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Gender differences in the relationships of cardiovascular symptoms and somatosensory amplification to mortality
Emily F Shortridge1, Peter V Marsden, John Z Ayanian
1National Opinion Research Center, University of Chicago (E.F.S.), Chicago, IL; Yale School of Public Health (P.D.C.), New Haven, CT; Department of Sociology, Harvard University (P.V.M.), Cambridge, MA; Division of General Medicine and Primary Care, Brigham and Women's Hospital (J.Z.A.), Boston, MA; and Department of Health Care Policy, Harvard Medical School (J.Z.A.), Boston, MA.
Abstract:
Symptoms of angina and dyspnea predict coronary artery disease and death less well in women than in men. Greater somatosensory amplification - a psychosocial propensity to report symptoms of physical discomfort - may lead women to report relatively high levels of angina and dyspnea for reasons unrelated to coronary disease, reducing their associations with mortality. We assessed this hypothesis in a nationally representative survey of U.S. adults. When stratified by gender, angina and dyspnea significantly predicted mortality among men, but predicted it less well among women. After adjusting for amplification, cardiovascular symptoms did not predict mortality among women, but amplification was positively associated with mortality among older women.
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