Crispell Studies Psychosocial Influences on Cardiovascular Health

By Purnell T. Cropper | July 7, 2010

Molly Dale Crispell, who earned a Master of Public Health degree in May, conducted her thesis on “Psychosocial Influences on Endothelial Health in Adults with Cardiovascular Risk Factors.” The purpose of her study was to assess the influence of aggression, depression, stress, anxiety, and rumination on endothelial function.

Crispell concluded that the study “revealed significant associations between measures of hostility, depression, and anxiety and endothelial dysfunction. Individuals with mild to moderate biological risk factors for CVD may benefit from management or reduction of harmful psychosocial characteristics. Further research is needed to elucidate connections between psychological and cardiovascular well-being.”

“Cardiovascular disease (CVD) is the leading cause of mortality and morbidity in the United States (American Heart Association, 2006). In addition to traditional risk factors such as high cholesterol, high blood pressure, and obesity (Vogel & Benitez, 2000), CVD is also influenced by emerging physiological factors such as endothelial function (Landmesser, Hornig, & Drexler, 2004) and psychological characteristics such as aggression, depression, stress, anxiety, and rumination (Bunker et al., 2003),” Crispell wrote in her abstract.

Crispell’s study group consisted of “61 healthy adults with one or more CVD risk factors (hypertension, hypertriglyceridemia, hyperlipidemia, pre-diabetes, and obesity). Endothelial function was assessed using EndoPAT 2000, a non-invasive office-based device. Psychological characteristics were assessed using seven research-established questionnaires: the 26-item Cook Medley Hostility Scale; the Positive and Negative Affect Scale; the Center for Epidemiologic Studies Depression Scale; the Spielberger State Anxiety Inventory; the Spielberger Trait Anxiety Inventory; the Perceived Stress Scale; and, the Ruminative Response Scale. Statistical analyses were conducted using SPSS for Windows, Release 11.0.1.

“Results: Thirty-six percent of the subjects were identified as having endothelial dysfunction. Most mean psychosocial measures were similar to reported norms. Measures of hostility, aggression, depression, anxiety, stress, and rumination were significantly inter-correlated. Hostility (r = 0.25, p = 0.045) and cynicism (r = 0.34, p = 0.008) were positively correlated with total cholesterol/high density lipoprotein ratios. Aggressive responding (β = -0.76, p = 0.009), negative affect (β = -0.71, p = 0.040), and grouped measures of hostility (F = 3.13, p = 0.043) and depression (F = 6.60, p = 0.008) were most predictive of endothelial dysfunction.”