BIOLOGICAL AND PSYCHOSOCIAL RISK-FACTORS IN ISCHEMIC-HEART-DISEASE - EMPIRICAL-FINDINGS AND A BIOPSYCHOSOCIAL MODEL

The objective of this research was to investigate simultaneously biolo gical and psychosocial risk factors in groups of 187 male ischaemic he art disease (IHD) patients and 187 controls. Initially, a multivariate logistic regression was used to compare the two groups on 11 standard biological and 7 suggested psychosocial risk factors, The multivariat e regression model supported altogether 9 risk factors for IHD: 5 indi vidual ones with sensitisation amongst;them and 4 interactions of risk factors including a synergistic one between neuroticism and smoking: Next, the principal component analysis of all 18 (11 biological and 7 psychosocial) was used to extract 4 biopsychosocial and 2 biological c orrelates of IHD risk factors, it was concluded that psychosocial coro nary proneness plays an important role in predicting IHD, even after t aking into account the main, most notably atherogenic, biological risk factors. Two potential mechanisms of psychosocial pathogenicity have been suggested, notably alterations in health related behaviours. and behaviourally evoked perturbations of neuroendocrine responses, Moreov er, the presence of synergistic psychobiological interaction between n euroticism and smoking suggests the involvement of the former risk fac tor in sudden deteriorations in the coronary flow due to vasoconstrict ion, The results and related implications are consistent with the pres ent knowledge about the risk of developing IHD. (C) 1998 Elsevier Scie nce Ltd. All rights reserved.