Abstract
Background
Controversy still exists over the independent role of psychosocial factors in acute myocardial infarction (AMI). This study aimed to compare psychometric indices in Portuguese patients surviving a first episode of AMI and a community sample free of AMI.
Design
A community-based, case–control study. The study sample included 153 male patients with a first episode of AMI and 156 male controls randomly selected from the community.
Methods
Information on demographic, social, medical and behavioural characteristics was obtained using a structured questionnaire; anthropometric, blood pressure, and serum measurements were performed, and the psychometric evaluation was obtained using a self-evaluation questionnaires (Bortner scale, Beck Depression Inventory, SCL-90-R, Psychological General Well-Being and the Nottingham Health Profile).
Results
Cases of AMI more often exhibited type A behaviour (15.4 ±3.0 versus 14.7 ±2.7, P = 0.041), had more depressive symptoms (10.8 ±8.0 versus 8.6 ±8.0, P = 0.005) and showed worse scores on general well-being (68.4 ± 17.7 versus 76.6 ± 16.2, P < 0.001) than controls. Cases were significantly different from controls in terms of years of education (6.7 ±4.4 versus 9.0 ± 4.7 years, P < 0.001), hypertension (43.1% versus 30.1%, P = 0.024), dislipidaemia (43.8% versus 34.0%, P = 0.038), type I obesity (53.6% versus 42.3%, P = 0.045), smoking (54.1% versus 26.5%, P < 0.001), no practise of exercise (68.5% versus 50.3%, P = 0.002) and presence of non-insulin-dependent diabetics (16.3% versus 6.4%, P = 0.010). After adjusting for such factors a similar set of significant psychometric results was found.
Conclusion
Type A behaviour, depression and lower levels of well-being and quality of life, independent of other cardiovascular risk factors, were significant features of AMI cases.
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