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Mediation and Modification of the Association Between Hopelessness, Hostility, and Progression of Carotid Atherosclerosis

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Abstract

Hopelessness and hostility are linked to progression of carotid atherosclerosis (PCA). The purpose of this study was to replicate such relations and to evaluate the role of biological pathways involving hyperactivation of the sympathetic nervous system (SNS) and the hypothalamic–pituitary–adrenocortical (HPA) axis. PCA was evaluated by 4-year change in three ultrasound measures of intima-media thickness (IMT) in 1027 men aged 42–60 years at baseline. Effect modification and mediation of relationships between psychosocial factors and PCA were examined for the measures systolic blood pressure (SBP), fibrinogen, and waist-to-hip ratio (WHR), levels of which are indicative of activity along these pathways. Hopelessness and hostility were associated with PCA. Fibrinogen mediated to a moderate extent the association between hopelessness and PCA. SBP significantly modified the relation between hostility and PCA in participants of moderate hostility. The above biological pathways are implicated in the mechanisms connecting hopelessness, hostility, and PCA.

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Authors and Affiliations

  1. Department of Epidemiology, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina

    Ricardo A. Pollitt, Mark Daniel & Jay S. Kaufman

  2. Département de Médecine Sociale et Preventive, l’ Université de Montréal, Montreal, Quebec

    Mark Daniel

  3. Department of Epidemiology, Center for Social Epidemiology and Population Health, The University of Michigan, Ann Arbor, Michigan

    John W. Lynch & George A. Kaplan

  4. Research Institute of Public Health and Department of Public Health and General Practice, The University of Kuopio, Kuopio, Finland

    Jukka T. Salonen

  5. Inner Savo Health Centre, Suonenjoki, Finland

    Jukka T. Salonen

  6. Department of Epidemiology, School of Public Health, The University of North Carolina, Campus Box # 7435, Chapel Hill, North Carolina, 27599-7435

    Ricardo A. Pollitt

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  1. Ricardo A. Pollitt
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Pollitt, R.A., Daniel, M., Kaufman, J.S. et al. Mediation and Modification of the Association Between Hopelessness, Hostility, and Progression of Carotid Atherosclerosis. J Behav Med 28, 53–64 (2005). https://doi.org/10.1007/s10865-005-2563-y

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