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(Arteriosclerosis, Thrombosis, and Vascular Biology. 2001;21:136.)
© 2001 American Heart Association, Inc.

Atherosclerosis and Lipoproteins

Sustained Anxiety and 4-Year Progression of Carotid Atherosclerosis

Sabrina Paterniti; Mahmoud Zureik; Pierre Ducimetière; Pierre-Jean Touboul; Jean-Marc Fève; Annick Alpérovitch

From the National Institute of Health and Medical Research (INSERM), Unit 360 (S.P., A.A.), Unit 258 (M.Z., P.D.), Centre de Diagnostic et de Prévention Neurovasculaire (P.-J.T.), and Centre d’Examen EVA-INSERM (J.-M.F.), Nantes, France.

Correspondence to Dr Sabrina Paterniti, INSERM U360 Hôpital de la Salpêtrière, 84 bd. de l’Hôpital, 75651 Paris Cedex 13, France. E-mail paternit{at}chups.jussieu.fr

Abstract—Several studies have shown that anxiety disorders are associated with a higher risk of coronary artery disease. However, the relationship between anxiety disorders and atherosclerosis has been studied to a lesser extent. The goal of this study was to examine whether high and stable trait anxiety was associated with the progression of atherosclerosis. The study group consisted of 726 subjects (297 men and 429 women), aged 59 to 71 years, recruited from the electoral rolls of the city of Nantes. The subjects had no history of coronary artery disease at baseline evaluation and or at the 2-year follow-up. Two follow-up examinations were conducted 2 and 4 years after the baseline evaluation. Trait anxiety was evaluated by means of the French translation of the Spielberger Inventory (a 20-item trait inventory, form X-2). The "sustained anxiety" group consisted of men and women with the highest Spielberger Inventory scores at baseline and at the 2-year follow-up examination. Each ultrasound examination included measurement of intima-media thickness and the sites of plaque in the extracranial carotid arteries. Men with sustained anxiety showed a higher 4-year increase of common carotid intima-media thickness than did men without sustained anxiety (adjusted means 0.08 versus 0.04 mm, respectively; P=0.05) and a higher risk of 4-year plaque occurrence (adjusted OR 3.5, 95% CI 1.4 to 8.5). Among women, sustained anxiety was associated with a higher 4-year increase of common carotid intima-media thickness (0.07 versus 0.04 for women with versus women without sustained anxiety, respectively; P=0.07). These results suggest that chronically high levels of anxiety may contribute to accelerating the evolution of carotid atherosclerosis.

Key Words: trait anxiety • carotid arteries • atherosclerosis • longitudinal studies

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