Progression of coronary artery calcification in black and white women: Do the stresses and rewards of multiple roles matter

Imke Janssen, Lynda H. Powell, Mateusz S. Jasielec, Karen A. Matthews, Steven M. Hollenberg, Kim Sutton-Tyrrell, Susan A. Everson-Rose

Research output: Contribution to journalArticlepeer-review

12 Scopus citations


Background Black women experience higher rates of cardiovascular disease (CVD) than white women, though evidence for racial differences in subclinical CVD is mixed. Few studies have examined multiple roles (number, perceived stress, and/or reward) in relation to subclinical CVD, or whether those effects differ by race. Purpose The aim of this study was to investigate the effects of multiple roles on 2-year progression of coronary artery calcium. Methods Subjects were 104 black and 232 white women (mean age 50.8 years). Stress and reward from four roles (spouse, parent, employee, caregiver) were assessed on five-point scales. Coronary artery calcium progression was defined as an increase of =10 Agatston units. Results White women reported higher rewards from their multiple roles than black women, yet black women showed cardiovascular benefits from role rewards. Among black women only, higher role rewards were related significantly to lower progression of coronary artery calcium, adjusting for body mass index, blood pressure, and other known CVD risk factors. Blacks reported fewer roles but similar role stress as whites; role number and stress were unrelated to coronary artery calcium progression. Conclusion Rewarding roles may be a novel protective psychosocial factor for progression of coronary calcium among black women.

Original languageEnglish (US)
Pages (from-to)39-49
Number of pages11
JournalAnnals of Behavioral Medicine
Issue number1
StatePublished - Feb 2012

Bibliographical note

Funding Information:
Acknowledgments The Study of Women’s Health Across the Nation (SWAN) has grant support from the National Institutes of Health (NIH), DHHS, through the National Institute on Aging (NIA), the National Institute of Nursing Research (NINR), and the NIH Office of Research on Women’s Health (ORWH) (grants NR004061; AG012505, AG012535, AG012531, AG012539, AG012546, AG012553, AG012554, AG012495). The content of this article is solely the responsibility of the authors and does not necessarily represent the official views of the NIA, NINR, ORWH, or the NIH. SWAN Heart was supported by grants from the NHLBI (HL065581, HL065591, HL089862). The Chicago site of the SWAN Heart study was also supported by the Charles J. and Margaret Roberts Trust.


  • Coronary artery calcium
  • Middle-aged
  • Multiple roles
  • Role reward
  • Role stress
  • Women


Dive into the research topics of 'Progression of coronary artery calcification in black and white women: Do the stresses and rewards of multiple roles matter'. Together they form a unique fingerprint.

Cite this