Shively CA, Clarkson TB. Social status and coronary artery atherosclerosis in female monkeys. Arteriosclerosis and Thrombosis 1994; 14: 721-6

It has been known in captive populations that social subordination is thought to be a stressor and therefore deleterious to the health of monkeys and these earlier studies are summarized here. Subordinates receive more aggression, spend more time alone, hypersecrete cortisol and have suppressed reproductive function relative to dominants. In this study social status in captive monkeys fed high cholesterol diets was manipulated, with hierarchies reversed in a cross-over experiment to determine atherosclerosis in their coronary arteries. Subordinates have more disease in their coronary arteries. Artificially altering social status in these monkeys in this experiment increased the deleterious effects on the heart. [The relevance of these artificially created hierarchies for the human are unclear, but the demonstration that social subordination has effects on the heart is significant.] 

Abstract

While coronary heart disease is the leading cause of death in women in the United States, research in the area is lacking, especially concerning psychosocial risk factors. The purpose of this experiment was to study the effect of a known psychosocial risk factor in female monkeys, social status, and the effect of alteration of social status on coronary artery atherosclerosis. In previous experiments it has been demonstrated that social status is an enduring characteristic of the individual and that socially subordinate female monkeys have poor ovarian function and exacerbated coronary artery atherosclerosis. In the present experiment, adult female monkeys were fed an atherogenic diet and housed in small social groups, and social status was altered in half of the animals (subordinates become dominant and dominants became subordinate). The manipulation of social status had minimal effects on risk factors but significantly affected coronary artery atherosclerosis, supporting the hypothesis that social status affects atherogenesis in these females. However, all animals that changed social positions had worsened coronary artery atherosclerosis whether they became dominant or became subordinate, and this effect was independent of ovarian function. Subordinates that became dominant had 44% more and dominants that became subordinate had 500% more atherosclerosis than their counterparts that did not change social status. Thus, modification of this psychosocial risk factor was not effective in reducing coronary artery atherosclerosis. The manipulation of social status may have deleteriously altered a complex interaction between individuals and their psychosocial environment.

Keywords

• atherosclerosis
• cause specific mortality
• heart disease
• hierarchy
• psychosocial factors
• relative deprivation
• risk factor
• social stratification
• stress
• women