A history of heart interventions moderates the relationship between psychological variables and the presence of chest pain in older women with self-reported coronary heart disease

Br J Health Psychol. 2013 Nov;18(4):687-706. doi: 10.1111/bjhp.12011. Epub 2012 Dec 7.

Abstract

Objectives: This study examines the hypothesis that a past history of heart interventions will moderate the relationship between psychosocial factors (stressful life events, social support, perceived stress, having a current partner, having a past diagnosis of depression or anxiety over the past 3 years, time pressure, education level, and the mental health index) and the presence of chest pain in a sample of older women.

Design: Longitudinal survey over a 3-year period.

Methods: The sample was taken from a prospective cohort study of 10,432 women initially aged between 70 and 75 years, who were surveyed in 1996 and then again in 1999. Two groups of women were identified: those reporting to have heart disease but no past history of heart interventions (i.e., coronary artery bypass graft/angioplasty) and those reporting to have heart disease with a past history of heart interventions.

Results: Binary logistic regression analysis was used to show that for the women with self-reported coronary heart disease but without a past history of heart intervention, feelings of time pressure as well as the number of stressful life events experienced in the 12 months prior to 1996 were independent risk factors for the presence of chest pain, even after accounting for a range of traditional risk factors. In comparison, for the women with self-reported coronary heart disease who did report a past history of heart interventions, a diagnosis of depression in the previous 3 years was the significant independent risk factor for chest pain even after accounting for traditional risk factors.

Conclusion: The results indicate that it is important to consider a history of heart interventions as a moderator of the associations between psychosocial variables and the frequency of chest pain in older women.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Angioplasty, Balloon, Coronary / psychology
  • Angioplasty, Balloon, Coronary / statistics & numerical data
  • Anxiety Disorders / epidemiology
  • Anxiety Disorders / psychology*
  • Chest Pain / psychology*
  • Coronary Artery Bypass / psychology
  • Coronary Artery Bypass / statistics & numerical data
  • Coronary Disease / epidemiology
  • Coronary Disease / psychology*
  • Coronary Disease / therapy
  • Depressive Disorder / epidemiology
  • Depressive Disorder / psychology*
  • Educational Status
  • Epidemiologic Methods
  • Female
  • Humans
  • Life Change Events
  • Myocardial Revascularization / psychology*
  • Myocardial Revascularization / statistics & numerical data
  • Social Support
  • Stress, Psychological / epidemiology
  • Stress, Psychological / psychology*