Acute Myocardial Infarction: Psychosocial and Cardiovascular Risk Factors in Men

Abstract

Background Controversy still exists over the independent role of psychosocial factors in acute myocardial infarction (AMI). This study aimed to compare psychometric indices in Portuguese patients surviving a first episode of AMI and a community sample free of AMI.Design A community-based, case-control study. The study sample included 153 male patients with a first episode of AMI and 156 male controls randomly selected from the community.Methods Information on demographic, social, medical and behavioural characteristics was obtained using a structured questionnaire; anthropometric, blood pressure, and serum measurements were performed, and the psychometric evaluation was obtained using a self-evaluation questionnaires (Bortner scale, Beck Depression Inventory, SCL-90-R, Psychological General Well-Being and the Nottingham Health Profile).Results Cases of AMI more often exhibited type A behaviour (15.4 ± 3,0 versus 14.7 ± '2.7, p= 0.041), had more depressive symptoms (1 0.8 ± 8.0 versus 8.6 ± 8.0, P= 0.005) and showed worse scores on general well-being (68.4 ± 17.7 versus 76.6± 16.'2, P< 0.00 l) than controls. Cases were significantly different from controls in terms of years of education (6.7 ± 4.4 versus 9.0±4.7 years, P<O.OO1), hypertension (43.1% versus 30.1%, P=0,0'24), dislipidaemia (43.8% versus 34.0%, P= 0.038), type I obesity (53.6% versus 42.3%, P= 0.045), smoking (54.1 % versus 26.5%, P< 0.00 1), no practise of exercise (68,5% versus 50.3%, P= 0,002) and presence of non-insulin-dependent diabetics (16.3% versus 6.4%, P= 0.0 10). After adjusting for such factors a similar set of significant psychometric results was found.Conclusion Type A behaviour, depression and lower levels of well-being and quality of life, independent of other cardiovascular risk factors, were significant features of AMI cases.

Erectile dysfunction is a marker for cardiovascular complications and psychological functioning in men with hypertension

“…Since prior literature has established that depression is a prognostic risk factor for CV complications, the strong correlation of ED on one hand and depression and low quality of life on the other, in our study can be viewed as an added CV risk in patients with hypertension. 6,7,16,17 The significance of this link between ED and CV risk in patients with hypertension is further magnified by our prior finding that ED is highly prevalent and severe in patients with hypertension. 3 Clinical depression is an independent risk factor for coronary artery disease for several decades after the onset of the clinical depression.…”

The relationship between depression and cardiovascular disease

“…Ongoing studies have demonstrated mixed results, with some demonstrating positive associations between type A behaviour and coronary heart disease risk [13] and acute myocardial infarction (AMI) [14], and others reporting no correlation between type A behaviour and abnormalities in sympathetic or cardiovascular reactivity [15], myocardial infarction, or 10-year prognosis after myocardial infarction [16,17]. A meta-analysis of research in this area identified that null findings were due to range-restriction biases, where only diseased people were selected for study, self-report measures of type A behaviour, which were more likely to produce null findings, and finally the use of myocardial infarction as the disease criterion.…”

Occurrence of coronary artery disease has an adverse impact on health-related quality of life: A longitudinal controlled study

“…doi:10.1016/j.ijcard.2005. 11.016 physical aspects of health-related quality of life in coronary artery disease patients compared with normative data [3][4][5][6][7][8][9]. However, these comparisons invariably lack precision and power, as they fail to take account of many factors with an influence on health-related quality of life, including personal history (disease), life habits and social situation.…”