Copyright © 1998 by the European Society of Cardiology.
Social relations and extent and severity of coronary artery disease
The Stockholm Female Coronary Risk Study
a Department of Public Health Sciences, Division of Preventive Medicine, Karolinska Institutet, Stockholm, Sweden
b Beth Israel, Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, U.S.A.
c Division of Cardiology, Medical School, University of Texas, Houston, Texas, U.S.A.
d Department of Thoracic Radiology, Karolinska Hospital, Stockholm, Sweden
e Department of Cardiology, Karolinska Hospital, Stockholm, Sweden
accepted June 10, 1998
Aims
Social relations have been repeatedly linked to coronary heart disease in men, even after careful control for standard risk factors. Women have rarely been studied and results have not been conclusive. We investigated the role of social support in the severity and extent of coronary artery disease in women.
Methods and Results
One hundred and thirty-one women, aged 30 to 65 years, who were hospitalized for an acute coronary event and were included in the Stockholm Female Coronary Risk Study, were examined with com-puter assisted quantitative coronary angiography. Angio-graphic measures included presence of stenosis greater than 50% in at least one coronary artery (severity) and the number of stenoses greater than 20% within the coronary tree (extent). Social factors included two measures of social support, which were previously shown to predict coronary disease in prospective studies of men. After adjustment for age, lack of social support was associated with both measures of coronary artery disease. With further adjustment for smoking, education, meno-pausal status, hypertension, high density lipoprotein and body mass index, the risk ratio for stenosis greater than 50% in women with poor as compared to those with strong social support was 2·5 (95% confidence interval 1·2 to 5·3;P=0·003). Also, women with poor social support had more stenoses obstructing at least 20% of the coronary lumen with multivariate adjustment, but the difference from women with strong support was only of borderline significance (P=0·09).
Conclusion
The findings suggest that lack of social support contributes to the severity of coronary artery disease in women, independent of standard risk factors.The European Society of Cardiology
Key Words: Cornoary disease • atherosclerosis • women • angiography • social support.
f1 Correspondence: Professor Kristina Orth-Gomér, Department of Public Health Sciences, Division of Preventive Medicine, Karolinska Institutet, Novum, Plan 7, S-141 57 Huddinge, Sweden.
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