Abstract
PurposeTo elucidate possible independent associations of psychological resources with inflammatory markers, all linked with coronary heart disease (CHD).MethodIn a middle-aged general population (n = 944), psychological resources (coping, self-esteem, and sense of coherence (SOC)), a global measure of quality of life (Cantril’s self-anchoring ladder, also called “ladder of life”), and psychological risk factors (hopelessness, vital exhaustion, and depressive symptoms) were used in linear regression models to evaluate associations with the inflammatory markers interleukin (IL)-6, C-reactive protein (CRP), and matrix metalloproteinase (MMP)-9. Adjustments were done for age, sex, medical conditions, and cardiovascular risk factors.ResultsAfter full adjustments, self-esteem was independently associated with all three biomarkers. Ladder of life was associated with IL-6 and log-CRP; coping, vital exhaustion, and depressive symptoms with IL-6; and SOC with MMP-9 (p < 0.05 for all associations).ConclusionNumerous significant associations of psychological resources and risk factors with IL-6, CRP, and MMP-9 were found in a community-based sample. The associations of psychological resources were mostly independent, while the psychological risk factors seemed preferentially dependent on lifestyle factors as smoking, physical activity, and body mass index (BMI). This suggests that the psychological resources’ (in particular self-esteem) protective effects on CHD are linked to inflammatory markers.
Highlights
There is abundant evidence that psychological distress is independently associated with risk for somatic disease and mortality
Numerous significant associations of psychological resources and risk factors with IL-6, C-reactive protein (CRP), and matrix metalloproteinase (MMP)-9 were found in a community-based sample
The associations of psychological resources were mostly independent, while the psychological risk factors seemed preferentially dependent on lifestyle factors as smoking, physical activity, and body mass index (BMI)
Summary
There is abundant evidence that psychological distress is independently associated with risk for somatic disease and mortality. Perceived stress [1, 2], anxiety [2], depressiveness [2,3,4,5], vital exhaustion [6], and hopelessness [7] have been prospectively associated with incidence and/or mortality of coronary heart disease (CHD). It was concluded that self-esteem seems to be of high relevance, as its cardioprotective effect remained after adjustment for depression or hopelessness [12]. This raises the question through which pathways psychological factors exert their effects of CHD
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