Psychosocial factors during the first year after a coronary heart disease event in cases and referents. Secondary Prevention in Uppsala Primary Health Care Project (SUPRIM)

Three hundred and forty-six coronary heart disease male and female cases no more than 75 years of age, discharged from hospital within the past 12 months, and 1038 referents from the general population, matched to the cases by age, sex and place of living, received a postal questionnaire in which information on lifestyle, psychosocial and quality of life measures were sought.The cases were, as expected, on sick leave to a larger extent than the referents, reported poorer fitness, poorer perceived health, fewer leisure time activities, but unexpectedly reported better social support, and more optimistic views of the future than the referents. There were no significant case-referent differences in everyday life stress, stressful life events, vital exhaustion, depressive mood, coping or life orientation test. However, women reported less favourable situations than men regarding stressful life events affecting others, vital exhaustion, depressive mood, coping, self-esteem, sleep, and symptom reporting, and female cases reported the most unfavourable situation of all groups.In this first controlled study of the situation during the first year after a CHD event disease and gender status both appeared to be determinants of psychological well-being, with gender status apparently the strongest. This may have implications for cardiac rehabilitation programmes.Cardiovascular disease (CVD) is the leading cause of death for men and women in the industrialized world, despite a decline in incidence [1] and mortality [2] in recent decades. CVD, and coronary heart disease (CHD) in particular, is influenced, positively or negatively, to a substantial degree, by lifestyle, and emotional and behavioural factors, in both first time event and recurrent events [3]. In recent decades psychosocial, emotional, and personality factors have come into focus [4-8].In a number of studies psychosocial risk factors have been shown causally related to coronary heart disease incidents among men as we