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Physical Aggression and Coronary Artery Calcification: A North Texas Healthy Heart Study
Kimberly G Fulda1, Karen L Roper2, Claude H Dotson2
1North Texas Primary Care Practice-Based Research Network (NorTex), Department of Family Medicine and Osteopathic Manipulative Medicine, Texas College of Osteopathic Medicine, University of North Texas Health Science Center, Fort Worth, TX, USA. Kimberly.Fulda@unthsc.edu.
Insights
Physical aggression, a component of hostility, is linked to coronary artery calcification (CAC) in adults over 45. This finding highlights the importance of psychosocial factors in cardiovascular risk assessment.
Area of Science:
- Cardiology
- Psychosocial Medicine
- Public Health
Background:
- Coronary artery calcification (CAC) is a marker of atherosclerosis.
- Hostility is a psychosocial factor that may influence cardiovascular health.
- Understanding the specific components of hostility related to CAC is crucial for risk stratification.
Purpose of the Study:
- To investigate the association between different subtypes of hostility and coronary artery calcification (CAC) scores.
- To determine if specific manifestations of aggression correlate with the presence of CAC.
Main Methods:
- A cohort of 571 patients (age ≥ 45, no prior cardiovascular disease) underwent assessments.
- Psychosocial factors, including hostility subtypes (Physical, Verbal, Anger, Hostility Aggression) via the Aggression Questionnaire, were evaluated.
- Logistic regression analysis was employed to assess the relationship between hostility measures and CAC presence.
Main Results:
- Physical aggression was significantly associated with an increased odds of coronary artery calcification (CAC).
- A 5% increase in CAC odds was observed for each point increase in physical aggression.
- Adjusted analyses confirmed this association and identified age, gender, race/ethnicity, BMI, and dyslipidemia as other significant factors for CAC.
Conclusions:
- Physical aggression emerges as a significant psychosocial predictor of coronary artery calcification.
- These findings underscore the need to incorporate psychosocial factors, specifically physical aggression, into cardiovascular risk stratification models.
- Further research into the mechanisms linking aggression and atherosclerosis is warranted.
Background:
The purpose of this study was to determine the association between aspects of hostility and coronary artery calcification (CAC) scores. Specifically, analyses differentiated between subtypes of hostility and their relation to CAC.
Methods:
A sample of 571 patients aged 45 or older with no history of cardiovascular disease completed assessments of demographic, psychosocial, and medical history, along with a radiological CAC determination. Logistic regression was used to determine the association between hostility and CAC. Hostility was measured using the Aggression Questionnaire, which measured total aggression and how aggression is manifested on four scales: Physical, Verbal, Anger, and Hostility Aggression.
Results:
Regression analyses indicated that only the physical aggression parameter was related to CAC: a 5% increase in odds of CAC presence was indicated for every point increase in physical aggression. The association remained significant in adjusted analyses. Other factors associated with CAC in adjusted analyses included: age, gender, race/ethnicity, BMI, and dyslipidemia.
Conclusions:
Psychosocial factors, such as physical aggression, are emerging factors that need to be considered in cardiovascular risk stratification.
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