Personality and social predictors of atherosclerotic progression: Edinburgh Artery Study

Objective: The aim of this study was to determine whether personality traits and social factors predict the progression of peripheral atherosclerosis. Progression was assessed using the objective, noninvasive ankle brachial pressure index (ABPI). Methods: In the Edinburgh Artery Study, 1592 men and women were randomly sampled from the general population, and their ABPI was measured at baseline and at the end of a 5-year follow-up period. A low ABPI suggests the presence of peripheral arterial disease. The revised Bedford-Foulds Personality Deviance Scale was administered at baseline to assess submissiveness and hostility. Data on other baseline risk factors, including physiological and social factors, were also collected. Results: Change in ABPI over 5 years was negatively correlated with age in both men and women (men, r = -0.10; women, r = -0.25). In multiple linear regression models, smoking, alcohol consumption, and submissiveness together accounted for 2% of the variance in ABPI change in men; in women, only age was related to change, accounting for 6% of the variance. Well-fitting structural equation models in both sexes showed that age influenced baseline ABPI and change in ABPI; that smoking and social deprivation directly affected baseline ABPI; and that the effect of hostility, and some of the effect of social deprivation, was mediated by smoking. Conclusions: Social and personality factors were associated directly with baseline ABPI levels and indirectly with progression of atherosclerosis. Structural equation models revealed that associations among personality, social factors, and atherosclerotic progression were complex, involving mediation through other variables.