Psychological correlates of early onset of ischemic heart disease in a sample drawn from a Pakistani population.

Even in the presence of substantial empirical evidence which proves that psychological risk factors play a significant role in onset of ischemic heart disease (IHD), in Pakistan researchers have not paid much attention to exploring these factors. This research was mainly undertaken to investigate whether psychological factors such as stress, anxiety, depression, anger, and hostility in their intense states are prevalent within the indigenous patients with IHD. It was hypothesized that: High levels of perceived stress will significantly increase risk for IHD versus lower levels of perceived stress; high levels of anxiety will significantly increase the risk for IHD versus lower levels of anxiety; high levels of depression will increase the chances of IHD versus lower levels. Likewise, it was proposed that elevated trait anger will significantly increase risk for IHD versus lower levels of trait anger and that higher levels of hostility significantly increase risk for IHD versus lower levels. A case-control research design was employed to conduct this study. To investigate the association of the abovementioned factors with IHD and to find whether these factors differ between cases and controls, we solicited a sample of 190 patients with confirmed diagnosis of IHD and 380 age- and gender-matched community controls, who were free of IHD, aged 35 to 55 years. Standardized tools to measure psychological factors were translated and semistandardized into the national language and their psychometric properties were predetermined before use in this study. To infer the proposed hypotheses, multivariate binary logistic regression analysis was carried out. Results highlight significant association between stress, depression, anxiety, anger, and IHD. Implications for the implementation of routine screening for psychological factors, particularly stress, depression and anger, are proposed.