Structural models of negative affectivity and social behavior can facilitate integrative study of psychosocial risk factors. Further, self-report measures of these traits might under-estimate related CHD risk.

In asymptomatic subjects, the initial CCS and CVS were the most important factors that affected rate of coronary artery calcium progression. Neither age nor sex was as important as these factors in determination of coronary artery calcium progression.

Objective Marital disruption and low marital quality confer risk of coronary artery disease (CAD) in some but not all studies. Inconsistencies might reflect limitations of self-reports of marital quality compared to behavioral observations. Also, aspects of marital quality related to CAD might differ for men and women. This study examined behavioral observations of affiliation (i.e., warmth vs. hostility) and control (i.e., dominance vs. submissiveness) and prior divorce as predictors of coronary artery calcification (CAC) in older couples. Methods Couples underwent CT scans for CAC and marital assessments including observations of laboratory-based disagreement. Participants were 154 couples (mean age = 63.5; mean length of marriage = 36.4 years) free of prio diagnosis of CAD. Results Controlling traditional risk factors, behavioral measures of affiliation (low warmth) accounted for 6.2% of variance in CAC for women, p<.01, but not for men. Controlling behavior (dominance) accounted for 6.0% of variance in CAC for men, p<.02, but not for women. Behavioral measures were related to self-reports of marital quality, but the latter were unrelated to CAC. History of divorce predicted CAC for men and women. Conclusions History of divorce and behavioral – but not self-report – measures of marital quality were related to CAD, such that low warmth and high dominance conferred risk for women and men, respectively. Prior research might underestimate the role of marital quality in CAD by relying on global self-reports of this risk factor.