Marital stress worsens prognosis in women with coronary heart disease: The Stockholm Female Coronary Risk Study
K Orth-Gomér1, S P Wamala, M Horsten
1Karolinska Institutet, Department of Public Health Sciences, Division of Preventive Medicine, Norrbacka Plan 7, SE, 171 76 Stockholm, Sweden. K.Orth-Gomer@phs.ki.se
JAMA
|December 21, 2000
Summary
Marital stress, not work stress, significantly increases the risk of recurrent coronary events in women with coronary heart disease (CHD). This highlights the need for tailored preventive strategies for female CHD patients.
Area of Science:
- Cardiology
- Psychosocial Medicine
- Women's Health
Background:
- Psychosocial stress is linked to coronary heart disease (CHD) incidence in men.
- The prognostic impact of psychosocial stress in women with CHD is less understood.
Purpose of the Study:
- To examine the prognostic significance of psychosocial work stress and marital stress in women diagnosed with CHD.
- To identify specific stressors impacting cardiovascular outcomes in female patients.
Main Methods:
- A prospective, population-based follow-up study in Stockholm, Sweden.
- Included 292 female patients (aged 30-65) hospitalized for acute myocardial infarction or unstable angina.
- Assessed recurrent coronary events, marital stress (Stockholm Marital Stress Scale), and work stress (demand-control ratio) over a median of 4.8 years.
Main Results:
- Marital stress was associated with a 2.9-fold increased risk of recurrent coronary events in married/cohabiting women.
- Work stress did not significantly predict recurrent coronary events in working women.
- Adjustments were made for multiple cardiovascular risk factors and demographic variables.
Conclusions:
- Marital stress, but not work stress, is a significant predictor of poor prognosis in women aged 30-65 with CHD.
- Findings contrast with previous studies in men, suggesting gender-specific risk factors.
- Recommends tailored preventive measures for women with CHD, addressing marital stress.
Related Concept Videos
01:30Coronary Artery Disease I: Introduction
1.8K
Coronary Artery Disease (CAD): An Overview with Scientific InsightsCoronary Artery Disease (CAD), often referred to as C-A-D, is a prevalent blood vessel disorder classified under the broader category of atherosclerosis. Atherosclerosis is a pathological process characterized by the hardening and narrowing of arteries due to the accumulation of atherosclerotic plaques. These plaques are composed of cholesterol, fatty substances, inflammatory cells, calcium, and fibrin, reducing blood flow to...
1.8K
01:30Coronary Artery Disease III: Clinical Manifestations
620
Coronary Artery Disease (CAD) is a primary health risk worldwide, leading to significant morbidity and mortality. The condition arises from the buildup of atherosclerotic plaques within the coronary arteries, resulting in diminished blood supply to the heart muscle.The clinical manifestations of CAD vary widely, from asymptomatic stages to severe, life-threatening conditions. Understanding these manifestations is crucial for early diagnosis and effective management.Angina Pectoris: The Warning...
620
01:26Coronary Artery Disease IV: Preventive Measures
890
Effective preventive measures for coronary artery disease (CAD) focus on controlling modifiable risk factors, including cholesterol abnormalities and lifestyle changes.Cholesterol ManagementFirst, the Mediterranean diet and the American Heart Association advocate for maintaining low-density lipoprotein (LDL) cholesterol levels below 100 mg/dL, with a more stringent recommendation of below 70 mg/dL for individuals at high risk. LDL cholesterol, often termed "bad cholesterol," can lead to the...
890
01:30Acute Coronary Syndrome III: Diagnostic Studies
495
Diagnosing acute coronary syndrome or ACS begins with a thorough patient history. Notable symptoms include central, crushing chest pain radiating to the left arm, neck, jaw, or back, along with shortness of breath, sweating (diaphoresis), nausea, vomiting, dizziness, and palpitations.It is crucial to note any history of cardiac illnesses and assess risk factors, including age, gender, smoking, hypertension, diabetes, hyperlipidemia, and a sedentary lifestyle.During physical examination, vital...
495
01:28Acute Coronary Syndrome IV: Interprofessional Care
522
IntroductionThe management of Acute Coronary Syndrome (ACS) aims to minimize myocardial damage, preserve myocardial function, and prevent complications.Initial ManagementInpatient management involves continuous cardiac monitoring, preferably in an ICU, focusing on blood pressure, serum sodium, potassium, and creatinine levels, and urine output. Ongoing pharmacologic management is crucial for stabilizing the patient.Supplemental Oxygen: Administer supplemental oxygen if oxygen saturation is...
522
01:27Psychoneuroimmunology: Cardiovascular Disease
757
Psychoneuroimmunology (PNI) is a multidisciplinary field that examines how psychological factors, particularly stress, interact with the immune system and impact physical health. Research in PNI has shown that chronic or traumatic stress can disrupt both the hypothalamic-pituitary-adrenal axis and the sympathetic nervous system. These disruptions contribute to serious health conditions, including cardiovascular diseases.
A key area of focus in PNI is the relationship between stress and coronary...
A key area of focus in PNI is the relationship between stress and coronary...
757