title: Relationship between stress and coronary heart disease.
abstract: BACKGROUND
  Coronary heart disease is the leading cause of death worldwide and accounts for 13.7% of deaths in countries like Pakistan. Its association with stress has not been well considered in our setup. Patients with coronary artery disease admitted for coronary artery bypass grafting may have a high prevalence of stress that might increase the risk of adverse outcomes.
  
  
  METHODS
  60 patients with coronary artery disease admitted to the Civil Hospital Karachi for coronary artery bypass graft surgery from January 1 to March 31, 2012, were evaluated using a stress evaluation scale.
  
  
  RESULTS
  Stress of varying degrees was found to be a significant independent risk factor in patients with coronary heart disease. Analysis of our collected sample of patients with stress showed 60% with high stress (p = 0.025) and 36.7% moderate stress (p = 0.0025). An appreciable relationship was found between stress and patient age, sex, body mass index, blood group, and the incidence of myocardial infarction.
  
  
  CONCLUSIONS
  Our study found evidence of an independent causative association between psychological stress and coronary heart disease, of a similar order to the more conventional coronary heart disease risk factors.
authors.affiliation: Dow University of Health Science, Karachi, Pakistan.
authors.forename: Bushra Jawaid
authors.initials: BJ
authors.lastname: Kurd
authors.forename: Mudassir Iqbal
authors.initials: MI
authors.lastname: Dar
authors.forename: Maria
authors.initials: M
authors.lastname: Shoaib
authors.forename: Laraib
authors.initials: L
authors.lastname: Malik
authors.forename: Zobia
authors.initials: Z
authors.lastname: Aijaz
authors.forename: Iqra
authors.initials: I
authors.lastname: Asif
mesh_terms: D000328:Adult; D000368:Aged; D015897:Comorbidity; D001026:Coronary Artery Bypass; D003324:Coronary Artery Disease / Q000175:diagnosis / Q000453:epidemiology* / Q000601:surgery; D005260:Female; D006801:Humans; D015994:Incidence; D008019:Life Style; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000175:diagnosis / Q000453:epidemiology; D010154:Pakistan / Q000453:epidemiology; D018570:Risk Assessment; D012307:Risk Factors; D012720:Severity of Illness Index; D013315:Stress, Psychological / Q000175:diagnosis / Q000453:epidemiology*
keywords: Coronary artery bypass; coronary artery disease; psychological; stress