[Physical and psychological risk factors of ischemic heart diseases. Apropos of a prospective survey in Marseilles].

The results of a survey carried out in Marseilles between 1972 and 1979 are reported. A common protocol was used to compare results with two other surveys performed conjointly in Paris and Brussels. The protocol was designed with special emphasis on the psychological factors with respect to the risk factors for ischaemic heart disease (IHD). Seven hundred and eighty six men in a Marseilles administrative department, aged 40 to 60 years (mean age 48.5 +/- 4.5 years) were followed-up for 74 months. Apart from cardiovascular clinical examination with measurement of height, weight, blood pressure and ECG recording, the initial check-up included serum cholesterol, triglycerides and glucose determination and a study of psychological risk factors based on the Bortner's scale for the evaluation of type A profile, and on a questionnaire : the SHEPI for evaluation of the N score (neuroticism). The annual IHD incidence was 9.5% with 4.2% of major events (death or infarction), and 5.3% of minor events (angina pectoris, suggestive ECG changes). Age, tobacco consumption, average systolic blood pressure, serum cholesterol and obesity index were higher in patients who became ill than in those who remained healthy, but overall and separate analysis of major and minor events showed no significant difference apart from age. On the other hand, the study of increased risk according to the level of each of these major factors gave significantly positive results except for the serum glucose level. The correlations between incidence of IDH and the value of each risk factor were not always the same according to the clinical expression (major or minor events). Psychological factors also differed according to the clinical expression of IHD : the Bortner scale was higher in patients developing IHD than in healthy subjects, and higher in those who suffered major events than in those who suffered minor events. On the other hand, the N score was higher in patients with minor events than in those suffering major events. These differences which were not statistically significant in the Marseilles study alone, became significant in the Franco-Belgian cooperative study. The increased risk with the number of associated factors (including psychological) is significant from the association of 2 factors, but only in the fifth decade.(ABSTRACT TRUNCATED AT 400 WORDS)