Alexithymia was not associated with the risk of incident cardiovascular diseases in the supplementation en vitamines et mineraux antioxydants (su.vi.max) cohort

Background: Alexithymia is a personality construct defined by difficulties in identifying and labelling one’s own emotional state. Although it has been suggested to be associated with cardiovascular diseases and mortality, studies are scarce and a causal relationship is questionable. For instance, no study examined the association of alexithymia with the incidence of cardiovascular diseases among a nonclinical population. The aim of this study was to explore this prospective association in participants without cardiovascular history at baseline. Methods: The 26-item Toronto Alexithymia Scale (TAS-26) was completed by 5,586 participants of the French Supplementation en Vitamines et Mineraux AntioXydants (SU.VI.MAX) cohort (41.4 % of men, mean age ± SD: 52.2 ± 6.3 years). All participants were free from cardiovascular history at baseline. Covariates measured at baseline were age, occupational status, depressive symptoms, smoking status, body mass index, hypertension, diabetes, hypercholesterolemia and hypertriglyceridemia. The cardiovascular events were recorded using self-reported information or clinical visits, and were validated by an independent expert committee. Associations between alexithymia as well as covariates at baseline and cardiovascular events at follow-upwere estimated with hazard ratios (HR) and 95% confidence intervals (CI) computed in Cox regressions. Results: A total of 173 first cardiovascular events were recorded and validated during an average of 11.4 years of followup. After an initial adjustment for age and occupational status, the association between baseline alexithymia and cardiovascular events at follow-up was not significant among men (HR [95% CI] 1.00 [0.99-1.02]) or among women (HR [95% CI] 1.00 [0.97-1.03]). Similar results were found after further adjustment for all covariates. Likewise, exploratory analyses based on TAS-26 subscores showed no association. Conclusion: In this large prospective study, alexithymia and incident cardiovascular events were not associated among a nonclinical population. Greater CV mortality previously associated with alexithymia might result from poorer outcome in individuals with CV diseases rather than from increased incidence. The association between alexithymia and CV diseases in cross-sectional studies might result from the psychological impact of CV diseases