No relation between excess fatigue and asymptomatic carotid atherosclerosis

Prospective studies have reported a positive association of excess fatigue and hopelessness with coronary heart disease mortality; a relation to atherosclerosis has not been investigated, We examined the cross-sectional association of the Maastricht excess fatigue questionnaire with carotid intimal medial wall thickness among 12,448 coronary heart disease free individuals age 47-68 years. In age-, race-, and field center-adjusted analyses, we found a strong, positive association between excess fatigue and carotid intimal-medial wall thickness in both sexes. Adjustment for other coronary heart disease risk factors substantially attenuated the relation. Pack-years of smoking was the strongest confounder. Furthermore, there was little association among never smokers. It appears that the association of excess fatigue with atherosclerotic disease is largely accounted for by established risk factors.