Siegrist J, Dittmann K, Weidemann H
Act Nerv Super (Praha). 1982 Mar;24(1):14-24.
Results of a retrospective case-control study on 380 male patients with clinically documented first myocardial infarction (age 30-55) as well as findings of a follow-up over 18 months of 70% of this sample are presented. First, the presence of somatic risk factors and in a subsample of 53 patients, degree of atherosclerosis as demonstrated by coronary angiography are documented. Second, the role of possible additional risks due to higher nervous activity, and especially to neurohormonal imbalance, is explored by analyzing psychosocial risk constellations of the MI group vs. healthy controls. It is shown that significantly greater parts of MI subjects can be classified as simultaneously exposed to several chronic and acute social risks and that social stressors are related to the recurrence of cardiac symptoms in a follow-up after rehabilitation. Findings are discussed with reference to evidence from prospective studies, and the question of validity of reported data is addressed to by controlling for possible methodological bias such as the role of denial and neuroticism in patients under study and influences caused by interviewers. It can be demonstrated that findings basically remained stable after controlling for these biases. Finally, additional evidence for the validity of subjective stress rating is presented.
