International Journal of Epidemiology, Vol 28, 652-658, Copyright © 1999 by International Epidemiological Association
L Moore, F Meyer, M Perusse, B Cantin, GR Dagenais, I Bairati and J Savard
BACKGROUND: We assessed the relationship between psychological stress and
ischaemic heart disease (IHD) incidence in a population of 868 men over a
10-year follow-up period. METHODS: In 1981, 869 men aged 42-60, free from
IHD and living around Quebec City completed a questionnaire assessing the
presence of psychological stress in different areas of their life. They
also underwent a medical examination and provided information on IHD risk
factors. From 1981 to 1991, the incidence of IHD events was ascertained.
The relationship between 13 stress dimensions and IHD incidence was
investigated using Cox regression while controlling for important IHD risk
factors. Cross-sectional analyses were also performed to investigate the
relationship between stress dimensions and IHD risk factors. RESULTS:
Between 1981 and 1991, 79 men (9%) experienced a first IHD event. The
following risk factors were associated with the risk of IHD: age, (rate
ratio (RR) = 1.93, 95% CI: 1.21-3.09), hypertension (RR = 1.90, 95% CI:
1.22-2.98), triglycerides (RR = 1.87, 95% CI: 1.19-2.95) and high density
lipoprotein (HDL) cholesterol (RR = 1.64, 95% CI: 1.05-2.55). After
controlling for risk factors, not one of the psychological stress
dimensions significantly altered the risk of IHD. CONCLUSIONS: While
confirming the influence of hypertension, age, triglycerides and HDL
cholesterol on IHD incidence, this study suggests that there is no
important connection between the explored stress dimensions and IHD
incidence. It is unlikely that this lack of association is due to the
stress questionnaire since the 13 stress dimensions were rigorously
developed through independent evaluation of the questions by three
specialists and many statistically significant relationships were observed
between stress dimensions and IHD risk factors.
ARTICLES
Psychological stress and incidence of ischaemic heart disease
Departement de Medecine Sociale et Preventive, Universite Laval, Quebec, Canada. Lmoore@gre.ulaval.ca
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