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a Department
of Primary Care and Population Sciences, Royal Free and University
College Medical School, Rowland Hill Street, London NW3 2PF, UK, b MRC Epidemiology and Medical
Care Unit, St Bartholomew's and the Royal London School of Medicine
and Dentistry, Wolfson Institute of Preventive Medicine, Charterhouse
Square, London EC1M 6BQ, UK
Correspondence to: Dr Haines, London School of Hygiene & Tropical Medicine, Keppel Street, London WC1E 7HT, UK andy.haines{at}lshtm.ac.uk
Accepted 21
November 2000
OBJECTIVE
To determine the relation
between psychological characteristics and subsequent fatal ischaemic
heart disease (IHD) events.
DESIGNProspective study of
participants in the Northwick Park heart study (NPHS) recruited between
1972 and 1978 and followed up for fatal events until 1997.
SETTINGThree occupational groups in
north west London.
SUBJECTS1408 white men without a
history of myocardial infarction aged 40-64 years at entry who
completed a Crown-Crisp experiential index form (CCEI).
MAIN OUTCOME MEASUREFatal IHD during
follow up.
RESULTSA one point increase in the
score on the obsessionality/obsessional neurosis subscale was
associated with a relative risk of fatal IHD of 1.08 (95% confidence
interval (CI) 1.02 to 1.15). For the functional somatic complaint
subscale the relative risk was also 1.08 (95% CI 1.02 to 1.15). In the
case of the total score the relative risk of fatal IHD was 1.28 (95%
CI 1.09 to 1.50) for a 10 point increase. The associations were
independent of age, social class, and known cardiovascular risk
factors. In the case of phobic anxiety, which had previously been found
to be associated with fatal IHD in NPHS, the association was evident in
the first 10 years of follow up but overall the relative risk was only
1.07 (95% CI 0.99 to 1.15) for a one point increase in the score.
CONCLUSIONScores on two of the
subscales of the CCEI and the total score are significantly associated
with fatal IHD on long term follow up independently of other known risk factors.
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