Psychological characteristics and fatal ischaemic heart disease.
OBJECTIVE
To determine the relation between psychological characteristics and subsequent fatal ischaemic heart disease (IHD) events.


METHODS
Prospective study of participants in the Northwick Park heart study (NPHS) recruited between 1972 and 1978 and followed up for fatal events until 1997.


METHODS
Three occupational groups in north west London.


METHODS
1408 white men without a history of myocardial infarction aged 40-64 years at entry who completed a Crown-Crisp experiential index form (CCEI).


METHODS
Fatal IHD during follow up.


RESULTS
A one point increase in the score on the obsessionality/obsessional neurosis subscale was associated with a relative risk of fatal IHD of 1.08 (95% confidence interval (CI) 1.02 to 1.15). For the functional somatic complaint subscale the relative risk was also 1.08 (95% CI 1.02 to 1.15). In the case of the total score the relative risk of fatal IHD was 1.28 (95% CI 1.09 to 1.50) for a 10 point increase. The associations were independent of age, social class, and known cardiovascular risk factors. In the case of phobic anxiety, which had previously been found to be associated with fatal IHD in NPHS, the association was evident in the first 10 years of follow up but overall the relative risk was only 1.07 (95% CI 0.99 to 1.15) for a one point increase in the score.


CONCLUSIONS
Scores on two of the subscales of the CCEI and the total score are significantly associated with fatal IHD on long term follow up independently of other known risk factors.
Department of Primary Care and Population Sciences, Royal Free and University College Medical School, Rowland Hill Street, London NW3 2PF, UK. andy.haines@lshtm.ac.uk
A
A
Haines
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J
Cooper
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Meade
D000328:Adult; D001008:Anxiety Disorders / Q000150:complications*; D006801:Humans; D008297:Male; D008875:Middle Aged; D019964:Mood Disorders / Q000150:complications*; D017202:Myocardial Ischemia / Q000209:etiology / Q000401:mortality*; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012307:Risk Factors; D018709:Statistics, Nonparametric; D013315:Stress, Psychological / Q000150:complications*