Acute myocardial infarction: psychosocial and cardiovascular risk factors in men

Background Controversy still exists over the independent role of psychosoci al factors in acute myocardial infarction (AMI), This study aimed to compar e psychometric indices in Portuguese patients surviving a first episode of AMI and a community sample free of AMI. Design A community-based, case-control study. The study sample included 153 male patients with a first episode of AM I and 156 male controls randomly selected from the community. Methods Information on demographic, social, medical and behavioural charact eristics was obtained using a structured questionnaire; anthropometric, blo od pressure, and serum measurements were performed, and the psychometric ev aluation was obtained using a self-evaluation questionnaires (Bortner scale , Beck Depression Inventory, SCL-90-R, Psychological General Well-Being and the Nottingham Health Profile). Results Cases of AM I more often exhibited type A behaviour (15.4 +/- 3.0 v ersus 14.7 +/- 2.7, P = 0.041), had more depressive symptoms (10.8 +/- 8.0 versus 8.6 +/- 8.0, P = 0.005) and showed worse scores on general well-bein g (68.4 +/- 17.7 versus 76.6 +/- 16.2, P < 0.001) than controls. Cases were significantly different from controls in terms of years of education (6.7 +/- 4.4 versus 9.0 +/- 4.7 years, P < 0.001), hypertension (43.1% versus 30 .1%, P = 0.024), dislipidaemia (43.8% versus 34.0%. P = 0.038), type I obes ity (53.6% versus 42.3%, P = 0.045), smoking (54.1% versus 26.5%, P < 0.001 ), no practise of exercise (68.5% versus 50.3%, P = 0.002) and presence of non-insulin-dependent diabetics (16.3% versus 6.4%, P = 0.010). After adjus ting for such factors a similar set of significant psychometric results was found. Conclusion Type A behaviour, depression and lower levels of well-being and quality of life, independent of other cardiovascular risk factors, were sig nificant features of AMI cases. (C) 1999 Lippincott Williams & Wilkins.