Marital Stress Worsens Prognosis in Women With Coronary Heart Disease

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Abstract
Before 70 years of age, women have a worse prognosis than men following acute myocardial infarction (AMI),1,2 but the causes are poorly understood. Studies in men suggest that psychosocial factors are important determinants of cardiovascular health.3-7 In particular, work stress has been associated with increased coronary heart disease (CHD) incidence and poorer prognosis in men.8-10 Among women in this age group, psychosocial stress in relation to CHD rarely has been studied,11,12 and models of psychosocial influences are usually derived from studies in men.5,13 Whereas marital stress has been shown to affect women's mental health,13 to our knowledge, no studies have evaluated whether marital stress has adverse effects on CHD among women.