Abstract 1171: Greater Negative Emotional Profiles in Young Women Compared to Young Men Following Coronary Heart Disease Diagnosis
Background: Young women with coronary heart disease (CHD) represent an extreme phenotype with a worse prognosis than similarly aged men. Understanding what differentiates these young women may identify new targets to improve their treatment and outcome.
Methods: We examined clinical and psychosocial factors among cases of early onset CHD for women age <55 yrs and men age <45 yrs, and similarly aged controls without CHD, participating in the ADVANCE (Atherosclerotic Disease, VAscular functioN, and genetiC Epidemiology) Study at Kaiser Permanente of Northern California and Stanford University Medical Center from 1999 –2003. Data were obtained by self-report and electronic health plan databases.
Results: Women with early onset CHD were more likely than men with early onset CHD to have diabetes, obesity, and a family history of premature CHD (all p<0.05), but there was no sex difference in dyslipidemia, hypertension, or smoking. As detailed in the table⇓, female cases were more likely than male cases to report a history of depression, being stressed, hostility, and poorer general health. Further, female cases were more likely than female controls to report anxiety, stress, anger, and hostility, while these differences were not seen between male cases and male controls. Separate sex-specific logistic multivariate analyses were performed to explore the relationship of psychosocial factors and case status after controlling for the CHD clinical factors listed above. A history of depression (OR 1.01, 95% CI 1.002 to 1.02) and poorer general health (OR 1.68, 95% CI 1.14 to 2.48) were both independent psychosocial predictors of early onset CHD among women, whereas there were no clear predictors among men.
Conclusions: Young women with CHD demonstrate significantly worse psychosocial health than female controls and young men with CHD. This may contribute to their worse prognosis and should be a focus of further investigation.