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Independent contribution of psychological factors to fibrin turnover in subjects with sleep apnoea and/or systemic hypertension
- Source :
- Clinical Science. 103:331-337
- Publication Year :
- 2002
- Publisher :
- Portland Press Ltd., 2002.
-
Abstract
- By promoting atherosclerosis and thrombosis, a blood-clotting diathesis could contribute to excess cardiovascular morbidity and mortality in patients with systemic hypertension and/or obstructive sleep apnoea. Since psychological states affect haemostatic activity, we wondered about the contribution of behavioural factors to a hypercoagulable state in subjects with increased risk of cardiovascular disease. To tease apart the potential additive nature of cardiovascular disease risk, we examined four patient groups–hypertensives and normotensives, with and without sleep apnoea. The procoagulant molecules thrombin–antithrombin III complex, fibrin D-dimer and von Willebrand factor antigen were measured in 88 subjects (mean age 47 years; range 32–64 years) who underwent full polysomnography. Subjects completed the Center for Epidemiological Studies–Depression (CES-D) Scale, the Cook–Medley (CM) Hostility Scale, and the Profile of Mood States (POMS). Sleep apnoea, hypertension status, age, body mass index and psychological variables (CES-D, CM Stress, and POMS Vigour–Activity) together explained 29% of the variance in D-dimer, a marker of fibrin turnover (r2 = 0.29, P = 0.001). CES-D, CM Stress and POMS Vigour–Activity explained 17% of this variance even after controlling for sleep apnoea, hypertension status, age and body mass index (Δr2 = 0.17, P = 0.001). Thrombin–antithrombin III complex and von Willebrand factor were not significantly related to psychological variables, but this may reflect limited statistical power. Thus psychological factors are independently associated with D-dimer and explain as much of its variance as do traditional correlates (hypertension, sleep apnoea, age and body mass index). These results may provide a rationale for linking behavioural aspects with cardiovascular events.
- Subjects :
- Adult
Male
medicine.medical_specialty
Psychometrics
Polysomnography
Antithrombin III
Profile of mood states
Body Mass Index
Fibrin Fibrinogen Degradation Products
Von Willebrand factor
Risk Factors
Internal medicine
von Willebrand Factor
D-dimer
medicine
Humans
Risk factor
Depression (differential diagnoses)
Psychiatric Status Rating Scales
Analysis of Variance
Hemostasis
Sleep Apnea, Obstructive
medicine.diagnostic_test
biology
business.industry
Mental Disorders
Age Factors
General Medicine
Middle Aged
Endocrinology
Cardiovascular Diseases
Hypertension
biology.protein
Cardiology
Female
business
Body mass index
Peptide Hydrolases
Cohort study
Subjects
Details
- ISSN :
- 14708736 and 01435221
- Volume :
- 103
- Database :
- OpenAIRE
- Journal :
- Clinical Science
- Accession number :
- edsair.doi.dedup.....b01656b84ff03319aaa7e59608c7dec4