Psychological risk factors and the metabolic syndrome in patients with coronary heart disease: Findings from the Heart and Soul Study |
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| Authors: | Beth E. Cohen Praveen Panguluri Beeya Na Mary A. Whooley |
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| Affiliation: | 1. Freemasons Foundation Centre for Men''s Health, Discipline of Medicine, School of Medicine, The University of Adelaide, Australia;2. Department of Rehabilitation Psychology and Psychotherapy, Institute of Psychology, University of Freiburg, Germany;3. Clinic of Psychiatry and Psychotherapy II, University of Ulm, Gunzburg, Germany;1. EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands;2. Department of Health Sciences, VU University Medical Center, Amsterdam, The Netherlands;3. Department of Psychiatry, VU University Medical Center, Amsterdam, The Netherlands;4. Department of General Practice, VU University Medical Center, Amsterdam, The Netherlands;5. Diabetes Center, Department of Internal Medicine, VU University Medical Center, Amsterdam, The Netherlands;6. Department of Psychiatry, Leiden University Medical Center, Leiden, The Netherlands;7. Department of Psychiatry, University Medical Center Groningen, Groningen, The Netherlands;1. EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands;2. Department of Psychiatry, VU University Medical Center, Amsterdam, The Netherlands;3. Department of Health Sciences, VU University Medical Center, Amsterdam, The Netherlands;4. Department of Psychiatry, Leiden University Medical Center, Leiden, The Netherlands;5. Department of Psychiatry, University Medical Center Groningen, Groningen, The Netherlands;1. Department of Psychiatry, Massachusetts General Hospital, Boston, MA;2. Harvard Medical School, Boston, MA;3. Department of Neurology, Massachusetts General Hospital, Boston, MA;4. Interdisciplinary Center Psychopathology and Emotion Regulation, Department of Psychiatry, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands;1. Department of Psychosomatic and General Internal Medicine, University of Heidelberg, Medical Hospital, Heidelberg, Germany;2. Department of Psychosomatic Medicine and Psychotherapy, Klinikum rechts der Isar München, Munich, Germany |
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| Abstract: | Psychological factors, such as depression and anxiety, are independently associated with an increased risk of both diabetes mellitus and cardiovascular disease, but the reasons for these associations are unknown. We sought to determine whether psychological factors were associated with a greater prevalence of the metabolic syndrome in patients with coronary heart disease, and the extent to which such an association may be explained by socioeconomic status, health behaviors, and biological mediators. We conducted a cross-sectional study of 1024 outpatients with stable coronary heart disease. Psychological factors, including depressive and anxiety symptoms, hostility, anger, and optimism–pessimism, were assessed using validated standardized questionnaires. The presence or absence of the metabolic syndrome was determined using the criteria outlined by the National Cholesterol Education Program, Adult Treatment Panel III. Higher levels of depression, anger expression, hostility, and pessimism were significantly associated with increased prevalence of the metabolic syndrome. These associations were explained by differences in socioeconomic status and health behaviors. Additional adjustment for potential biological mediators had little impact. Further research is needed to determine whether addressing socioeconomic and behavioral factors in people with depression or high levels of anger or hostility could reduce the burden of the metabolic syndrome. |
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