Welin C L, Rosengren A, Wilhelmsen L W
Department of Internal Medicine, Ostra Hospital, Gothenburg University, Sweden.
J Cardiovasc Risk. 1995 Jun;2(3):247-54.
Over the past 10-20 years, evidence has accumulated suggesting that it is not just biological risk factors that are important for the development of coronary heart disease. The present study is one of a series of case-control studies in which a wide range of psychosocial factors have been analysed in the same population to obtain information on their relationship with myocardial infarction, as well as of the interaction between psychosocial and biomedical variables.
The relationship between behavioural factors and non-fatal myocardial infarction was studied by comparing consecutively admitted male (n = 288) and female (n = 55) patients with a population sample of 283 men and 129 women. All participants were under 65 years of age. The behavioural variables (type-A behaviour, health locus of control, sleep problems and alcohol consumption) were investigated by means of a self-administered questionnaire.
No significant differences emerged between patients with myocardial infarction and controls in terms of their type-A behaviour pattern. After controlling for traditional risk factors (smoking, hypertension, serum cholesterol level and diabetes), men with myocardial infarction reported a significantly stronger external health locus of control (i.e. a weak belief in their capacity to control their health) compared with their controls, as well as more problems with sleep and a lower alcohol consumption; women with myocardial infarction reported significantly more problems with sleep than their controls.
The importance of health locus of control, sleep problems and alcohol consumption is amplified by the fact that they are related to myocardial infarction independently of conventional biomedical risk factors. These behavioural factors should be studied further in prospective investigations.
在过去的10至20年里，越来越多的证据表明，对于冠心病的发展而言，重要的不仅仅是生物风险因素。本研究是一系列病例对照研究之一，在同一人群中分析了广泛的社会心理因素，以获取它们与心肌梗死的关系信息，以及社会心理和生物医学变量之间的相互作用信息。
通过将连续入院的男性患者（n = 288）和女性患者（n = 55）与283名男性和129名女性的人群样本进行比较，研究行为因素与非致命性心肌梗死之间的关系。所有参与者年龄均在65岁以下。通过自我填写问卷对行为变量（A型行为、健康控制点、睡眠问题和饮酒情况）进行调查。
心肌梗死患者与对照组在A型行为模式方面没有显著差异。在控制了传统风险因素（吸烟、高血压、血清胆固醇水平和糖尿病）后，与对照组相比，心肌梗死男性患者报告的外部健康控制点明显更强（即对自身控制健康能力的信念较弱），睡眠问题更多，饮酒量更低；心肌梗死女性患者报告的睡眠问题明显多于对照组。
健康控制点、睡眠问题和饮酒情况的重要性因它们与心肌梗死独立于传统生物医学风险因素相关这一事实而得到强化。这些行为因素应在前瞻性研究中进一步研究。
