title: Baseline health-related quality of life in postmenopausal women with coronary heart disease: the Estrogen Replacement and Atherosclerosis (ERA) trial.
abstract: OBJECTIVE
  This study examined the baseline health-related quality of life (HRQL) of 301 postmenopausal women with heart disease enrolled in the Estrogen Replacement and Atherosclerosis (ERA) trial.
  
  
  METHODS
  The primary measure of HRQL was the Medical Outcomes Study Short Form-36 (MOS SF-36). The SF-36 was augmented with secondary assessments, including measures of depressive symptoms, life satisfaction, urinary incontinence, sleep disturbance, and physical symptoms. Multiple regression analyses were used to test hypotheses regarding the contribution of positive (social support) and negative (social strain) aspects of social relations after accounting for other correlates of HRQL and heart disease.
  
  
  RESULTS
  Results indicate that social support was positively associated with better functioning for all measured outcomes (all p < 0.05) except symptom frequency and severity. Social strain was negatively associated with HRQL functioning (all p < 0.05) except overall physical functioning, sleep disturbance, and urinary incontinence. In addition, several comorbid conditions were negatively associated with HRQL outcomes. In particular, chest pain was significantly associated with worse functioning on all HRQL outcomes except urinary incontinence.
  
  
  CONCLUSIONS
  These data suggest that both clinical status variables (particularly chest pain) and the psychosocial context (represented by dimensions of relationship quality) influenced HRQL in this cohort. Thus, interventions that combine medical treatments with psychosocially based interventions may be most effective for women at risk for impaired HRQL.
authors.affiliation: Department of Public Health Services, Wake Forest University School of Medicine, Medical Center Boulevard, Winston-Salem, NC 27157-1045, USA.
authors.forename: Aurora M
authors.initials: AM
authors.lastname: Sherman
authors.forename: Sally A
authors.initials: SA
authors.lastname: Shumaker
authors.forename: Cynthia
authors.initials: C
authors.lastname: Kancler
authors.forename: Beiyao
authors.initials: B
authors.lastname: Zheng
authors.forename: David M
authors.initials: DM
authors.lastname: Reboussin
authors.forename: Claudine
authors.initials: C
authors.lastname: Legault
authors.forename: David M
authors.initials: DM
authors.lastname: Herrington
mesh_terms: D000223:Adaptation, Psychological; D000368:Aged; D003324:Coronary Artery Disease / Q000523:psychology*; D003430:Cross-Sectional Studies; D003863:Depression / Q000523:psychology; D015914:Estrogen Replacement Therapy; D005260:Female; D015438:Health Behavior; D006304:Health Status; D006801:Humans; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D011788:Quality of Life; D012044:Regression Analysis; D012107:Research Design; D012720:Severity of Illness Index; D012893:Sleep Wake Disorders / Q000523:psychology; D012944:Social Support; D011795:Surveys and Questionnaires; D014481:United States; D014549:Urinary Incontinence / Q000523:psychology; D016387:Women's Health