title: 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) with known coronary artery disease who entered an aggressive lifestyle modification programme were administered a clinical/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.
authors.affiliation: Heart and Vascular Institute, Henry Ford Health Sciences Center, Detroit, USA. markwketterer@cs.com
authors.forename: M W
authors.initials: MW
authors.lastname: Ketterer
authors.forename: F
authors.initials: F
authors.lastname: Fitzgerald
authors.forename: B
authors.initials: B
authors.lastname: Thayer
authors.forename: R
authors.initials: R
authors.lastname: Moraga
authors.forename: G
authors.initials: G
authors.lastname: Mahr
authors.forename: S J
authors.initials: SJ
authors.lastname: Keteyian
authors.forename: C
authors.initials: C
authors.lastname: McGowan
authors.forename: P
authors.initials: P
authors.lastname: Stein
authors.forename: A D
authors.initials: AD
authors.lastname: Goldberg
mesh_terms: D003327:Coronary Disease / Q000453:epidemiology* / Q000523:psychology*; D003430:Cross-Sectional Studies; D005260:Female; D006305:Health Status Indicators; D006801:Humans; D008297:Male; D013315:Stress, Psychological