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Psychosocial Risk Factors for Coronary Heart Disease in Women: The Stockholm Studies of Women’s Hearts

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Psychosocial Stress and Cardiovascular Disease in Women

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Abstract

Previous research on coronary risk factors has defined risk profiles for coronary heart disease (CHD) largely according to the male norm, but emerging research has described female deviations from this norm: Women with an acute myocardial infarction (AMI) complain of tiredness and nausea rather than central chest pain. Women more often than men have diabetes and hypertension. Smoking, sedentary life, and other risk behaviors convey a stronger risk in women. Women are more stress sensitive, and they report more negative feelings, particularly depressed mood and fatigue/exhaustion. Stockholm women with CVD were typical of women in these respects. Almost all women patients were employed outside home, but in contrast to men, they reported being stressed by family rather than by the job. In particular the two stressors combined, accelerated the coronary artery atherosclerosis and worsened prognosis. Conclusion: Women’s stress, their emotions, their lifestyle and associated CVD risk differ from that of men and require their own specific methods of primary and secondary prevention.

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References

  • Al-Khalili, F., Wamala, S. P., Orth-Gomér, K., & Schenck-Gustafsson, K. (2000). Prognostic value of exercise testing in women after acute coronary syndromes. The American Journal of Cardiology, 86, 211–213.

    Article  PubMed  Google Scholar 

  • Brunt, J. N., Watts, G. F., Lewis, B., & Smith, L. D. (1995). Quantitative coronary cineangiography for the study of atherosclerosis. Medical Engineering and Physics, 17(5), 356–365.

    Article  PubMed  Google Scholar 

  • Büchi, M., Hess, O. M., Kirkeeide, R. L., Suter, T., Muser, M., Osenberg, H. P., …, Krayenbühl, H. P. (1990). Validation of a new automatic system for biplane quantitative coronary angiography. The International Journal of Cardiovascular Imaging, 5, 93–103.

    Google Scholar 

  • Claesson, M., Birgander, L. S., Lindahl, B., Nasic, S., Aström, M., Asplund, K., & Burell, G. (2005). Women’s hearts—Stress management for women with ischemic heart disease: Explanatory analyses of a randomized controlled trial. Journal of Cardiopulmonary Rehabilitation, 25(2), 93–102.

    Article  PubMed  Google Scholar 

  • Crawford, M. H., DiMarco, J. P., & Paulus, W. J. (2004). Cardiology textbook (2nd ed.). London, England: Mosby.

    Google Scholar 

  • Dock, A. M. (2000). Friskare kvinnohjärtan inger hopp för framtiden [Healthier Women’s Hearts—A promise for the future]. Medicinsk Vetenskap (Medical Sckiences). Karolinska Institutet, 3, 12–16 (Swedish).

    Google Scholar 

  • Frankenhaeuser, M. (1991). The psychophysiology of sex differences as related to occupational status. In M. Frankenhaeuser, U. Lundberg, & M. Chesney (Eds.), Women, work, and health: Stress and opportunities (pp. 39–61). New York, NY: Plenum Press.

    Chapter  Google Scholar 

  • Gould, K. L., Ornish, D., Kirkeeide, R., Brown, S., Stuart, Y., Buchi, M., …, Scherwitz, L. (1992). Improved stenosis geometry by quantitative coronary arteriography after vigorous risk factor modification. The American Journal of Cardiology, 69(9), 845–853.

    Google Scholar 

  • Gulliksson, M., Burell, G., Vessby, B., Lundin, L., Toss, H., & Svärdsudd, K. (2011). Randomized controlled trial of cognitive behavioral therapy vs standard treatment to prevent recurrent cardiovascular events in patients with coronary heart disease: Secondary Prevention in Uppsala Primary Health Care project (SUPRIM). Archives of Internal Medicine, 171(2), 134–140.

    Article  PubMed  Google Scholar 

  • Horsten, M., Mittleman, M. A., Wamala, S. P., Schenck-Gustafsson, K., & Orth-Gomér, K. (2000). Depressive symptoms and lack of social integration in relation to prognosis of CHD in middle-aged women. The Stockholm Female Coronary Risk Study. The European Heart Journal, 21(13), 1072–1080.

    Article  Google Scholar 

  • Karasek, R., & Theorell, T. (1990). Healthy work: Stress, productivity and the reconstruction of working life. New York, NY: Wiley.

    Google Scholar 

  • Koertge, J. (2003). Vital exhaustion and coronary heart disease in women. Academic thesis, Karolinska Institut, Stockholm.

    Google Scholar 

  • Lindfors, P., von Thiele, U., & Lundberg, U. (2006). Work characteristics and upper extremity disorders in female dental health workers. Journal of Occupational Health, 48(3), 192–197.

    Article  PubMed  Google Scholar 

  • Lundberg, U., & Frankenhaeuser, M. (1999). Stress and workload of men and women in high-ranking positions. Journal of Occupational Health Psychology, 4(2), 142–151.

    Article  PubMed  Google Scholar 

  • Lundberg, U., Mårdberg, B., & Frankenhaeuser, M. (1994). The total workload of male and female white collar workers as related to age, occupational level, and number of children. Scandinavian Journal of Psychology, 35(4), 315–327.

    Article  PubMed  Google Scholar 

  • Ornish, D., Brown, S. E., Scherwitz, L. W., Billings, J. H., Armstrong, W. T., Ports, T. A., …, Gould, K. L. (1990). Can life style changes reverse coronary heart disease? The Life Style Heart Trial. Lancet, 336, 129–133.

    Google Scholar 

  • Ornish, D., Scherwitz, L., Billings, J., Brown, S. E., Gould, K. L., Merritt, T. A., …, Brand, R. J. (1998). Intensive lifestyle changes for reversal of coronary heart disease. Five-year follow-up of the Lifestyle Heart Trial. JAMA, 280, 2001–2007.

    Google Scholar 

  • Orth-Gomer, K. (1979). Ischemic heart disease and psychological stress in Stockholm and New York. Journal of Psychosomatic Research, 23(3), 165–173.

    Article  PubMed  Google Scholar 

  • Orth-Gomer, K. (1998). The risk ratio of heart disease is twice as high in women with low education. DAISY, The Pfizer annual cardiovascular review, pp. 10–11.

    Google Scholar 

  • Orth-Gomer, K., Horsten, M., Wamala, S. P., Mittleman, M. A., Kirkeeide, R., Svane, B., …, Schenck-Gustafsson, K. (1998). Social relations and extent and severity of coronary artery disease. The Stockholm Female Coronary Risk Study. European Heart Journal, 19(11), 1648–1656.

    Google Scholar 

  • Orth-Gomér, K., Moser, V., Blom, M., Wamala, S. P., Schenck-Gustafsson, K. (1997). Survey of stress in women. Heart disease in Stockholm women is caused by both family- and work-related stress]. Lakartidningen, 94(8), 632, 635–638 (Swedish).

    Google Scholar 

  • Orth-Gomer, K., Schneiderman, N., Wang, H. X., Walldin, C., Blom, M., & Jernberg, T. (2009). Stress reduction prolongs life in women with coronary disease: the Stockholm Women’s Intervention Trial for Coronary Heart Disease (SWITCHD). Circulation. Cardiovascular Quality and Outcomes, 2(1), 25–32.

    Article  PubMed  Google Scholar 

  • Orth-Gomér, K., Wamala, S. P., Horsten, M., Schenck-Gustafsson, K., Schneiderman, N., & Mittleman, M. A. (2000). Marital stress worsens prognosis in women with coronary heart disease: The Stockholm Female Coronary Risk Study. Journal of the American Medical Association, 284(23), 3008–3014.

    Article  PubMed  Google Scholar 

  • Orth-Gomer, K., Weidner, G., Anderson, D. E., & Chesney, M. A. (2004). Psychosocial influences on the heart. In M. H. Crawford, J. P. DiMarco, & W. J. Paulus (Eds.), Cardiology textbook (2nd ed.). London, England: Mosby.

    Google Scholar 

  • Seiler, C., Kirkeeide, R. L., & Gould, K. L. (1992). Basic structure-function relations of the epicardial coronary casculrar tree. Basis of quatitative coronary arteriography for diffuse coronary artery disease. Circulation, 85(6), 1987–2003.

    Article  PubMed  Google Scholar 

  • Stamler, J. (1980). Preventive cardiology. In T. Cheng (Ed.), Textbook of cardiology (pp. 1237–1255). New York, NY: Pergamon.

    Google Scholar 

  • Stenlund, T., Ahlgren, C., Lindahl, B., Burell, G., Steinholtz, K., Edlund, C., …, Birgander, L. S. (2009). Cognitively oriented behavioral rehabilitation in combination with Qigong for patients on long-term sick leave because of burnout: REST—A randomized clinical trial. The International Journal of Behavioral Medicine, 16(3), 294–303.

    Google Scholar 

  • von Thiele, U., Lindfors, P., & Lundberg, U. (2006). Evaluating different measures of sickness absence with respect to work characteristics. Scandinavian Journal of Public Health, 34(3), 247–253.

    Article  Google Scholar 

  • Wang, H. X., Mittleman, M. A., Leineweber, C., & Orth-Gomer, K. (2006). Depressive symptoms, social isolation, and progression of coronary artery atherosclerosis: The Stockholm Female Coronary Angiography Study. Psychotherapy and Psychosomatics, 75(2), 96–102.

    Article  PubMed  Google Scholar 

  • Wang, H. X., Mittleman, M. A., & Orth-Gomer, K. (2005). Influence of social support on progression of coronary artery disease in women. Social Science and Medicine, 60(3), 599–607.

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Clinical Neuroscience, Karolinska Institute, Stockholm, Sweden

    Kristina Orth-Gomér M.D., Ph.D.

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  1. Kristina Orth-Gomér M.D., Ph.D.
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Correspondence to Kristina Orth-Gomér M.D., Ph.D. .

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Editors and Affiliations

  1. Karolinska Institute, Stockholm, Sweden

    Kristina Orth-Gomér

  2. Department of Psychology, University of Miami, Coral Gables, Florida, USA

    Neil Schneiderman

  3. Department of Epidemiology, Rollins School of Public Health Emory University, Atlanta, Georgia, USA

    Viola Vaccarino

  4. Department of Psychosomatic Medicine, Charité University Medicine, Campus Benjamin Franklin, Berlin, Germany

    Hans-Christian Deter

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Orth-Gomér, K. (2015). Psychosocial Risk Factors for Coronary Heart Disease in Women: The Stockholm Studies of Women’s Hearts. In: Orth-Gomér, K., Schneiderman, N., Vaccarino, V., Deter, HC. (eds) Psychosocial Stress and Cardiovascular Disease in Women. Springer, Cham. https://doi.org/10.1007/978-3-319-09241-6_4

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