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Vital exhaustion and retinal microvascular changes in cardiovascular disease: atherosclerosis risk in communities study.

TitleVital exhaustion and retinal microvascular changes in cardiovascular disease: atherosclerosis risk in communities study.
Publication TypeJournal Article
Year of Publication2009
AuthorsCheung N, Rogers S, Mosley TH, Klein R, Couper D, Wong TY
JournalPsychosom Med
Volume71
Issue3
Pagination308-12
Date Published2009 Apr
ISSN1534-7796
KeywordsAged, Community Health Services, Coronary Artery Disease, Depression, Fatigue, Female, Humans, Male, Microcirculation, Middle Aged, Retinal Diseases, Risk Factors
Abstract

OBJECTIVE: To determine if vital exhaustion, a measure of negative emotion, is associated with microvascular changes in the retina. Negative psychological factors, such as depression, have been implicated in the development of cardiovascular disease. Whether this link is mediated by macrovascular or microvascular disease is unknown.

METHODS: We performed a population-based, cross-sectional study of 10,364 White and African Americans aged 48 to 73 years. Vital exhaustion scores were determined from the Maastricht questionnaire and categorized into quartiles. Retinopathy signs and retinal vascular caliber were graded from retinal photographs following standardized protocols.

RESULTS: After adjusting for age, gender, race, study center, education, smoking, blood pressure, diabetes, and other risk factors, higher vital exhaustion scores (highest versus lowest quartiles) were associated modestly with the presence of retinopathy (odds ratio [OR] = 1.27; 95% Confidence Interval [CI] = 1.01-1.59), particularly retinal hemorrhages (OR = 1.71; 95% CI = 1.20-2.44), and with generalized retinal venular widening (OR = 1.19; 95% CI = 1.03-1.38). Analyzing vital exhaustion as a continuous variable did not change the pattern of the associations.

CONCLUSIONS: Middle-aged people with vital exhaustion may be more likely to have retinopathy signs that have been identified as risk predictors of cardiovascular events. Further research is needed to explore the possible adverse effects of negative emotion on the microcirculation.

DOI10.1097/PSY.0b013e318190f009
Alternate JournalPsychosom Med
PubMed ID19073748
PubMed Central IDPMC2987558
Grant ListN01HC55020 / HL / NHLBI NIH HHS / United States
N01HC55018 / HL / NHLBI NIH HHS / United States
N01-HC-55022 / HC / NHLBI NIH HHS / United States
N01-HC-55016 / HC / NHLBI NIH HHS / United States
N01HC55022 / HL / NHLBI NIH HHS / United States
N01-HC-55021 / HC / NHLBI NIH HHS / United States
N01HC55015 / HL / NHLBI NIH HHS / United States
N01-HC-55019 / HC / NHLBI NIH HHS / United States
N01-HC-55015 / HC / NHLBI NIH HHS / United States
R03 EY013939-02 / EY / NEI NIH HHS / United States
N01-HC-55020 / HC / NHLBI NIH HHS / United States
N01HC55016 / HL / NHLBI NIH HHS / United States
R21 HL077166-01 / HL / NHLBI NIH HHS / United States
N01HC55019 / HL / NHLBI NIH HHS / United States
R03 EY013939-01 / EY / NEI NIH HHS / United States
N01-HC-55018 / HC / NHLBI NIH HHS / United States
N01HC55021 / HL / NHLBI NIH HHS / United States