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Occupational Mobility and Carotid Artery Intima-Media Thickness: Findings From the Coronary Artery Risk Development in Young Adults Study

Janicki-Deverts, Denise PhD; Cohen, Sheldon PhD; Matthews, Karen A. PhD; Jacobs, David R. Jr PhD; Adler, Nancy E. PhD

doi: 10.1097/PSY.0b013e3182365539
Original Articles
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Objective: To examine whether a 10-year change in occupational standing is related to carotid artery intima-media thickness (IMT) 5 years later.

Methods: Data were obtained from 2350 participants in the Coronary Artery Risk Development in Young Adults (CARDIA) Study. Occupational standing was measured at the Year 5 and 15 CARDIA follow-up examinations when participants were 30.2 (standard deviation = 3.6) and 40.2 (standard deviation = 3.6) years of age, respectively. IMT (common carotid artery [CCA], internal carotid artery [ICA], and bulb) was measured at Year 20. Occupational mobility was defined as the change in occupational standing between Years 5 and 15 using two semicontinuous variables. Analyses controlled for demographics, CARDIA center, employment status, parents' medical history, own medical history, Year 5 Framingham Risk Score, physiological risk factors and health behaviors averaged across the follow-up, and sonography reader.

Results: Occupational mobility was unrelated to IMT save for an unexpected association of downward mobility with less CCA-IMT (β = −0.04, p = .04). However, associations differed depending on initial standing (Year 5) and sex. For those with lower initial standings, upward mobility was associated with less CCA-IMT (β = −0.07, p = .003), and downward mobility was associated with greater CCA-IMT and bulb-ICA-IMT (β = 0.14, p = .01 and β = 0.14, p = .03, respectively); for those with higher standings, upward mobility was associated with greater CCA-IMT (β = 0.15, p = .008), but downward mobility was unrelated to either IMT measure (p values > .20). Sex-specific analyses revealed associations of upward mobility with less CCA-IMT and bulb-ICA-IMT among men only (p values < .02).

Conclusions: Occupational mobility may have implications for future cardiovascular health. Effects may differ depending on initial occupational standing and sex.

CARDIA = Coronary Artery Risk Development in Young Adults; CCA = common carotid artery; CI = confidence interval; CVD = cardiovascular disease; HDL-C = high-density lipoprotein cholesterol; FRS = Framingham Risk Score; ICA = internal carotid artery; IMT = intima-media thickness; OC/HRT = oral contraceptive/hormone replacement therapy; SBP = systolic blood pressure; SD = standard deviation; SE = standard error; SEI = Socioeconomic Index; SES = socioeconomic status; TC = total cholesterol

From the Department of Psychology (D.J.-D., S.C.), Carnegie Mellon University; and Department of Psychiatry (K.A.M.), University of Pittsburgh, Pittsburgh, Pennsylvania; Division of Epidemiology and Community Health (D.R.J.), School of Public Health, University of Minnesota, Minneapolis, Minnesota; Department of Nutrition (D.R.J.), University of Oslo, Oslo, Norway; and Department of Psychiatry (N.E.A.), University of California, San Francisco, California.

Address correspondence and reprint requests to Denise Janicki-Deverts, PhD, Department of Psychology, Carnegie Mellon University, Pittsburgh, PA 15213. E-mail: djanicki@andrew.cmu.edu

Work on this article was supported (or partially supported) by contracts from the University of Alabama at Birmingham, Coordinating Center (N01-HC-95095); University of Alabama at Birmingham, Field Center (N01-HC-48047); University of Minnesota, Field Center and Diet Reading Center (Year 20 Examination; N01-HC-48048); Northwestern University, Field Center (N01-HC-48049); Kaiser Foundation Research Institute (N01-HC-48050); and New England Medical Center Hospitals, Inc, Ultrasound Reading Center (Year 20 Examination; N01-HC-45204 from the National Heart, Lung, and Blood Institute). This study was also supported by the MacArthur Research Network on Socioeconomic Status and Health through grants from the John D. and Catherine T. MacArthur Foundation. Preparation of the article was also facilitated by the Pittsburgh Mind-Body Center (HL076852, R24HL076858) and R01-HL095296-01 from the National Heart, Lung, and Blood Institute.

Received for publication September 9, 2010; revision received June 30, 2011.

Copyright © 2011 by American Psychosomatic Society
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