Psychological factors and subclinical atherosclerosis in postmenopausal Chinese women in Hong Kong

Abstract

Background: Substantial evidence shows that psychological factors are associated with cardiovascular diseases. However, data on the association between psychological factors and subclinical atherosclerosis is lacking in postmenopausal Chinese women.

Objectives: To examine the associations of perceived stress and trait anxiety with subclinical atherosclerosis in postmenopausal Chinese women in Hong Kong. Their relationships with biological and behavioral risk factors were also examined.

Methods: Between 2002 and 2004, we recruited 518 postmenopausal women aged 50-64 years. Perceived stress and trait anxiety were evaluated by the perceived stress scale and the state-trait anxiety inventory, respectively. Subclinical atherosclerosis was determined by measuring carotid intima-media thickness (IMT) and plaque using B-mode ultrasonography.

Results: Perceived stress and trait anxiety showed no significant association with IMT or plaque. Multivariate analyses showed high perceived stress scores were associated with an increased risk of elevated total cholesterol (OR=2.10; 95% CI=1.17-3.77) and elevated low-density lipoprotein cholesterol (LDL-C) (OR=2.39; 95% CI=1.36-4.21). High trait anxiety scores were associated with a 2.7-fold risk of elevated LDL-C (OR=2.74; 95% CI=1.56-4.80). Women with high perceived stress or trait anxiety scores were more likely to be physically inactive.

Conclusions: Perceived stress and trait anxiety were associated with atherogenic lipid levels, but not subclinical atherosclerosis. Maintaining high physical activity may help alleviate psychological stress and anxiety.