Psychological factors like anger and anxiety are associated with impaired artery function in healthy postmenopausal women, which could put them at greater risk for heart disease, a new study reports. Hormone replacement therapy provides some artery protection for women with high levels of anger and Type A behavior (exhibiting competitive, impatient and aggressive feelings), but not for women with anxiety or depression, according to Kelly F. Harris and Karen A. Matthews, of the University of Pittsburgh School of Medicine.
The study, appearing in the current issue of Psychosomatic Medicine, is the first to link these psychological traits to impaired artery function in healthy women.
Psychological traits could affect blood vessel function through several pathways, the researchers say. Previous studies have linked anger, hostility and depression to unhealthy behaviors like eating a high-fat diet, smoking, lack of exercise and alcohol abuse. Stress can also affect the part of the body's nervous system that controls blood vessel function.
The 193 women in the study received psychological evaluations before and after menopause and an examination of a major arm artery post-menopause. Harris and colleagues used ultrasound imaging to watch how well the artery dilated in response to a stimulus. Inability of the blood vessels to dilate can be an early sign of narrowed and hardened arteries, or atherosclerosis.
Women who had high levels of anger and Type A behavior and or high levels of anxiety and depression also had the lowest amount of artery dilation, say the researchers.
The association was the same whether the traits were measured pre- or postmenopausal, although the women who took hormone replacement therapy post-menopause were protected somewhat from the effects of anger and aggression.
"Trait anxiety may be a more 'toxic' characteristic in relation to artery function than the other psychosocial traits and could therefore be more resistant to protective factors, such as hormone replacement therapy," Harris suggests.
In premenopausal women, estrogen and other circulating hormones help blood vessels maintain their function, which may explain why replacement therapy provides some artery protection in healthy postmenopausal women, the researchers say.
