Socioeconomic factors in coronary artery disease - Results from the SPIRR-CAD study.

Autor: Orth-Gomér K; Dept of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden; Dept. of Psychosomatics and Psychotherapy, Charité Universitaetsmedizin, Campus Benjamin Franklin, Berlin, Germany. Electronic address: Kristina.Orth-Gomer@ki.se., Deter HC; Dept. of Psychosomatics and Psychotherapy, Charité Universitaetsmedizin, Campus Benjamin Franklin, Berlin, Germany., Grün AS; Dept. of Psychosomatics and Psychotherapy, Charité Universitaetsmedizin, Campus Benjamin Franklin, Berlin, Germany., Herrmann-Lingen C; Dept. of Psychosomatic Medicine and Psychotherapy, University of Goettingen Medical Centre, German Centre for Cardiovascular Research, Partner Site Goettingen, Germany., Albus C; Dept. of Psychosomatics and Psychotherapy, University of Cologne, Germany., Bosbach A; Dept. of Psychosomatic Medicine and Psychotherapy, University of Goettingen Medical Centre, German Centre for Cardiovascular Research, Partner Site Goettingen, Germany., Ladwig KH; Inst. of Epidemiology, Helmholtz Zentrum Muenchen, German Research Centre for Environmental Health., Ronel J; Dept. of Psychosomatic Medicine and Psychotherapy, University Hospital Rechts der Isar, Technische Universitaet Muenchen, Germany., Söllner W; Dept. of Psychosomatic Medicine and Psychotherapy, Paracelsus Medical University, Nuremberg General Hospital, Germany., de Zwaan M; Dept. of Psychosomatic Medicine and Psychotherapy, Hannover Medical School, Germany., Petrowski K; Dept. of Psychotherapy and Psychosomatics, Technical University of Dresden, Germany., Weber C; Dept. of Psychosomatics and Psychotherapy, Charité Universitaetsmedizin, Campus Benjamin Franklin, Berlin, Germany.
Jazyk: angličtina
Zdroj: Journal of psychosomatic research [J Psychosom Res] 2018 Feb; Vol. 105, pp. 125-131. Date of Electronic Publication: 2017 Dec 05.
DOI: 10.1016/j.jpsychores.2017.12.005
Abstrakt: Low socio-economic status (SES) has been associated with an increased coronary risk in Western countries. All stress experiences are more pronounced in low SES patients with stress emanating from problems with family, job, or money. The SPIRR-CAD study offered an excellent opportunity to examine these risk factors in German speaking mildly and medium depressed patients. In the SPIRR CAD study, a German multi centre randomized clinical trial of 450 male and 120 female coronary patients, we examined the standard and psychosocial risk factor profiles in relation to SES, as assessed by educational level. All differences in risk factors between low and high SES were in the inverse direction. Of standard risk factors, only smoking was socially graded and more common in low SES. Of psychosocial factors and emotions, exhaustion showed the strongest and most consistent inverse social gradient, but also anger, anxiety and depression were socially graded. The findings suggest that in German patients, as in other national groups, social gradients in CHD risk are considerable. They can be ascribed to both psychosocial and to standard risk factors. In the present two years follow-up, the prospective significance of psychological and social risk factors was analyzed showing that emotional factors played an important role, in that low and high SES patients differed in the expected direction. However, the differences were not statistically significant and therefore firm conclusions from follow up were not possible.
Trial Registration: ISRCTN 76240576; NCT00705965.
(Copyright © 2017. Published by Elsevier Inc.)
Databáze: MEDLINE
Externí odkaz: