Psychological stress and incidence of ischaemic heart disease

Background We assessed the relationship between psychological stress and is chaemic 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 str ess in different areas of their life. They also underwent a medical examina tion and provided information on IHD risk factors. From 1981 to 1991, the i ncidence of IHD events was ascertained. The relationship between 13 stress dimensions and IHD incidence was investigated using Cox regression while co ntrolling for important IHD risk factors. Cross-sectional analyses were als o performed to investigate the relationship between stress dimensions and I HD risk factors. Results Between 1981 and 1991, 79 men (9%) experienced a first IHD event. T he 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 li poprotein (HDL) cholesterol (RR = 1.64, 95% CI : 1.05-2.55). After controll ing for risk factors, not one of the psychological stress dimensions signif icantly altered the risk of IHD. Conclusions While confirming the influence of hypertension, age, triglyceri des and HDL cholesterol on IHD incidence, this study suggests that there is no important connection between the explored stress dimensions and IHD inc idence. It is unlikely that this lack of association is due to the stress q uestionnaire since the 13 stress dimensions were rigorously developed throu gh independent evaluation of the questions by three specialists and many st atistically significant relationships were observed between stress dimensio ns and IHD risk factors.