Background
Psychological factors are associated with an increased risk of developing ischemic heart disease (
IHD
). Women more often report psychological factors, and sex and gender differences are present in
IHD
. In this meta‐analysis we examine the risks of psychological factors for
IHD
incidence in women and men. We hypothesize that a broad range of psychological factors are related to a higher risk for incident
IHD
, with a higher risk for women.
Methods and Results
PubMed,
EMBASE
, and Psyc
INFO
were searched for studies assessing the risk between psychological factors and incident
IHD
. Psychological factors included depression, anxiety or panic disorder, social support, hostility, anger, personality (type D), type A behavior pattern, posttraumatic stress disorder, and psychological distress. In the primary analyses, 62 studies (77 separate reports) that included 2 145 679 women and 3 119 879 men and reported confounder‐adjusted hazard ratios or relative risks were included. Pooled effect confounder‐adjusted estimates from random‐effects models showed that psychological factors (all combined) were associated with incident
IHD
in women (hazard ratio: 1.22; 95%
CI
, 1.14–1.30) and men (hazard ratio: 1.25; 95%
CI
, 1.19–1.31). No sex and gender differences were found for these pooled effect estimates (
P
=0.547).
Conclusions
Psychological factors are associated with incident
IHD
in both women and men, but no significant differences were observed between women and men.
IHD
is predominantly being studied as obstructive coronary artery disease, which is more prevalent in men. Data are needed on psychological predictors and other manifestations of
IHD
such as coronary microvascular disease, which is more common in women.