Cardiovascular Diseases Clinical Trial
To study psychosocial risk factors for coronary heart disease in Swedish women.
BACKGROUND:
The incidence of non-fatal myocardial infarction in Swedish women below age 60 increased
during the past 20 years. Standard risk factor change includes a decrease in average
systolic blood pressure and S-cholesterol but a moderate increase in smoking and diabetes
prevalence. During the same time period Swedish women have 'moved' into the labor market, so
that employment rates are now similar in Swedish men and women. However, women have kept the
main responsibilities for household and child care. In spite of generous legislation for
maternity leave and child care, the strains from multiple roles and responsibilities have
probably increased in Swedish women. The study sought to provide an answer to: 1) which
factors - biological and behavioral - influenced both the extent of and progress of coronary
artery disease, 2) which physiological, biochemical, or neuroendocrine mechanisms
participated in the process. In addition to conventional statistical methods, canonical
correlations analyses were used to describe direct and indirect pathways of the
pathogenesis. Furthermore, by means of the two comparison groups, information was obtained
about the specific characteristics of the female psychosocial and behavioral coronary heart
disease risk profile.
DESIGN NARRATIVE:
The role of social strain was studied within a broader psychosocial context including social
networks, social supports, social skills, reciprocity, coping, stressors, chronic work
strain, family structure, personality and behavior characteristics. These aspects were
related to possible physiologic cardiovascular mechanisms including reactivity of and
persistent elevated heart rates and blood pressure on ambulatory monitoring as well as
cardiac dysrhythmia and silent or symptomatic ischemia. Psychoneuroendocrine pathways were
also investigated. These included catecholamines, cortisol, prolactin, estrogen,
testosterone, gastrin, somatostatin. Other biochemical measures included lipid profile,
coagulation, thrombolysis and immune function. These examinations were applied to all women
below age 60, living in the greater Stockholm area, with signs or symptoms of coronary heart
disease. The women were followed and reexamined (including angiograms) after 2 to 2.5 years.
They were compared to an equal number of age matched men and to an equal number of age
matched healthy women from the same catchment area.
The study completion date listed in this record was obtained from the "End Date" entered in
the Protocol Registration and Results System (PRS) record.
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