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Physical and psychological correlates of severe heart disease in men

Published online by Cambridge University Press:  09 July 2009

Christopher Bass  and
Fawaz Akhras
Christopher Bass*
Affiliation:
Academic Department of Psychological Medicine and Department of Cardiology, King's College School of Medicine and Dentistry, London
Fawaz Akhras
Affiliation:
Academic Department of Psychological Medicine and Department of Cardiology, King's College School of Medicine and Dentistry, London
*
1Address for correspondence: Dr C. Bass, Academic Department of Psychological Medicine, King's College School of Medicine and Dentistry, Denmark Hill, London SE5 9RS.
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Synopsis

Seventy eight men were assessed one month before coronary artery bypass graft surgery using standardized measures of psychiatric morbidity and personality as well as a measure of emotional expression (the CECS). All patients had at least one coronary vessel occluded by 75% or more of its diameter, and functional capacity was assessed by calculating the exercise treadmill time (in seconds) for each patient.

Most of the variance in exercise treadmill time was accounted for by the following variables: young age, short duration of symptoms, and less severe angina. Only one in five men was designated a psychiatric ‘case’. The only psychological measure significantly associated with atherosclerosis was expression of fear (on the CECS). A measure of Type A behaviour (Bortner score) was related to exercise treadmill time, but not to any of the angiographic or clinical indices of coronary heart disease (CHD).

Like other measures of Type A behaviour, the Bortner scale is psychometrically impure and has doubtful validity. More valid behavioural variables (such as those measured by the CECS) require further investigation. Future studies on the relation between psychological factors and the extent of CHD should take account of not only sex differences but also patients without significant CHD: high rates of psychiatric morbidity in such patients confound the relation between psychological trait measures and atherosclerosis.

Type
Research Article
Information
Psychological Medicine , Volume 17 , Issue 3 , August 1987 , pp. 695 - 703
Copyright
Copyright © Cambridge University Press 1987

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