Psychosocial risk factors for coronary heart disease, their importance compared with other risk factors and gender differences in sensitivity

Background Few studies have focused on risk factors in women's lives concer ning psychosocial factors and coronary heart disease (CHD). The present stu dy is one of a series in which a wide range of psychosocial factors will be analysed with a focus on women. Women and men have been compared with resp ect to sensitivity to psychosocial risk factors regarding CHD. The importan ce of psychosocial risk factors for women, compared with biomedical risk fa ctors has also been studied. Methods A questionnaire (The Stress Profile) was answered by 538 rehabilita tion participants (97 women, 441 men) and a reference group (5308 women, 51 77 men), aged 40-65 years. Psychosocial factors were investigated using mea ns and b-coefficients. Comparisons between psychosocial and biomedical risk factors were made, with respect to the product of the p-coefficient and th e standard deviation for each compared risk factor. Results Significant differences appeared concerning five areas: work conten t, workload and control, physical stress reactions, emotional stress reacti ons and burnout. All showed that the relative sensitivity was larger for wo men than for men. Predictive psychosocial risk factors for women with respe ct to CHD were physical stress reactions. emotional stress reactions. burno ut, family relationships and daily hassles/satisfactions, and they were on approximately the same level as biomedical risk factors. Conclusions Women appear to be more sensitive than men with respect to psyc hosocial risk factors for CHD, and the predictive ability of psychosocial r isk factors shows great importance. Actions against unhealthy psychosocial conditions are recommended. Both presumptive CHD patients and others might benefit from preventive actions, and since women are more sensitive they wi ll probably gain more than men. J Cardiovasc Risk 8:39-49 (C) 2001 Lippinco tt Williams & Wilkins.