Psychological Factors and Coronary Artery Disease

Abstract
O'Malley et al. (Nov. 2 issue),1 conclude that psychological factors are not associated with subclinical coronary artery disease as assessed by electron-beam computed tomography. Most of the established factors that influence the risk of coronary artery disease (such as systolic blood pressure, smoking status, and levels of homocysteine, fibrinogen, and insulin) were also not associated with subclinical coronary artery disease in this analysis of 630 healthy U.S. Army personnel. Indeed, only three established risk factors for coronary artery disease (male sex, a higher body-mass index, and a higher level of low-density lipoprotein cholesterol) had sufficient power to be significantly correlated with coronary-artery calcification. In addition, psychological data were obtained during Army-mandated physical examinations, rendering the accuracy of reports of psychological distress suspect.

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