Relationship of alexithymia to cardiovascular disease risk factors among African Americans

Alexithymia, a deficit in emotional awareness and expression, may contribute to cardiovascular disease (CVD) and other diseases. African Americans have a high prevalence of CVD, but almost nothing is known about alexithymia in this ethnic group. This study examined the relationship of alexithymia to a range of risk factors for CVD among African Americans.

On a community sample of 162 African American adults, we assessed alexithymia (Toronto Alexithymia Scale-20) and several risk factor domains: physiological (body mass index, blood pressure), behavioral (smoking, exercise), emotional (trait anxiety, depression, and anger; forms of anger expression), racial discriminatory, and socioeconomic (income, education).

Alexithymia was positively correlated with all emotional risk factors (P < .01) and inversely correlated with socioeconomic status (P < .01). Alexithymia has a small, inverse relationship with responses to racism (P < .01) but was not significantly related to the experience of racism. Alexithymia was weakly related to smoking but was unrelated to physiological risk factors. These relationships were largely unchanged when only people without hypertension (n = 116) were studied.

This pattern of relationships is consistent with findings on ethnic majority samples and suggests that alexithymia as measured with the Toronto Alexithymia Scale-20 is a valid construct among African Americans. It correlates with socioeconomic and emotional variables in this population, but only minimally or not at all with behavioral or physiological factors. If alexithymia influences CVD and other diseases, it appears to do so through social and emotional pathways.