POSITIVE AND NEGATIVE PSYCHOLOGICAL CORRELATES, GENDER SPECIFIC AND TRADITIONAL FACTORS FOR FIRST ONSET ANGINA IN A SAMPLE OF PAKISTANI WOMEN

Authors

  • Rafia Rafique Institute of Applied Psychology, University of the Punjab, Lahore
  • Afifa Anjum Institute of Applied Psychology, University of the Punjab, Lahore

Abstract

Background: Coronary Heart Disease (CHD) occurs to a greater extent in developed than developing countries like Pakistan. Our understanding of risk factors leading to this disease in women, are largely derived from studies carried out on samples obtained from developed countries. Since prevalence of CHD in Pakistan is growing, it seems pertinent to infer risk and protective factors prevalent within the Pakistani women. This case control study investigated the role of psychological, traditional and gender specific risk and protective factors for Angina in a sample of Pakistani women aged between 35–65 years. Methods: Female patients admitted with first episode of Angina fulfilling the study inclusion/exclusion criteria were recruited within the first three days of stay in the hospital. One control per case matched on age was recruited. Translated versions of standardized tools: Life Orientation Test (LOT), The Hope Scale, Subjective Happiness Scale and Depression, Anxiety and Stress Scale (DASS) were used to measure the psychological variables. Information on medical conditions like diabetes, hypertension, family history of IHD, presence and absence of menopause and use of oral contraceptive pills was obtained from the participants. Body Mass Index for cases and controls was calculated separately with the help of height and weight recorded for the participants. Results: Multivariate logistic regression analyses revealed that depression, anxiety and stress are risk factors, were as optimism and hope are protective predictors of Angina. 64% and 85 % of variance in Angina were attributed to psychological factors. Menopause, diabetes and hypertension are significantly associated with the risk of Angina, explaining 37% and 49 % of variance in Angina. The study provides evidence for implementation of gender specific risk assessment and preventive strategies for Angina. The study gives directions for large scale prospective, epidemiological, longitudinal as well as interventional studies, to be tailored for indigenous population and secondly development and standardization of measures to appraise psychological factors of Angina prevalent within the Pakistani population

References

American Heart Association. Statistical Fact Sheets; 2007.

Angell M. Caring for women's health - What is the problem? N Engl J Med 1993;329(4):271–2.

Hallstrom T, Samuelsson S, Balldin J, Walinder J, Bengtsson C, Nystrom E, et al. Abnormal dexamethasone suppression test in normal females. Br J Psychiatry 1983;142:489–97.

Orth-Gomer K, Horsten M, Wamala SP, Mittleman MA, Kirkeeide R, Svane B, et al. Social relations and extent and severity of coronary artery disease: The Stockholm Female Coronary Risk Study. Eur Heart J 1988;19(11):1648–56.

Henig RM. Are Women’s Hearts Different-NYTimes.com [Internet]. [cited 2013 Dec 17]. Available from: http://www.nytimes.com/1993/10/03/magazine/are-women-s-hearts-different.html?pagewanted=all&_r=0

Judelson D. Gender differences in evaluation and management of coronary disease. Cardiovasc Dis Chest Pain 1994;10:3–8.

Hemingway H, Marmot M. Evidence based cardiology: Psychosocial factors in the aetiology and prognosis of coronary heart disease. Systematic review of prospective cohort stuides. BMJ 1999;318(7196):1460–7.

Strike PC, Steptoe A. Psychosocial factors in the development of coronary artery disease. Prog Cardiovasc Dis 2004;46(4):337–47.

Wang HX, Mittleman MA, Orth-Gomer K. Influence of social support on progression of coronary artery disease in women. Soc Sci Med 2005;60(3):599–607.

Smith TW, Ruiz JM. Psychosocial influences on the development and course of coronary heart disease: Current status and implications for research and practice. J Consult Clin Psychol 2002;70(3):548–68.

Kubzansky LD, Sparrow D, Vokonas P, Kawachi I. Is the glass half empty or half full? A prospective study of optimism and coronary heart disease in the normative aging study. Psychosom Med 2001;63(6):910–6.

Grace SL, Fry R, Cheung A, Stewart DE. Cardiovascular Disease. BMC Womens Health 2004:4(Suppl 1):S15.

Crook D, Godsland IF, Wynn V. Oral contraceptives and coronary heart disease: modulation of glucose tolerance and lasma lipid risk factors by progestins. Am J Obset Gynecol 1988;158(6 Pt 2):1612–20.

Hamideh S, Behzad M, Ebrahim G, Hassan E, Mojtaba S. Diet, hypercholesterolemia and diabetes in ischemic heart disease. Pak J Med Sci 2007;23(4):596–601.

LinkBack PNT, Karim T. waist-hip ratio and its relationship with coronary heart disease in hospital, swat. Pak J Med Sci 2007;23(4):585–8.

Nishtar S. The riskcorn study: A study of the risk factors for coronary artery disease in a Pakistani population., Islamabad:Heartfile,Pakistan;2006.

Jafary MH, Samad A, Ishaq M, Jawaid SA, Ahmad M, Vohra EA. Profile of acute myocardial infarction (AMI) in Pakistan. Pak J Med Sci 2007;23(4):485–9.

Havranek EP, Masoudi FA, Westfall KA, Wolfe P, Ordin DL, Krumholz HM. Spectrum of heart failure in older patients: Results from the National heart Failure project. Am Heart J 2002;143(3):412–7.

Kubzansky LD, Kawachi I. Going to the heart of the matter: Do negative emotions cause coronary heart disease? J Psychosom Res 2000;48(4-5):323–37.

Yusuf S, Hawken S, Ôunpuu S, Dans T, Avezum A, Lanas F, et al. Effect of potentially modifiable risk factors associated with myocardial infarction in 52 countries (the INTERHEART study): case-control study. Lancet 2004;364(9438):937–52.

Everson SA, Kauhanen J, Kaplan GA, Goldberg DE, Julkunen J, Toumilehto J, et al. Hostility and increased risk of mortality and acute myocardial infarction: The mediating role of behavioural risk factors. Am J Epidemiol 1997;146(2):142–52.

Dykema J, Bergbower K, Peterson C. Pessimistic explanatory style, stress, and illness. J Soc Clin Psychol 1995;14(4):357–77.

Langer EJ, Abelson RP. The psychology of control. Beverly Hills: Sage Publications; 1983;p.311.

O'Carroll RE, Smith KB, Grubb NR, Fox KAA, Masterton G. Psychological factors associated with delay in attending hospital following a myocardial infarction. J Psychom Res 2001;51(4):611–4.

Lerner JJ, Kannel WB. Patterns of coronary heart disease morbidity and mortality in the sexes: A 26-year follow-up of the Framingham population. Am Heart J 1986;111(2):383–90.

Din S, Rabbi F, Qadir F, Khattak M. Statistical analysis of risk factors for cardiovascular disease in Malakand division. Pak J Stat Oper Res 2007;3(2):117–24.

Patel KC, Bhopal R. Diabetes epidemic in the South Asian Diaspora: Action before desperation. J R Soc Med 2007;100(3):115–6.

Woodward M, Oliphant J, Lowe G, Tunstall-Pedoe H. Contribution of contemporaneous risk factors to social inequality in coronary heart disease and all causes mortality. Prev Med 2003;36(5):561–8.

Adebamowo CA, Ogundiran TO, Adenipekun AA, Oyesegun RA, Campbell OB, Akang EE, et al. Waist-hip ratio and breast cancer risk in urbanized Nigerian women. Breast Cancer Res 2003;5(2):R18–24.

Downloads

Published

2015-12-15