title: Gender differences and determinants of health related quality of life in coronary patients: a follow-up study.
abstract: BACKGROUND
  The role of gender differences in Health Related Quality Life (HRQL) in coronary patients is controversial, so understanding the specific determinants of HRQL in men and women might be of clinical importance. The aim of this study was to know the gender differences in the evolution of HRQL at 3 and 6 months after a coronary event, and to identify the key clinical, demographic and psychological characteristics of each gender associated with these changes.
  
  
  METHODS
  A follow-up study was carried out, and 175 patients (112 men and 63 women) with acute myocardial infarction (AMI) or unstable angina were studied. The SF-36v1 health questionnaire was used to assess HRQL, and the GHQ-28 (General Health Questionnaire) to measure mental health during follow-up. To study the variables related to changes in HRQL, generalized estimating equation (GEE) models were performed.
  
  
  RESULTS
  Follow-up data were available for 55 men and 25 women at 3 months, and for 35 men and 12 women at 6 months. Observations included: a) Revascularization was performed later in women. b) The frequency of rehospitalization between months 3 and 6 of follow-up was higher in women c) Women had lower baseline scores in the SF-36. d) Men had progressed favourably in most of the physical dimensions of the SF-36 at 6 months, while at the same time women's scores had only improved for Physical Component Summary, Role Physical and Social Functioning; e) the variables determining the decrease in HRQL in men were: worse mental health and angina frequency; and in women: worse mental health, history of the disease, revascularization, and angina frequency.
  
  
  CONCLUSIONS
  There are differences in the evolution of HRQL, between men and women after a coronary attack. Mental health is the determinant most frequently associated with HRQL in both genders. However, other clinical determinants of HRQL differed with gender, emphasizing the importance of individualizing the intervention and the content of rehabilitation programs. Likewise, the recognition and treatment of mental disorders in these patients could be crucial.
authors: Área de Medicina Preventiva y Salud Pública, Universidad de Cádiz, Spain.
authors: María
authors: M
authors: Dueñas
authors: Carmen
authors: C
authors: Ramirez
authors: Roque
authors: R
authors: Arana
authors: Inmaculada
authors: I
authors: Failde
references: Am J Cardiol. 1979 Jul;44(1):53-9
references: 453046
references: JAMA. 2006 Mar 22;295(12):1404-11
references: 16551712
references: Lancet. 2000 Feb 26;355(9205):688-700
references: 10703800
references: J Psychosom Res. 2000 Apr-May;48(4-5):417-23
references: 10880663
references: J Adv Nurs. 2000 Jun;31(6):1368-75
references: 10849148
references: Health Qual Life Outcomes. 2004 May 05;2:21
references: 15128455
references: Rev Esp Cardiol. 2006 Aug;59(8):785-93
references: 16938227
references: Heart. 2005 Feb;91(2):237-8
references: 15657249
references: Eur J Cardiovasc Nurs. 2007 Jun;6(2):92-8
references: 16843729
references: Qual Life Res. 2005 Apr;14(3):749-57
references: 16022067
references: J Clin Epidemiol. 2002 Apr;55(4):329-37
references: 11927199
references: J Health Soc Behav. 1989 Sep;30(3):282-304
references: 2778300
references: Ann Intern Med. 2002 May 21;136(10):723-32
references: 12020140
references: Psychosom Med. 2001 Mar-Apr;63(2):221-30
references: 11292269
references: Int J Cardiol. 2008 Nov 28;130(3):449-56
references: 18221803
references: Eur Heart J. 1984 Aug;5(8):649-51
references: 6479192
references: Psychol Med. 1986 Feb;16(1):135-40
references: 3961039
references: J Cardiopulm Rehabil. 2001 Nov-Dec;21(6):353-62
references: 11767809
references: Eur Heart J. 1993 Oct;14(10):1315-9
references: 8262076
references: Womens Health. 1997 Spring;3(1):53-60
references: 9106370
references: Scand Cardiovasc J. 1999;33(3):160-5
references: 10399804
references: J Clin Epidemiol. 2002 Nov;55(11):1105-12
references: 12507674
references: Heart. 2000 Oct;84(4):390-4
references: 10995407
references: Actas Luso Esp Neurol Psiquiatr Cienc Afines. 1982 Jan-Feb;10(1):21-32
references: 7148527
references: Eur J Epidemiol. 2004;19(8):769-76
references: 15469034
references: Clin Cardiol. 2004 May;27(5):271-4
references: 15188941
references: Rehabil Nurs. 1991 Sep-Oct;16(5):248-53
references: 1891649
references: Am Heart J. 2001 Aug;142(2):271-9
references: 11479466
references: Psychosom Med. 2004 Mar-Apr;66(2):190-7
references: 15039503
references: Psychosom Med. 2003 Nov-Dec;65(6):944-51
references: 14645771
references: Soc Sci Med. 2006 Nov;63(9):2367-80
references: 16884840