Carotid arterial wall thickness, measured as intima-media thickness (IMT), is an early subclinical indicator of cardiovascular disease. Few studies have investigated the association of psychological factors with IMT across multiple ethnic groups and by gender.
We included 6,561 men and women (2,541 whites, 1,790 African Americans, 1,436 Hispanics, and 794 Chinese) aged 45 to 84 years who took part in the first examination of the Multi-Ethnic Study of Atherosclerosis. Associations of trait anger, trait anxiety, and depressive symptoms with mean values of common carotid artery (CCA) and internal carotid artery (ICA) IMTs were investigated using multivariable regression and logistic models.
In age, gender, race/ethnicity-adjusted analyses, the trait anger score was positively associated with CCA and ICA IMTs (mean differences per one SD increment of trait anger score were 0.014 (95% CI, 0.003–0.025, p=0.01) and 0.054 (0.017–0.090, p=0.004) for CCA and ICA IMTs respectively). Anger was also associated with the presence of carotid plaque (age, gender, and race/ethnicity-adjusted odds ratio per one SD increase in trait anger: 1.27 (95%CI, 1.06–1.52)). The associations of the trait anger score with thicker IMT was attenuated after adjustment for covariates, but remained statistically significant. Associations were stronger in men than in women and in whites than in other race/ethnic groups but heterogeneity was only marginally statistically significant by race/ethnicity. There was no association of depressive symptoms or trait anxiety with IMT.
Only one of the three measures examined was associated with IMT and the patterns appeared to be heterogeneous across race/ethnic groups.