title: Psychological distress and exertional angina in men and women undergoing thallium scintigraphy.
abstract: The relation between psychological factors and angina has mostly been studied in male patients with confirmed CAD and few have evaluated this relation during actual provocation of ischemia. This study evaluated gender differences in the association between psychological distress and angina pain experience in 907 Caucasian patients (479 women, mean age = 60 years) undergoing exercise stress testing with thallium scintigraphy. Data were analyzed separately for patients with and without exercise related ischemia using a series of 2 (low/high distress) x 2 (gender) ANOVAs as well as binary logistic regressions. Among all patients, distress and gender were associated with greater risk and intensity of angina pain during testing (p < 0.05) and more angina following exertion (p < 0.05) or stress (p < 0.05) at home.
  
  
  CONCLUSIONS
  angina pain was more severe in women and individuals with high levels of distress, regardless of their ischemic status. A generalized hypersensitivity to pain/symptoms may be indicated in these patients.
authors.affiliation: Montreal Heart Institute, Belanger Street East, Montreal, Quebec, H1T 1C8, Canada.
authors.forename: Karine
authors.initials: K
authors.lastname: St-Jean
authors.forename: Bianca
authors.initials: B
authors.lastname: D'Antono
authors.forename: Gilles
authors.initials: G
authors.lastname: Dupuis
mesh_terms: D000704:Analysis of Variance; D000787:Angina Pectoris / Q000503:physiopathology / Q000523:psychology*; D005080:Exercise Test / Q000523:psychology*; D005260:Female; D006321:Heart / Q000000981:diagnostic imaging*; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D011792:Quebec; D012307:Risk Factors; D012720:Severity of Illness Index; D012737:Sex Factors; D013315:Stress, Psychological / Q000503:physiopathology*; D015899:Tomography, Emission-Computed, Single-Photon / Q000523:psychology*