Association of psychological risk factors and acute myocardial infarction in China: the INTER-HEART China study

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XU Tao(Cardiovascular Institute & Fuwai Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College,Beijing 100037,China)
LI Wei(Cardiovascular Institute & Fuwai Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College,Beijing 100037,China)
Koon Teo(The Population Health Research Institute and McMaster University, Hamilton, ON,Canada)
WANG Xing-yu(Beijing Hypertension League Institute, Beijing 100037, China)
LIU Li-sheng(Cardiovascular Institute & Fuwai Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College,Beijing 100037,China)
Salim Yusuf(The Population Health Research Institute and McMaster University, Hamilton, ON,Canada)
Journal Title:
Volume 124, Issue 14, 2011
Key Word:
acute myocardial infarction;psychological factors;stress;depression;negative life event;China

Abstract: Background Most data about psychological factors relating to acute myocardial infarction (AMI) were obtained from studies carried out in western countries. Results from small descriptive cross-sectional studies in China were inconclusive. The aim of this study was to explore possible associations between psychological risk factors and AMI among the Chinese population with a large-scale case-control study.Methods This study was part of the INTER-HEART China study, itself part of the large international INTER-HEART study of cardiovascular risk factors. In this case-control study, 2909 cases and 2947 controls were recruited from 17 cities.Psychological stress, negative life events, depression and controllability of life circumstances were assessed.Results Cases reported more psychological stress at home or work and odds ratios (ORs) were 3.2 (95% CI 2.1-4.9)for permanent stress and 2.1 (95% CI 1.5-2.8) for several periods of stress respectively. More cases experienced depression compared with controls (19.6% vs. 9.3%) and ORs were 2.2 (95% CI 1.9-2.6). Subjects with 1, 2 and 3 or more depressive symptoms had increased risk of AMI by 2.1, 2.2 and 2.6 fold, respectively, i.e., more depressive symptoms were associated with higher risks of AMI (P for trend <0.0001). Women had a greater risk of AMI from depression (OR 3.0, 95% CI 2.2-4.0) compared to men (OR 2.0, 95% CI 1.6-2.4), P for interaction =0.0364. Negative life events in subjects were associated with increased risk of AMI, OR 1.7 (95% CI 1.4-2.0) for one event and 1.8 (95% CI 1.3-2.4) for two or more events. High levels of controllability of life circumstances reduced the risk for AMI (OR 0.8, 95%CI 0.7-1 .0).Conclusions Several psychological factors were closely associated with increased AMI risk among Chinese population.Psychological stress had a greater AMI risk in men but depression was more significant among women.

  • [1]Brborovi(c) O,Rukavina TV,Pavlekovi(c) G,Dzakula A,Sogori(c) S,Vuleti(c) S.Psychological distress within cardiovascular risks behaviors,conditions and diseases conceptual framework.Coll Antropol 2009; 33:93-98.
  • [2]Whipple MO,Lewis TT,Sutton-Tyrrell K,Matthews KA,Barinas-Mitchell E,Powell LH,et al.Hopelessness,depressive symptoms,and carotid atberosclerosis in women:the Study of Women's Health Across the Nation (SWAN) heart study.Stroke 2009; 40:3166-3172.
  • [3]Augustin T,Glass TA,James BD,Schwartz BS.Neighborhood psychosocial hazards and cardiovascular disease:the Baltimore Memory Study.Am J Public Health 2008; 98:1664-1670.
  • [4]Dimsdale JE.Psychological stress and cardiovascular disease.J Am Coll Cardiol 2008:51:1237-1246.
  • [5]Surtees PG,Wainwright NW,Luben RN,Wareham NJ,Bingham SA,Khaw KT.Psychological distress,major depressive disorder,and risk of stroke.Neurology 2008; 70:788-794.
  • [6]Theorell T,Svensson J,Knox S,Waller D,Alvarez M.Young men with high blood pressure report few recent life events.J Psychosom Res 1986; 30:243-249.
  • [7]Radi S,Lang T,Lauwers-Cancès V,Diène E,Chatellier G,Larabi L,et al.Job constraints and arterial hypertension:different effects in men and women:the IHPAF Ⅱ case control study.Occup Environ Med 2005; 62:711-717.
  • [8]Chinese National Center for Cardiovascular Diseases.Report on cardiovascular diseases in China (2008-2009).Beijing:Encyclopedia of China Publishing House; 2009:6.
  • [9]Shi RY,Bai HZ,Chen YX.Influence of emotional stress and behavior during acute myocardial infarction on prognosis.Chin J Intern Med (Chin) 1989; 28:212-215,251.
  • [10]Wu ZS.Epidemiological studies on the relationship between psychosocial factors and cardiovascular disease.Acta Acad Med Sin 2001; 23:73-77,82.
  • [11]Wu D,Hua Q,Jia SQ,Li ZQ,Zhao XL,Sun YX,et al.Primary risk factors in Chinese patients with first acute myocardial infarction.Chin J Cardiol (Chin) 2008; 36:581-585.
  • [12]Ounpuu S,Negassa A,Yusuf S,for the INTERHEART investigators.INTERHEART,a global study of risk factors for myocardial infarction.Am Heart J 2001; 141:711-721.
  • [13]Rosengren A,Hawken S,Ounpuu S,Sliwa K,Zubaid M,Almahmeed WA,et al.Association of psychosocial risk factors with risk of acute myocardial infarction in 11 119 cases and 13 648 controls from 52 countries (the INTERHEART study):case-control study.Lancet 2004; 364:953-962.
  • [14]Teo KK,Liu L,Chow CK,Wang X,Islam S,Jiang L,et al.Potentially modifiable risk factors associated with myocardial infarction in China:the INTERHEART China study.Heart 2009; 95:1857-1864.
  • [15]Yusuf S,Hawken S,Ounpuu S,Dans T,Avezum A,Lanas F,et al.Effect of potentially modifiable risk factors associated with myocardial infarction in 52 countries (the INTERHEART study):case-control study.Lancet 2004; 364:937-952.
  • [16]Zhou BE Effect of body mass index on all-cause mortality and incidence of cardiovascular diseases-report for recta-analysis of prospective studies open optimal cut-off points of body mass index in Chinese adults.Biomed Environ Sci 2002; 15:245-252.
  • [17]Patten SB.Performance of the Composite International Diagnostic Interview Short Form for major depression in community and clinical samples.Chronic Dis Can 1997; 18:109-112.
  • [18]Patten SB,Brandon-Christie J,Devji J,Sedmak B.Performance of the composite international diagnostic interview short form for major depression in a community sample.Chronic Dis Can 2000; 21:68-72.
  • [19]Bobak M,Pikhart H,Rose R,Hertzman C,Marmot M.Socioeconomic factors,material inequalities,and perceived control in self-rated health:cross-sectional data from seven post-communist countries.Soc Sci Med 2000; 51:1343-1350.
  • [20]Jood K,Redfors P,Rosengren A,Blomstrand C,Jern C.Self-perceived psychological stress and ischemic stroke:a case-control study.BMC Med 2009; 7:53.
  • [21]Augustin T,Glass TA,James BD,Schwartz BS.Neighborhood psychosocial hazards and cardiovascular disease:the Baltimore Memory Study.Am J Public Health 2008; 98:1664-1670.
  • [22]Yang XW,Wang ZM,Jin TY.Appraisal of occupational stress in different gender,age,work duration,educational level and marital status groups.Health Res (Chin) 2006; 35:268-271.
  • [23]Bonde JP,Munch-Hansen T,Agerbo E,Suadicani P,Wieclaw J,Westergaard-Nielsen N.Job strain and ischemic heart disease:a prospective study using a new approach for exposure assessment.J Occup Environ Med 2009; 51:732-738.
  • [24]Lee S,Tsang A,Huang YQ,He YL,Liu ZR,Zhang MY,et al.The epidemiology of depression in metropolitan China.Psychol Med 2009; 39:735-747.
  • [25]Lφvlien M,Schei B,Hole T.Myocardial infarction:psychosocial aspects,gender differences and impact on pre-hospital delay.J Adv Nurs 2008; 63:148-154.
  • [26]Rafanelli C,Roncuzzi R,Milaneschi Y,Tomba E,Colistro MC,Pancaldi LG,et al.Stressful life events,depression and demoralization as risk factors for acute coronary heart disease.Psychothcr Psychosom 2005; 74:179-184.
  • [27]Deljanin Z,Rancic N,Tiodorovi(c) B,Petrovi(c) B,Velickovi(c) Z,Ili(c) M.Association of stressful life events with acute myocardial infarction in population in the city of Nis within the period from 1998-2000.Vojnosanit Pregl 2007; 64:463-468.
  • [28]Kopp MS,Skrabski A,Székely A,Stauder A,Williams R.Chronic stress and social changes:socioeconomic determination of chronic stress.Ann N Y Acad Sci 2007; 1113:325-38.
  • [29]Hamer M,Molloy GJ,Stamatakis E.Psychological distress as a risk factor for cardiovascular events:pathophysiological and behavioral mechanisms.J Am Coll Cardiol 2008; 52:2156-2162.
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