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Relation between psychological strain and carotid atherosclerosis in a general population
  1. B Wolff1,
  2. H J Grabe5,
  3. H Völzke2,
  4. J Lüdemann3,
  5. C Kessler4,
  6. J B Dahm1,
  7. H J Freyberger5,
  8. U John2,
  9. S B Felix1
  1. 1Klinik für Innere Medizin B, Universität Greifswald, Greifswald, Germany
  2. 2Institut für Epidemiologie und Sozialmedizin, Universität Greifswald
  3. 3Institut für Klinische Chemie, Universität Greifswald
  4. 4Klinik für Neurologie, Universität Greifswald
  5. 5Klinik für Psychiatrie und Psychotherapie, Universität Greifswald, Klinikum der Hansestadt Stralsund, Stralsund, Germany
  1. Correspondence to:
    Dr Birger Wolff
    Klinik für Innere Medizin B, Ernst-Moritz-Arndt-Universität Greifswald, Friedrich-Loeffler-Strasse 23 a, 17487 Greifswald, Germany;


Objective: To investigate the hypothesis that psychological strain is related to carotid atherosclerosis in a large general population sample.

Methods: Intima–media thickness and the prevalence of atherosclerotic plaques in the carotid arteries were quantitatively assessed by high resolution ultrasound among 2164 participants (1112 women and 1052 men, aged 45 to 75 years) of the SHIP (study of health in Pomerania), an epidemiological survey of a random sample of the population of north eastern Germany. Psychological strain was measured by 13 items reflecting typical psychological complaints. Each item was graded by the study participants on a four point scale (from 0, absent, to 3, severe) and a psychological strain score was generated by summing these 13 items.

Results: Mean psychological strain score was 10.8 (7.0) (median score 10) among women and 8.5 (6.2) (median score 8) among men. Psychological strain did not predict carotid intima–media thickness among either men or women. However, after adjustment for covariates, high psychological strain and carotid plaques were independently and linearly related, with plaque prevalence odds of 1.03 (95% confidence interval (CI) 1.01 to 1.05, p  =  0.009) per increment of the psychological strain score among women and 1.04 (95% CI 1.01 to 1.07, p  =  0.003) among men.

Conclusions: This study identified a relation between general psychological strain and carotid atherosclerosis.

  • CI, confidence interval
  • HDL, high density lipoprotein
  • IMT, intima–media thickness
  • LDL, low density lipoprotein
  • SHIP, the study of health in Pomerania
  • atherosclerosis
  • cardiovascular disease
  • carotid ultrasound
  • epidemiology
  • psychological strain

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  • The funding source had neither been involved in the submission of the manuscript nor in the decision to publish the data. None of the authors has to make any financial disclosures or has a potential conflict of interest.