Impaired quality of life as a risk factor in cardiovascular disease.

Traditionally, quality of life has been considered a major outcome variable in the study of patients with chronic disease or handicap. In this paper, impaired quality of life is analyzed as a risk, that is, a condition influencing early manifestation of cardiovascular disease. Specific social contexts as well as a psychological coping style (need for control) that generates sustained emotional distress are defined, and data from two socio-epidemiological studies are presented. The first is a retrospective case-control study of 380 men with a first myocardial infarction. The second is a prospective study of 416 middle-aged blue-collar workers followed over 3 years. Findings show that indicators of impaired quality of life are related to high levels of cardiovascular risk factors and high prevalence of overt cardiovascular disease. Practical implications point to the importance of a socio-behavioral approach in cardiovascular prevention.