News of Risk for Early Heart Disease as a Stressful Event

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Abstract
Modern prevention includes efforts to reduce the frequency of coronary heart disease by screening populations for certain risk factors, and then advising persons high in risk on how to alter their vulnerability. But what is the effect of telling persons they are at increased risk for such threatening events as heart attacks? Without such information they may not be motivated to change such behavior as cigarette smoking or to comply with blood pressure reducing regimens. With it, worry about their health status may increase. Variables were examined in 575 men with no previous symptoms of heart disease who were informed of increased risk and followed for 3 yr. The men were divided at random into 2 groups of equal size. A special intervention group received repeated reminders of risk and procedures for cessation of smoking, reduction of blood pressure and dietary alteration to lower serum cholesterol. A contrast group received usual medical care, as they saw fit, in response to the news of risk. At yearly intervals, scores on level of subjective distress, avoidance and coping were obtained. Of the men 1/3 reported intrusive or avoidance experiences 1 yr after receipt of the news of increased risk. The special intervention group, with its more frequent reminders, had significantly higher levels of intrusive ideas and feelings about the news of risk than the usual care group, and significantly higher levels of coping experiences.

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