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Anger, depression and anxiety associated with endothelial function in childhood and adolescence
  1. Walter Osika1,*,
  2. Scott M Montgomery2,
  3. Frida Dangardt1,
  4. Peter Wahrborg1,
  5. Li Ming Gan1,
  6. Eva Tideman3,
  7. Peter Friberg1
  1. 1 Department of Metabolism and Cardiovascular Research/Clinical Physiology, Sahlgrenska University Hos, Sweden;
  2. 2 Clinical Epidemiology Unit, Department of Medicine, Karolinska Hospital, Karolinska Institutet, Stoc, Sweden;
  3. 3 Division of Clinical Psychology, Lund University, Sweden
  1. Correspondence to: Walter Osika, Clinical Physiology, Dept of Molecular and Clinical Medicine, Sahlgrenska University Hospital, Vita Stråket 12, uppg J, 2 tr, Göteborg, 413 45, Sweden; osika{at}


Objective: Psychosocial adversity is a risk factor for cardiovascular disease (CVD) in adults. We assessed associations of reactive hyperemia peripheral arterial tonometry (RH-PAT) – a measure of endothelial function predictive of CVD – with self-assessed psychological health among school children.

Methods: A total of 248 healthy school children (age 14.0±1.0 136 girls, 112 boys) underwent RH-PAT testing. They completed Beck Youth Inventories of Emotional and Social Impairment scales (BYI), used to screen for depression, anxiety, anger and disruptive behaviour.

Results: No sex differences were observed for the RH-PAT score. Statistically significant differences were observed for the BYI scores; girls had higher scores for depression, anger and anxiety. Among girls there were statistically significant associations between lower RH-PAT scores and higher scores for anger (B coefficient = -0.100, p=0.040), depression (-0.108, p=0.009) and anxiety (-0.138, p=0.039), after adjustment for age. Among boys, disruptive behaviour was associated with higher RH-PAT scores (0.09, p=0.006).

Conclusions: Girls have higher levels of self assessed anger; depression and anxiety compared with boys, and these characteristics are associated with lower RH-PAT scores, indicating attenuated endothelial function. Among boys, disruptive behaviour was associated with better endothelial function. As psychological ill-health is associated with impaired endothelial function and CVD among adults, such processes may also be relevant to children. Psychosocial adversity in childhood might be a risk factor for subsequent CVD.

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