Arterial hypertension, myocardial infarction and stroke: risk of development and psychosocial factors.

OBJECTIVE: To evaluate an influence of personal anxiety on risk of development of arterial hypertension (AH), myocardial infarction (MI) and stroke in men aged 25-64.

STUDY DESIGN AND METHODS: Within the framework of program WHO MONICA-MOPSY a representative sample of men 25-64 years old (1984, 1988, 1994 years) was examined. The total sample was 2,149 persons. The period of supervision was 10-20 years. We counted as outcome all cases of AH, MI and stroke which had arisen for the first time. We used Spielberger's scale for estimation of personal anxiety (PA). Cox-proportional regression model was used for estimation of relative risk (RR).

RESULTS: 58.7% men with developed MI had a high level of personal anxiety (HLA) and 41.3% an average level of anxiety (ALA); 72.2% men with developed stroke had HLA and 27.8% ALA, 42% men with developed AH had HLA. The relative risk of developed cardiovascular disease within five years in a group of men with HLA in comparison with a group of men with ALA was 2.5 times higher for MI and 6.4 times higher for stroke, 6.0 for AH. Within 10 years, RR of MI development increased 3.1 times, stroke -3.8 times, AH--5.0 times. Within 15 years, RR of MI development increased three times (p < 0.01), stroke -2.9 times. Within 20 years the tendency to RR decrease for development of MI (RR = 2.7) and stroke (RR = 1.6), AH (RR = 1.4) was observed.

CONCLUSION: The data indicate that high level of personal anxiety may predict higher cardiovascular risk in middle-age men.