Psychological Stress Increases Mortality Risk in Coronary Heart Disease

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Mild distress was not associated with a greater risk for early mortality in CHD.
Mild distress was not associated with a greater risk for early mortality in CHD.

HealthDay News — The cumulative burden of psychological stress increases mortality risk in patients with stable coronary heart disease, according to a study published online in Heart.1

Ralph Stewart, MD, an adjunct professor of medicine at the University of Auckland in New Zealand, and colleagues looked at data on 950 patients with stable coronary heart disease who took part in a long-term trial on statin use. The participants were between 31 and 74 years old, and all had had an acute myocardial infarction or hospitalization for unstable angina pectoris in the previous 3 to 36 months. The patients completed a general health questionnaire to gauge their levels of mental distress 6 months after hospital admission and again 1, 2, and 4 years afterwards.

During an average follow-up of 12 years, 398 patients died from all causes and 199 died from cardiovascular disease. Questionnaire responses showed that 3.7% said they suffered from persistent moderate or more severe distress. The researchers found that their risk for early mortality was substantially higher (hazard ratios, 3.94 and 2.85 for cardiovascular and all-cause mortality, respectively, compared with patients with no distress). According to the investigators, 7.7% reported persistent mild distress, which was not linked to greater risk for early mortality.

"Despite epidemiological and other lines of evidence linking psychological distress with the risk of coronary events or mortality, many aspects of the association between psychological distress and these outcomes remain poorly investigated," the authors of an accompanying editorial wrote.2

References

1. Stewart RAH, Colquhoun DM, Marschner SL, et al; on behalf of the LIPID Study Investigators. Persistent psychological distress and mortality in patients with stable coronary artery disease [published online June 26, 2017]. Heart. doi:10.1136/heartjnl-2016-311097

2. Ndrepepa G. Psychological distress and mortality in stable coronary heart disease: persistence of high distress means increased risk [published online June 26, 2017]. Heart. doi:10.1136/heartjnl-2017-311610

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