Association of hostility with coronary artery calcification in young adults - The CARDIA study

Context Psychosocial factors, including personality and character traits, m ay play a role in the development and expression of coronary artery disease . Objective To evaluate whether hostility, a previously reported predictor of clinical coronary artery disease, is associated with coronary calcificatio n, which is a marker of subclinical atherosclerosis. Design Prospective cohort study. Setting and Participants Volunteer subsample from Chicago, ill, and Oakland , Calif, consisting of 374 white and black men and women, aged 18 to 30 yea rs at baseline, who participated in the Coronary Artery Risk Development in You ng Adults (CARDIA) study. Cook-Medley hostility assessment data were c ollected at baseline from 1985 to 1986 and at year 5 examinations from 1990 to 1992. After the 10-year examinations in the 1995-1996 year, electron-be am computed tomographic scans were performed. Main Outcome Measures Presence of any detectable coronary artery calcificat ion (coronary calcium score >0), and coronary artery calcium scores of 20 o r higher. Results In logistic regression analysis adjusting for age, sex, race, and f ield center comparing those with hostility scores above and below the media n of the distribution of the present sample, the odds ratio of having any c oronary calcification was 2.57 (95% confidence interval, 1.31-5.22), and th e odds ratio of having a calcium score of 20 or higher was 9.56 (95% confid ence interval. 2.29-65.9) for calcium scores of 20 or higher. The associati ons with any coronary artery calcification persisted after adjusting for de mographic, lifestyle, and physiological variables. Results using a cynical distrust subscale were somewhat weaker than for those using the global host ility score. Power was inadequate to perform sex- or race-specific analyses . Conclusion These results suggest that a high hostility level may predispose young adults to coronary artery calcification.