Hostility, social support, and carotid artery atherosclerosis in the National Heart, Lung, and Blood Institute family heart study

This cross-sectional study investigates the association of hostility and so cial support (measured by standardized instruments) to carotid artery ather osclerosis in men and women with a high familial risk for coronary heart di sease (CHD) and those with low to medium risk. The hypothesis was that high hostility and low social support would have a stronger association in subj ects with a familial predisposition to CHD. There were 535 low- to medium-r isk women, 491 low- to medium-risk men, 1,950 high-risk women, and 1,667 hi gh-risk men in the study. The extent of carotid artery atherosclerosis was assessed by B-mode ultrasound imaging. A lesion was defined as an intimal-m edial far wall thickness of 1 mm in the common, internal, or carotid bifurc ation, or identification of plaque at any site. Odds ratios and their 95% c onfidence intervals were calculated using generalized estimating equations (GEE) for logistic regression. Family was specified as the clustering varia ble, and robust SEEs were obtained that account for dependence of the data within families. After controlling for age, education, body mass index, eve r having smoked, ever drinking >5 drinks a day, and metabolic index, hostil ity was significantly associated with increased odds of carotid lesions in only high-risk women. High-risk women showed a significantly reduced odds o f carotid lesions with high social support, but the extent of this protecti on was reduced when age and education were included in the equation. A comb ination of high hostility and low social support was associated with higher odds than hostility alone in both high-risk men and women. These results s uggest that women with a high familial predisposition for CHD may be more v ulnerable to cardiovasculor influences from hostility and social support th an high-risk men or men and women with low to medium risk. (C) 2000 by Exce rpta Medica, Inc.