Stroke was predicted by dimensions of quality of life in treated hypertensive men

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S Agewall1, J Wikstrand, B Fagerberg

  • 1Department of Medicine and Wallenberg Laboratory for Cardiovascular Research, Sahlgrenska University Hospital, Göteborg University, Gothenburg, Sweden. agewall@ss.gu.se

Stroke
|November 6, 1998
PubMed

Insights

Reduced quality of life, specifically low contentment and vitality, independently predicted strokes in hypertensive men. This study highlights the importance of psychosocial factors in cardiovascular risk assessment.

Area of Science:

  • Cardiovascular Medicine
  • Psychosocial Epidemiology
  • Clinical Risk Prediction

Background:

  • Psychosocial factors are increasingly recognized as potential contributors to atherosclerotic disease development.
  • Understanding the interplay between mental well-being and cardiovascular events is crucial for comprehensive risk management.

Purpose of the Study:

  • To prospectively investigate the predictive value of quality of life on the incidence of strokes and acute coronary events.
  • To determine if psychosocial well-being is an independent risk factor for major adverse cardiovascular events in a high-risk population.

Main Methods:

  • A cohort of 412 treated hypertensive men (aged 50-72) with at least one additional cardiovascular risk factor (high cholesterol, smoking, or diabetes) was studied.
  • Quality of life was assessed at baseline using the Minor Symptoms Evaluation Profile (MSEP).
  • Follow-up data on stroke and acute coronary events were collected over a median period of 6.6 years.

Main Results:

  • A total of 37 strokes and 64 acute coronary events occurred during follow-up.
  • Cox regression analysis indicated that all three MSEP dimensions significantly predicted stroke incidence.
  • Reduced contentment (RR=1.04, P=0.003) and vitality (RR=1.04, P<0.0001) remained independent predictors of stroke after adjusting for traditional cardiovascular risk factors.
  • No significant association was found between MSEP scores and myocardial infarction.

Conclusions:

  • Reduced quality of life, particularly low contentment and vitality, is independently associated with an increased risk of future stroke in hypertensive men with high cardiovascular risk.
  • These findings suggest that psychosocial well-being may play a significant role in stroke pathogenesis.
  • The underlying causal mechanisms require further investigation.
Abstract

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