Psychological stress either at work or at home raises the risk of myocardial infarction across all ethnic groups, all geographic regions, and both genders, reported Annika Rosengren, M.D., of Sahlgrenska University Hospital, Göteborg, Sweden, and her associates.
They assessed preexisting psychosocial stressors in 11,119 patients who had experienced acute MI and 13,648 controls matched for age, sex, and geographic location who were free of heart disease. The subjects, recruited at 262 medical centers in 52 countries over a 4-year period, were questioned about how often and how strongly they had experienced stress in the preceding year at home and at work. Internal stressors included feeling irritable, anxious, or depressed or having difficulty sleeping. External stressors included experiencing major adverse life events or serious financial distress, or having little control over life circumstances (Lancet 2004;364:953–62).
After the data were adjusted to account for cardiovascular risk factors, the MI patients showed consistently higher levels of stress and for a longer period than did controls. The size of this effect makes stress a much more important risk factor than is commonly recognized and a likely contributor to the incidence of MI, they said.