Psychosocial and Traditional Risk Factors in Early Ischaemic Heart Disease: Cross-Sectional Correlates

Abstract

Background Psychosocial/ emotional distress has been repeatedly found to be a correlate of the onset/aggravation of ischaemic heart disease.Methods Eighty-three patients (63 men and 20 women)~ith known coronary artery disease who entered an aggressive lifestyle modification programme were adminis~ered a clini?all demographic history and the Symptom Checklist 90 -Revised at baseline. Several measures of social isolation/alienation (shyness/self-consciousness, feeling lonely, feeling abused and overall) were derived from the the Symptom Checklist 90 -Revised.Results Univariate tests of the association of known cardiovascular risk factors and the Symptom Checklist 90 -Revised scales with age at initial diagnosis yielded several significant results for history of hypercholesterolaemia (p= 0.018), history of hypertension (p= 0.030), somatization (p= 0.007), obsessive-compulsive (P= 0.009), depression (P= 0.006), anxiety (P= 0.021), hostility (P= 0.003), paranoia (P=0.050), psychoticism (P=0.029), the Global Severity Index (P= 0.007), the Positive Symptom Distress Index (P= 0.005), the Positive Symptom Total Score (P= 0.003) and feeling abused (P= 0.037). Only history of hypertension, history of hypercholesterolaemia and the hostility scale (overall F= 6.08 and P= 0.0009) emerged as unique correlates of age at initial diagnosis in a multiple regression using only the significant univariate predictors.Conclusions Psychosocial factors are sufficiently confounded with one another that they lose their predictive value once one is entered in the equation. High scores on the hostility scale were associated with a 5.7 year differential in age at initial diagnosis. The younger a patient is at initial diagnosis, the more likely he/she is to have high levels of emotional distress.J Cardiovasc Risk 7:409-413

The Big Mush: Psychometric Measures are Confounded and Non-Independent in Their Association with Age at Initial Diagnosis of Ischaemic Coronary Heart Disease

“…The redundancy of the psychometric measures in predicting age at initial diagnosis in the multiple regressions confirms this belief, and replicates our previous study [64]. Once one validated measure is used, the others seem to lose any utility as correlates of age at initial diagnosis.…”

Lasting impact on health-related quality of life after a first myocardial infarction

“…Younger myocardial infarction patients may have different personality traits than patients suffering from an acute myocardial infarction at older ages [25,26]. For example, in a cross-sectional study of ischaemic heart disease (IHD) patients, high hostility scores predicted a 5.7-year difference in age at first diagnosis [27]. Evidence suggests that interactions between genetic and psychosocial factors, like depression and hostility, have an effect on the disease process in IHD via life style and biological mechanisms [28,29].…”

Psychiatric Comorbidity and Hostility in Patients with Psychogenic Nonepileptic Seizures Compared with Somatoform Disorders and Healthy Controls

“…It has been associated both with SD and with the course of a series of somatic disorders (25)(26)(27)(28)(29)(30). Hostility also has been shown to influence CNS electrophysiologic activity, like the P300 of the event-related potential (31).…”