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Anger, depression and anxiety associated with endothelial function in childhood and adolescence
  1. W Osika1,2,
  2. S M Montgomery2,3,
  3. F Dangardt1,
  4. P Währborg1,
  5. L M Gan1,
  6. E Tideman4,
  7. P Friberg1
  1. 1Department of Metabolism and Cardiovascular Research/Clinical Physiology, Sahlgrenska University Hospital, Göteborg, Sweden
  2. 2Clinical Epidemiology Unit, Department of Medicine, Karolinska Hospital, Karolinska Institutet, Stockholm, Sweden
  3. 3Department of Primary Care and Social Medicine, Charing Cross Hospital, Imperial College, London, UK
  4. 4Division of Clinical Psychology, Lund University, Lund, Sweden
  1. Correspondence to Dr Walter Osika, Stress Research Institute, Stockholm University, SE-106 91 Stockholm, Sweden; walter.osika{at}


Objective Psychosocial adversity is a risk factor for cardiovascular disease (CVD) in adults. The authors assessed associations of reactive hyperaemia 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 (mean (SD) age 14.0 (1.0); 136 girls and 112 boys) underwent RH-PAT testing. They completed the Beck Youth Inventories (BYI) of emotional and social impairment scales, which is 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 the 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 the boys, disruptive behaviour was associated with higher RH-PAT scores (0.09, p=0.006).

Conclusions The girls have higher levels of self-assessed anger; depression and anxiety compared with the boys, and these characteristics are associated with lower RH-PAT scores, indicating attenuated endothelial function. Among the boys, disruptive behaviour was associated with better endothelial function. Although 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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  • Funding Funding for this study was provided by the Swedish Medical Research Council, The Göteborg Medical Association, The Majblomman Association, Ågrenska Foundation, Sahlgrenska University Hospital, Örebro University Hospital and The Committee for Public Health in the Västra Götaland region.

  • Ethics approval This study was conducted with the approval of the ethics committee at Sahlgrenska Academy at Göteborgs University, Sweden.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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