Document Detail

Lack of correlation between psychological factors and subclinical coronary artery disease.
MedLine Citation:
PMID:  11058674     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: The relation between psychological variables and clinically evident coronary artery disease has been studied extensively, although the potential mechanisms of such a relation remain speculative. We studied the relation between multiple psychological variables and subclinical coronary artery disease to assess the possible role of such variables in atherogenesis. METHODS: We conducted a prospective study of 630 consecutive consenting, active-duty U.S. Army personnel, 39 to 45 years of age, without known coronary artery disease. Each participant was assessed for depression, anxiety, somatization, hostility, and stress. Subclinical coronary artery disease was identified by electron-beam computed tomography. RESULTS: The mean (+/-SD) age of the subjects was 42+/-2 years; 82 percent were male, and 72 percent were white. The prevalence of coronary-artery calcification was 17.6 percent (mean calcification score, 10+/-49). The prevalence of prior or current psychiatric disorders was 12.7 percent. There was no correlation between the coronary-calcification score and the scores measuring depression (r= -0.07, P=0.08), anxiety (r=-0.07, P=0.10), hostility (r=-0.07, P=0.10), or stress (r=-0.002, P=0.96). Somatization (the number and severity of durable physical symptoms) was inversely correlated with calcification scores (r=-0.12, P=0.003), even after we controlled for age and sex. In multivariate logistic-regression models, a somatization score greater than 4 (out of a possible 26) was independently associated with the absence of any coronary-artery calcification (odds ratio, 0.49; 95 percent confidence interval, 0.25 to 0.96). CONCLUSIONS: Our data suggest that depression, anxiety, hostility, and stress are not related to coronary-artery calcification and that somatization is associated with the absence of calcification.
P G O'Malley; D L Jones; I M Feuerstein; A J Taylor
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The New England journal of medicine     Volume:  343     ISSN:  0028-4793     ISO Abbreviation:  N. Engl. J. Med.     Publication Date:  2000 Nov 
Date Detail:
Created Date:  2000-10-20     Completed Date:  2000-11-02     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0255562     Medline TA:  N Engl J Med     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1298-304     Citation Subset:  AIM; IM    
Department of Medicine, Walter Reed Army Medical Center, Washington, DC, USA.
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MeSH Terms
Anxiety / complications
Calcinosis / classification,  psychology*,  radiography
Coronary Artery Disease / radiography
Coronary Disease / classification,  psychology*,  radiography
Depression / complications
Logistic Models
Middle Aged
Prospective Studies
Somatoform Disorders / complications*
Stress, Psychological / complications
Comment In:
N Engl J Med. 2001 Feb 22;344(8):608-9; author reply 610-1   [PMID:  11221626 ]
N Engl J Med. 2001 Feb 22;344(8):609-10; author reply 610-1   [PMID:  11221627 ]
N Engl J Med. 2001 Feb 22;344(8):610; author reply 610-1   [PMID:  11221629 ]
N Engl J Med. 2001 Feb 22;344(8):609; author reply 610-1   [PMID:  11221628 ]

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