Vital exhaustion as a risk factor of myocardial infarction: A case-controlstudy in Venezuela

In this study, 32 first myocardial infarction (MI) cases and 42 healthy con trols were compared with respect to vital exhaustion (VE), a state characte rized by loss of energy, increased irritability, and feelings of demoraliza tion. This state has been found to precede the onset of cardiac events. Par ticipants also responded to questionnaires on type A behavior, anger expres sion (Anger In, Anger Out, sand Anger Control), and positive and negative s elf-concept. Results showed that VE discriminated well between MI patients and controls (Odds Ratio [OR] = 15.42, 95% confidence interval = 3.92-60.67 ) even when controlling for age, smoking, and exercise. The odds ratio decr eased to 12.34 when controlling for socioeconomic status. Groups also diffe red in Anger Tn but not in Anger Control, Anger Out, negative or positive s elf-concept. Anger In was correlated to VE in all participants pointing to the relevance of withholding emotions in relation to exhaustion. Exhaustion was strongly associated with negative self-concept in the MI cases group o nly but significantly discriminated between cases and controls when adjuste d for negative self-concept. Summarizing, the results show that, as has pre viously been found in other countries, in Venezuela VE is a precursor of MI .