Is Alexithymia a CV Risk Factor in Healthy Adults?

Background: We investigated whether alexithymia is associated with cardiometabolic risk factors (RF) and increased CVD risk. Methods: 1,170 adult blood donors (74.8% males, aged 46.1±10.0) were recruited and assessed for traditional, biochemical and lifestyle RF. Psychological factors, including alexithymia (TAS-20) and depressive symptoms (BDI-II) were concurrently assessed. We evaluated CVD risk according to Framingham risk score (FRS) and Italian NIH (National Institute of Health) CUORE risk score (CRS). Estimated 10-year CVD risk was calculated with both scores. Results: The prevalence of moderate-to-high risk was 13% (FRS) and 21% (CRS). The alexithymic group (23.6%) had significantly a lower education and occupational status, as well as higher BMI, higher total and LDL cholesterol, higher lipoprotein-a, and depression score than the non-alexithymic group. Consistently, the percentage of subjects at moderate-tohigh CVD risk was significantly higher in the alexithymic group for both FRS and CRS. A stepwise forward multivariate logistic regression was used to select predictors of moderateto-high CVD risk. The results showed that alexithymia was a strong independent predictor of increased estimated CVD risk at 10 years for both FRS (OR: 2.40; 95% CI: 1.38-4.14; p=0.002) and CRS (OR: 2.11; 95% CI: 1.32-3.38; p=0.002), after adjustment for sociodemographic and lifestyle factors, BMI, diastolic blood pressure, metabolic RF (fasting blood glucose, LDL and triglycerides), and biochemical RF. Conclusions: This large cohort study suggests that alexithymia may be considered a major psychological factor for CVD risk in healthy population. Longitudinal studies are needed for investigating the role of alexithymia in clinical outcomes (morbidity and mortality).