Depressive Symptoms, Social Isolation, and Progression of Coronary Artery Atherosclerosis: The Stockholm Female Coronary Angiography Study

Abstract

Background: Although both depressive symptoms and social isolation in relation to coronary heart disease have been studied previously, few have examined their joint effects on coronary atherosclerosis progression in women. Method: Among the women enrolled in the Stockholm Female Coronary Angiography Study, Sweden, between 1991 and 1994, 102 were evaluated for coronary atherosclerosis progression using a computer-assisted standardized assessment, repeated quantitative coronary angiographic documentation, of the mean luminal diameter change over 3 years in 10 predefined coronary segments. Depressive symptoms and social isolation were assessed by standard questionnaires. Results: Multivariable controlled mixed model ANOVAs revealed that women who were both depressed and socially isolated had the greatest disease progression: their absolute mean luminal diameter decreased by 0.18 mm [95% confidence interval (CI) = 0.11–0.24] and their percent narrowing was 5.5% (95% CI = 3.6–7.4), whereas in women who lacked both psychological risk factors, the mean luminal diameter decrease was 0.04 mm and their percent narrowing was 0.9%. These associations were independent of the baseline luminal diameter and standard risk factors, including age, smoking history, hypertension, and high-density lipoproteins. Conclusions:In women with coronary disease, depressive symptoms and social isolation in combination accelerated disease progression, suggesting a direct psychosocial effect on the atherosclerotic process. These findings provide an additional opportunity for therapeutic and preventive efforts against progression of coronary disease in women.

Social Relationships and Mortality Risk: A Meta-analytic Review

“…Likewise, social relationships have been linked to the development [16,17] and progression [18][19][20][21] of cardiovascular disease [22]-a leading cause of death globally. Therefore, synthesis of the current empirical evidence linking social relationships and mortality, along with clarifications of potential moderators, may be particularly relevant to public health and clinical practice for informing interventions and policies aimed at reducing risk for mortality.…”

Reflections on Relevance: The Fields of Psychosomatics and Psychotherapy in 2006

“…Studies by Wang et al [9] and Benninghoven et al [12] confirmed and expanded our knowledge about the negative impact of depression and anxiety on cardiovascular diseases and their outcome. Wang et al [9] in one of the reports from The Stockholm Female Coronary Angiography Study demonstrated that in women with coronary disease, depressive symptoms and social isolation in combination accelerated the progression of coronary disease.…”

“…Several studies [3,4,5,6,7,8,9] examined the complicated relationship between cardiovascular disease and depression.…”

“…Wang et al [9] in one of the reports from The Stockholm Female Coronary Angiography Study demonstrated that in women with coronary disease, depressive symptoms and social isolation in combination accelerated the progression of coronary disease. They felt that this finding suggests a direct psychosocial effect on the atherosclerotic process.…”

Occupational Stress and Coronary Artery Disease

“…It is found in a research that social isolation despondent syndrome could promote the development of atherosclerosis in female patients, whose diameter of coronary artery deceased by 0.18mm, while those of the comparing group decreased only 0.01mm. This has no relation with the vessel diameter, age, smoking history, hyper stress, and high-density lipoprotein [49] . In the research of Lander's team, there is higher rate of smoking and obese among social despondent, both of them can increase the risk of coronary artery disease [50] .…”