Relation between psychological strain and carotid atherosclerosis in a general population

Objective: To investigate the hypothesis that psychological strain is related to carotid atherosclerosis in a large general population sample. Methods: Intima - media thickness and the prevalence of atherosclerotic plaques in the carotid arteries were quantitatively assessed by high resolution ultrasound among 2164 participants ( 1112 women and 1052 men, aged 45 to 75 years) of the SHIP ( study of health in Pomerania), an epidemiological survey of a random sample of the population of north eastern Germany. Psychological strain was measured by 13 items reflecting typical psychological complaints. Each item was graded by the study participants on a four point scale ( from 0, absent, to 3, severe) and a psychological strain score was generated by summing these 13 items. Results: Mean psychological strain score was 10.8 (7.0) ( median score 10) among women and 8.5 (6.2) ( median score 8) among men. Psychological strain did not predict carotid intima - media thickness among either men or women. However, after adjustment for covariates, high psychological strain and carotid plaques were independently and linearly related, with plaque prevalence odds of 1.03 (95% confidence interval (CI) 1.01 to 1.05, p = 0.009) per increment of the psychological strain score among women and 1.04 ( 95% CI 1.01 to 1.07, p = 0.003) among men. Conclusions: This study identified a relation between general psychological strain and carotid atherosclerosis.