Psychological Resources are Associated with Reduced Incidence of Coronary Heart Disease. An 8-Year Follow-up of a Community-Based Swedish SampleReportar como inadecuado

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International Journal of Behavioral Medicine

, Volume 22, Issue 1, pp 77–84

First Online: 16 January 2014DOI: 10.1007-s12529-014-9387-5

Cite this article as: Lundgren, O., Garvin, P., Jonasson, L. et al. Int.J. Behav. Med. 2015 22: 77. doi:10.1007-s12529-014-9387-5


BackgroundA large number of studies have provided clear evidence for a link between the risk of coronary heart disease and psychological risk factors. Much less attention has been given to the potential protective effect of psychological resources.

PurposeThe major aim of this study was to investigate the independent association between psychological resources and incidence of coronary heart disease CHD in an 8-year follow-up study of a Swedish community-based cohort.

MethodsThe cohort consisted of 484 men and 497 women, aged 45–69 years at baseline. The incidence of first-time major event of CHD was analysed in relation to baseline levels of psychological resources, including mastery, self-esteem, and sense of coherence as well as psychological risk factors including cynicism and hostile affect, vital exhaustion, hopelessness, and depressive symptoms. In Cox proportional hazard models, adjustments were made for age, sex, eight traditional cardiovascular risk factors, and depressive symptoms.

ResultsA total of 56 CHD events had occurred after the 8-year follow-up. After adjustment for age, sex, and eight traditional risk factors, a significantly decreased risk of CHD was found for mastery HR 0.62 per SD, p = 0.003, self-esteem HR 0.64, p = 0.004, and sense of coherence HR 0.70, p = 0.031. An increased risk of CHD was found for vital exhaustion HR 1.46, p = 0.014, hopelessness HR 1.59, p = 0.003, and depressive symptoms HR 1.45, p = 0.009. After further adjustment for depressive symptoms, significant associations remained for mastery HR 0.67, p = 0.034, self-esteem HR 0.69, p = 0.048, and hopelessness HR 1.48, p = 0.023.

ConclusionsThe psychological resources, mastery and self-esteem, showed robust protective effects on CHD, also after adjustment for established risk factors as well as depressive symptoms. In parallel, hopelessness was an independent risk factor for CHD. The results may have implications for novel approaches in preventive efforts.

KeywordsMastery Self-esteem Sense of coherence Hopelessness Psychosocial Coronary heart disease Myocardial infarction  Download fulltext PDF

Autor: Oskar Lundgren - Peter Garvin - Lena Jonasson - Gerhard Andersson - Margareta Kristenson


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