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Psychological Resources are Associated with Reduced Incidence of Coronary Heart Disease: An 8-Year Follow-up of a Community-Based Swedish Sample
Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Health Sciences.
Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Local Health Care Services in West Östergötland, Research & Development Unit in Local Health Care.
Linköping University, Department of Medical and Health Sciences, Division of Cardiovascular Medicine. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Heart and Medicine Center, Department of Cardiology in Linköping.
Linköping University, The Swedish Institute for Disability Research. Linköping University, Department of Behavioural Sciences and Learning, Psychology. Linköping University, Faculty of Arts and Sciences. Karolinska Institute, Stockholm, Sweden.ORCID iD: 0000-0003-4753-6745
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2014 (English)In: International Journal of Behavioral Medicine, ISSN 1070-5503, E-ISSN 1532-7558, Vol. 22, no 1, 77-84 p.Article in journal (Refereed) Published
Abstract [en]

Background

A large number of studies have provided clear evidence for a link between the risk of coronary heart disease and psychological risk factors. Much less attention has been given to the potential protective effect of psychological resources.

Purpose

The major aim of this study was to investigate the independent association between psychological resources and incidence of coronary heart disease (CHD) in an 8-year follow-up study of a Swedish community-based cohort.

Methods

The cohort consisted of 484 men and 497 women, aged 45–69 years at baseline. The incidence of first-time major event of CHD was analysed in relation to baseline levels of psychological resources, including mastery, self-esteem, and sense of coherence as well as psychological risk factors including cynicism and hostile affect, vital exhaustion, hopelessness, and depressive symptoms. In Cox proportional hazard models, adjustments were made for age, sex, eight traditional cardiovascular risk factors, and depressive symptoms.

Results

A total of 56 CHD events had occurred after the 8-year follow-up. After adjustment for age, sex, and eight traditional risk factors, a significantly decreased risk of CHD was found for mastery (HR 0.62 per SD, p = 0.003), self-esteem (HR 0.64, p = 0.004), and sense of coherence (HR 0.70, p = 0.031). An increased risk of CHD was found for vital exhaustion (HR 1.46, p = 0.014), hopelessness (HR 1.59, p = 0.003), and depressive symptoms (HR 1.45, p = 0.009). After further adjustment for depressive symptoms, significant associations remained for mastery (HR 0.67, p = 0.034), self-esteem (HR 0.69, p = 0.048), and hopelessness (HR 1.48, p = 0.023).

Conclusions

The psychological resources, mastery and self-esteem, showed robust protective effects on CHD, also after adjustment for established risk factors as well as depressive symptoms. In parallel, hopelessness was an independent risk factor for CHD. The results may have implications for novel approaches in preventive efforts

Place, publisher, year, edition, pages
Springer, 2014. Vol. 22, no 1, 77-84 p.
Keyword [en]
Mastery, Self-esteem, Sense of coherence, Hopelessness, Psychosocial, Coronary heart disease, Myocardial infarction
National Category
Clinical Medicine Health Sciences
Identifiers
URN: urn:nbn:se:liu:diva-108566DOI: 10.1007/s12529-014-9387-5ISI: 000349011500009PubMedID: 24430130OAI: oai:DiVA.org:liu-108566DiVA: diva2:730992
Available from: 2014-06-30 Created: 2014-06-30 Last updated: 2017-12-05Bibliographically approved

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Lundgren, OskarGarvin, PeterJonasson, LenaAndersson, GerhardKristenson, Margareta

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Lundgren, OskarGarvin, PeterJonasson, LenaAndersson, GerhardKristenson, Margareta
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Division of Community MedicineFaculty of Health SciencesResearch & Development Unit in Local Health CareDivision of Cardiovascular MedicineDepartment of Cardiology in LinköpingThe Swedish Institute for Disability ResearchPsychologyFaculty of Arts and Sciences
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