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, M.S., and Karen A. Matthews, Ph.D. of the
University of Pittsburgh School of Medicine and colleagues.
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.
The study was supported by the National Institutes of Health and the Pittsburgh
Mind-Body Center.
