of acute coronary syndrome (ACS) patients ≤40 years of age from Oman. METHODS Data were analyzed from 1579 consecutive ACS patients from Oman during May, 2006 to June, 2007, as part of Gulf RACE (Registry of Acute Coronary Events). ACS patients ≤40 years of age were compared with patients >40 years of age. RESULTS A total of 121 (7.6%) patients were ≤40 years of age with mean age of 36 ± 4 vs. 61 ± 11 years in young and old adults, respectively (P<0.001). More men were seen in the younger age group (81 vs. 60%; P<0.001). Among all the coronary risk factors, young patients had more history of smoking (47 vs. 15%; P<0.001), obesity (72 vs. 58%; P = 0.009), and family history of coronary artery disease (CAD) (16 vs. 7%; P = 0.001). Both groups received aspirin, statins, thrombolytic therapy, and anticoagulants equally; however, younger patients received clopidogrel, glycoprotein IIb/IIIa inhibitors, β-blockers, and in-hospital coronary angiogram more. Younger patients experienced less heart failure (6 vs. 27%; P<0.001) and in-hospital mortality, especially among STEMI patients (0 vs. 10%; P = 0.037). CONCLUSIONS Young ACS patients from Oman have different risk profile. They were treated more aggressively and their outcome was better, which is similar to other populations. However, smoking, along with obesity and family history of CAD were strong risk factors in the young Omani ACS patients. There is a need for prevention programmes to control smoking and obesity epidemic by targeting young adults in the population.
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Cardiovascular and psychological reactivity and recovery from harassment in a biracial sample of high and low hostile men and women. Int J Behav Med 2011; 18:52-64. [PMID: 20635176 DOI: 10.1007/s12529-010-9110-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
BACKGROUND This study emphasizes the importance of studying the emotional, motivational, and cognitive characteristics accompanying and the potential hemodynamic mechanisms underlying cardiovascular reactivity to and recovery from interpersonal conflict. PURPOSE The relation of dispositional hostility to cardiovascular reactivity during a frustrating anagram task and post-task recovery was investigated. METHODS The sample was composed of 99 healthy participants (age, 18-30 years; 53% women; 51% Caucasian; 49% African American)-half randomly assigned to a harassment condition. High and low hostility groups were created by a median split specific to sex and race subgroup score distributions on the Cook-Medley Hostility Scale. It was hypothesized that hostility would interact with harassment such that harassed, high hostile individuals would display the greatest cardiovascular and emotional reactivity and slowest recovery of the four groups. Participants completed a 10-min baseline, a 6-min anagram task, and a 5-min recovery period with blood pressure, heart rate, pre-ejection period, stroke index, cardiac index, and total peripheral resistance index measured. RESULTS Harassed participants displayed significantly greater cardiovascular responses and lower positive affect to the task and slower systolic blood pressure (SBP) recovery than did nonharassed participants. The high hostile group, irrespective of harassment, showed blunted cardiovascular responses during the task and delayed SBP recovery than the low hostile group. CONCLUSION Although the predicted interaction between hostility and harassment was not supported in the context of cardiovascular responses, such an interaction was observed in the context of blame attributions, whereby harassed hostile participants were found to blame others for their task performance than the other subgroups.
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Affiliation(s)
- Carl J Lavie
- Department of Cardiovascular Diseases, John Ochsner Heart and Vascular Institute, Ochsner Clinical School, The University of Queensland School of Medicine, New Orleans, LA 70121, USA.
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Tindle H, Davis E, Kuller L. Attitudes and cardiovascular disease. Maturitas 2011; 67:108-13. [PMID: 20554132 DOI: 10.1016/j.maturitas.2010.04.020] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2010] [Revised: 04/28/2010] [Accepted: 04/30/2010] [Indexed: 11/17/2022]
Abstract
Psychological attitudes are prospectively related to cardiovascular disease (CVD), but a causal relationship has not been demonstrated. Trait optimism/pessimism (positive or negative future expectation, respectively), and cynical hostility (mistrust of people), are attitudes with features of personality traits. These attitudes may affect CVD risk in several ways, by influencing an individual's (1) adoption of health behaviors, (2) maladaptive stress responding resulting in direct alteration of physiology (i.e., autonomic dysfunction, thrombosis, arrhythmias), (3) development of traditional CVD risk factors, and (4) lack of adherence to therapy in both primary and secondary prevention. More adaptive attitudes may favorably influence CVD risk at each of these critical junctures. The genetic and environmental (i.e., social, economic, racial/ethnic) determinants of attitudes have not been extensively studied. In addition, it is important to understand how some of these environmental determinants may also moderate the association between attitudes and CVD. Clinical trials to modify attitudes for CVD risk reduction (either by reducing negative attitudes or by increasing positive attitudes) are difficult to conduct, but are necessary to determine whether attitudes can indeed be modified, and if, so, to quantify any CVD-related benefits. To address these questions we present a broad, multidisciplinary research agenda utilizing mixed methods and integrating principles of epidemiology, genetics, psychophysiology, and behavioral medicine over the lifecourse (first figure). This overview focuses on attitudes and CVD, but has broader implications for understanding how psychological factors relate to chronic diseases of adulthood.
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Affiliation(s)
- Hilary Tindle
- Division of General Internal Medicine, University of Pittsburgh, 230 McKee Place, Suite 600, Pittsburgh, PA 15213, USA.
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Abstract
OBJECTIVE To assess how clinical and psychological variables compare in their ability to predict coronary artery calcium (CAC) in a broad spectrum of subjects. Although prior studies reported contradictory findings on the association between psychological risk factors and CAC, psychological risk factors have not yet been compared with concurrent clinical coronary risk factors for their association to CAC measurements. METHODS We performed research CAC scans in three cohorts: 1,111 healthy volunteers; 138 asymptomatic patients; and 600 symptomatic patients. All subjects completed questionnaires designed to assess clinical and psychological coronary artery disease (CAD) risk factors, including measurements of depression, hostility, social support, perceived stress, job strain, and optimism. A serum sample was obtained to assess lipid parameters and glucose. All variables were compared for their correlation to CAC scores. RESULTS We observed a marked lack of association between psychosocial risk factors and CAC scores in each cohort. For symptomatic patients only, there was a modest negative correlation between depression and CAC scores (r = -.19, p < .001). Most CAD risk factors were also not associated with CAC. Once age and gender were considered as multivariable predictors of CAC, neither psychological nor CAD risk factors added to prediction of CAC. CONCLUSIONS Both psychological and clinical risk factors are poorly correlated with concurrent measurements of CAC. Given our findings and previously established associations of these risk factors to cardiac events, further assessment of the relationship between chronicity of these risk factors and coronary atherosclerosis could be of interest. Our findings cast doubt on the use of CAC scanning as a surrogate means for assessing the clinical significance of both concurrently measured psychological and clinical risk factors.
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Ethnic and gender differences in the relationship between hostility and metabolic and autonomic risk factors for coronary heart disease. Psychosom Med 2011; 73:53-8. [PMID: 20947780 DOI: 10.1097/psy.0b013e3181fd944c] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
OBJECTIVE To examine the relationship between hostility and biological risk factors for coronary heart disease (CHD) in a population of white European and South Asian men and women living in the United Kingdom. METHODS This cross-sectional study involved a community-based sample of 1,757 healthy white and South Asian men and women aged between 35 years and 75 years from West London. Participants completed the Cook-Medley Hostility Scale, together with measures of standard biological risk factors and heart rate variability. Associations between hostility and CHD risk factors were evaluated, controlling for age, education, smoking, physical activity, body mass index, and waist/hip ratio, using regression models. RESULTS In white men, hostility was associated positively with fasting glucose, glycosylated hemoglobin, and negatively with high-density lipoprotein cholesterol. High levels of hostility were also related to increased prevalence of diabetes and the metabolic syndrome in white men. Hostility in South Asian men was associated with impaired autonomic function. Hostility was not related to any biological CHD risk factors in South Asian or white women. CONCLUSIONS Our results showed that hostility was independently associated with glucose metabolism and dyslipidemia in white men, and with autonomic dysfunction in South Asian men. Hostility was found not to be relevant for measured CHD risk factors in females. Longitudinal data are required to establish whether the impact of hostility on CHD risk in men is mediated through metabolic and autonomic processes.
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