WASHINGTON — Psychosocial risk factors contribute a level of risk for cardiovascular events in clinically symptomatic women similar to that of the traditional major risk factors, Thomas Rutledge, Ph.D., reported at the annual meeting of the Society of Behavioral Medicine.
Dr. Rutledge and his associates prospectively studied the risk factors of smoking, hypertension, diabetes, dyslipidemia, inactivity, obesity, depression, and social isolation in 734 women with clinical symptoms of MI. Each patient underwent coronary angiography and psychosocial testing. About 30% of the patients experienced one event (MI, heart failure, stroke, or death) during a median follow-up of 5.9 years, said Dr. Rutledge of the department of psychiatry at the University of California, San Diego.
The rate of obstructive coronary artery disease on quantitative angiography was relatively low (39%), even though the women were clinically symptomatic. The prevalence of individual risk factors ranged from 20% for smoking to 59% for a history of hypertension. Risk factors also tended to cluster together: 78% of patients had two or more while 26% had four or more. The most common cluster consisted of diabetes combined with other risk factors, he said.
Death or CVD events occurred in 12% of women with no or one risk factor, 19% of women with two to three risk factors, and 30% with four to six risk factors. A graded increase in the prevalence of psychosocial risk factors coincided with increases in the total number of risk factors.
“The magnitude of the effects for depression and social isolation were very comparable to those for the major CVD risk factors,” he said. Significant risk factors increased the risk of death and CVD events by 50%–100%.