Skip to content
Accessible Unlicensed Requires Authentication Published by De Gruyter March 14, 2015

Endothelial dysfunction and negative emotions in adolescent girls

Kathleen Pajer, Robert Hoffman, William Gardner, Chien-Ni Chang, David Boley and Wei Wang

Abstract

Background: Endothelial dysfunction predicts adult cardiovascular disorder and may be associated with negative emotions in adolescents. This study was conducted to determine if hopelessness, hostility, and depressive, anxiety, or conduct disorders were associated with compromised endothelial function and whether those associations were mediated by health risk behaviors.

Methods: Endothelial function, assessed through brachial artery reactive hyperemia, was measured in a psychopathology enriched sample of 60 15–18-year-old girls. The correlations between hopelessness, hostility, and depressive, anxiety, or conduct disorders and the percent change in forearm vascular resistance (PCFVR) were measured. Possible mediation effects of health risk behaviors were tested.

Results: Hopelessness was negatively associated with PCFVR, controlling for race and body mass index. Conduct disorder without any anxiety disorder was associated with better endothelial function. The other negative emotions were not associated with PCFVR. Risky health behaviors were associated with conduct disorder and hopelessness, but not with PCFVR, so there was no evidence of mediation.

Conclusion: The main finding was that hopelessness in adolescent girls was associated with endothelial dysfunction. This may indicate that when present, hopelessness places a girl at risk for later cardiovascular disease, whether she has a psychiatric disorder or not. Possible mechanisms for this finding are examined and the surprising finding that conduct disorder is associated with better endothelial function is also discussed. Suggestions for future research are presented.


Corresponding author: Kathleen Pajer, Professor of Psychiatry, University of Ottawa Faculty of Medicine, Children’s Hospital of Eastern Ontario (CHEO) Chief, Department of Psychiatry, 401 Smyth Road Ottawa, ON K1H 8L1 Canada, Phone: 613 737-7600 x2723, Fax: 613 737-2257, E-mail:

Acknowledgments

The authors thank the nurses of the Ohio State University GCRC and the participants for their contributions to this work. This study was supported by the National Institute of Mental Health (1R01MH066003-01A1; Pajer-PI), the National Institutes of Health (2M01RR000034-42, General Clinical Research Center, Ohio State University), and the Research Institute of Nationwide Children’s Hospital, Columbus, OH (Pilot study funds; Pajer-PI). No funding source had any influence on the study or the manuscript preparation.

References

1. Flammer AJ, Anderson T, Celermajer DS, Creager MA, Deanfield J, et al. The assessment of endothelial function: from research into clinical practice. Circ 2012;126:753–67.Search in Google Scholar

2. Jarvisalo MJ, Raitakari M, Toikka JO, Putto-Laurila A, Rontu R, et al. Endothelial dysfunction and increased arterial intima-media thickness in children with type 1 diabetes. Circ 2004;109:1750–5.Search in Google Scholar

3. Urbina EM, Khoury PR, McCoy CE, Dolan LM, Daniels SR, et al. Triglyceride to HDL-C ratio and increased arterial stiffness in children, adolescents, and young adults. Pediatr 2013;131:e1082–90.Search in Google Scholar

4. Duck MM, Hoffman RP. Impaired endothelial function in healthy African-American adolescents compared with Caucasians. J Pediatr 2007;150:400–6.Search in Google Scholar

5. Jarvisalo MJ, Harmoinen A, Hakanen M, Paakkunainen U, Viikari J, et al. Elevated serum C-reactive protein levels and early arterial changes in healthy children. Arterioscler Thromb Vasc Biol 2002;22:1323–8.Search in Google Scholar

6. Beaglehole R, Magnus P. The search for new risk factors for coronary heart disease: occupational therapy for epidemiologists? Int J Epidemiol 2002;31:1117–22.Search in Google Scholar

7. Januzzi JL, Pasternak RC. Depression, hostility, and social isolation in patients with coronary artery disease. Curr Treat Options Cardiovasc Med 2002;4:77–85.Search in Google Scholar

8. Kubzansky LD, Davidson KW, Rozanski A. The clinical impact of negative psychological states: expanding the spectrum of risk for coronary artery disease. Psychosom Med 2005;67(Suppl 1):S10–14.Search in Google Scholar

9. Goldstein RB, Dawson DA, Chou SP, Ruan WJ, Saha TD, et al. Antisocial behavioral syndromes and past-year physical health among adults in the United States: results from the National Epidemiologic Survey on Alcohol and Related Conditions. J Clin Psychiatry 2008;69:368–80.Search in Google Scholar

10. Everson-Rose SA, Lewis TT, Karavolos K, Matthews KA, Sutton-Tyrrell K, et al. Cynical hostility and carotid atherosclerosis in African American and white women: the Study of Women’s Health Across the Nation (SWAN) Heart Study. Am Heart J 2006;152:982, 982.e7–13.Search in Google Scholar

11. Pollitt RA, Daniel M, Kaufman JS, Lynch JW, Salonen JT, et al. Mediation and modification of the association between hopelessness, hostility, and progression of carotid atherosclerosis. J Behav Med 2005;28:53–64.Search in Google Scholar

12. Nabi H, Kivimaki M, Zins M, Elovainio M, Consoli SM, et al. Does personality predict mortality? Results from the GAZEL French prospective cohort study. Int J Epidemiol 2008;37: 386–96.Search in Google Scholar

13. Tomfohr LM, Martin TM, Miller GE. Symptoms of depression and impaired endothelial function in healthy adolescent women. J Behav Med 2008;31:137–43.Search in Google Scholar

14. Osika W, Montgomery SM, Dangardt F, Wahrborg P, Gan LM, et al. Anger, depression and anxiety associated with endothelial function in childhood and adolescence. Arch Dis Child 2011;96:38–43.Search in Google Scholar

15. Gordon JL, Lavoie KL, Arsenault A, Ditto B, Bacon SL. Health behaviors and endothelial function. J Behav Med 2008;31:5–21.Search in Google Scholar

16. Bonnet F, Irving K, Terra JL, Nony P, Berthezene F, et al. Anxiety and depression are associated with unhealthy lifestyle in patients at risk of cardiovascular disease. Atherosclerosis 2005;178:339–44.Search in Google Scholar

17. Donahue RP, Rejman K, Rafalson LB, Dmochowski J, Stranges S, et al. Sex differences in endothelial function markers before conversion to pre-diabetes: does the clock start ticking earlier among women? The Western New York Study. Diabet Care 2007;30:354–9.Search in Google Scholar

18. Shaffer D, Fisher P, Dulcan MK, Davies M, Piacentini J, et al. The NIMH Diagnostic Interview Schedule for Children Version 2.3 (DISC-2.3): description, acceptability, prevalence rates, and performance in the MECA Study. Methods for the Epidemiology of Child and Adolescent Mental Disorders Study. J Am Acad Child Adolesc Psychiatry 1996;35:865–77.Search in Google Scholar

19. Starfield B, Ensminger M, Green B. Manual for the Child Health and Illness Profile-Adolescent Edition (CHIP-AE). Baltimore: The Johns Hopkins University Press, 1995.Search in Google Scholar

20. Wilkinson IB, Webb DJ. Venous occlusion plethysmography in cardiovascular research: methodology and clinical applications. Br J Clin Pharmacol 2001;52:631–46.Search in Google Scholar

21. Balletshofer BM, Rittig K, Stock J, Lehn-Stefan A, Overkamp D, et al. Insulin resistant young subjects at risk of accelerated atherosclerosis exhibit a marked reduction in peripheral endothelial function early in life but not differences in intima-media thickness. Atherosclerosis 2003;171:303–9.Search in Google Scholar

22. Singh TP, Groehn H, Kazmers A. Vascular function and carotid intimal-medial thickness in children with insulin-dependent diabetes mellitus. J Am Coll Cardiol 2003;41:661–5.Search in Google Scholar

23. Alomari M, Solomito A, Reyes R, Khalil SM, Wood RH, et al. Measurements of vascular function using strain-gauge plethysmography: technical considerations, standardization, and physiological findings. Am J Physiol 2003;286:99–107.Search in Google Scholar

24. Beck A, Steer R. Manual for the Beck Hopelessness Scale. San Antonio: Psychological Corporation, 1988.Search in Google Scholar

25. Liehr P, Meininger JC, Mueller WH, Chan W, Frazier L, et al. Psychometric testing of the adolescent version of the Cook-Medley hostility scale. Iss Compre Ped Nurs 2000;23:103–16.Search in Google Scholar

26. Whincup PH, Gilg JA, Donald AE, Katterhorn M, Oliver C, et al. Arterial distensibility in adolescents: the influence of adiposity, the metabolic syndrome, and classic risk factors. Circ 2005;112:1789–97.Search in Google Scholar

27. Baron RM, Kenny DA. The moderator-mediator variable distinction in social psychological research: conceptual, strategic, and statistical considerations. J Pers Soc Psychol 1986;51:1173–82.Search in Google Scholar

28. Pajer K. Cardiovascular disease risk factors in adolescents: do negative emotions and hypothalamic-pituitary-adrenal axis function play a role? Curr Opin Pediatr 2007;19:559–64.Search in Google Scholar

29. Engel GL. A life setting conducive to illness. The giving-up--given-up complex. Bull Menninger Clin 1968;32:355–65.Search in Google Scholar

30. Chover-Gonzalez AJ, Jessop DS, Tejedor-Real P, Gibert-Rahola J, Harbuz MS. Onset and severity of inflammation in rats exposed to the learned helplessness paradigm. Rheumatol 2000;39:764–71.Search in Google Scholar

31. Kleemann R, Zadelaar S, Kooistra T. Cytokines and atherosclerosis: a comprehensive review of studies in mice. Cardiovasc Res 2008;79:360–76.Search in Google Scholar

32. Kristenson M, Orth-Gomer K, Kucinskiene Z, Bergdahl B, Calkauskas H, et al. Attenuated cortisol response to a standardized stress test in Lithuanian versus Swedish men: the LiVicordia study. Int J Behav Med 1998;5:17–30.Search in Google Scholar

33. Nijm J, Kristenson M, Olsson AG, Jonasson L. Impaired cortisol response to acute stressors in patients with coronary disease. Implications for inflammatory activity. J Intern Med 2007;262:375–84.Search in Google Scholar

34. Broadley AJ, Korszun A, Jones CJ, Frenneaux MP. Arterial endothelial function is impaired in treated depression. Heart 2002;88:521–3.Search in Google Scholar

35. Liu Y, Mladinov D, Pietrusz JL, Usa K, Liang M. Glucocorticoid response elements and 11 beta-hydroxysteroid dehydrogenases in the regulation of endothelial nitric oxide synthase expression. Cardiovasc Res 2009;81:140–7.Search in Google Scholar

36. Kuvin JT, Patel AR, Sliney KA, Pandian NG, Sheffy J, et al. Assessment of peripheral vascular endothelial function with finger arterial pulse wave amplitude. Am Heart J 2003;146:168–74.Search in Google Scholar

37. Poredos P, Jezovnik MK. Testing endothelial function and its clinical relevance. J Atheroscler Thromb 2013;20:1–8.Search in Google Scholar

38. Hijmering ML, Stroes ES, Olijhoek J, Hutten BA, Blankestijn PJ, et al. Sympathetic activation markedly reduces endothelium-dependent, flow-mediated vasodilation. J Am Coll Cardiol 2002;39:683–8.Search in Google Scholar

39. Ortiz J, Raine A. Heart rate level and antisocial behavior in children and adolescents: a meta-analysis. J Am Acad Child Adolesc Psychiatry 2004;43:154–162.Search in Google Scholar

40. Harris KF, Matthews KA, Sutton-Tyrrell K, Kuller LH. Associations between psychological traits and endothelial function in postmenopausal women. Psychosom Med 2003;65:402–9.Search in Google Scholar

Received: 2014-11-5
Accepted: 2015-1-1
Published Online: 2015-3-14
Published in Print: 2016-5-1

©2016 by De Gruyter